WQ0042563_Application (FTSE)_20210602

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02VAXOti4F2011 TRACK SEVER SYSTEM EXTENSION APPLICATION
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION
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This application is for sewer extensions l V l j bE
e and force mains, or any combination that has been
certified by a professional engineer and the applicant that the project meets t e requirements of 15A NCAC 02T and the Division's
rMMMinin.rum Design Criteria and that plans, specifications and supporting documents have been prepared in accordance with, ISA
NCAC 02T, iSA. NCAC 02T .0300, Division policies and g r , etlgir eerie roracticas.
Whiie no upfront engineering design documents are required for submittal, in accordance ith 15A NCAC 02T .0305(b), design
documents must be prepared -prior to submittal of a fast track permit application to the Division. This vottld=include plans, design
calculations., and project specifications referenced in ISA NCAC 02T .005 and the applicable minimum design criteria. These
documents shall be available upon request by the Division.
Projects that are deemed permitted (do not require a permit from the Division) are explained in 15A NCAC 02T.0303.
Pro
jects
not eligible for review via the fast track process (must be submitted for full technical review):
Projects that require an environmental assessment in accordance with 1 5A NCA.0 1 C .0100;
Projects that do not meet any part of the minimum design criteria (IVIDC) document;
Projects that involve a variance from the requirements of 1 5A NCAC 2T;
Pressure sewer systems utilizing septic tank -effluent pumps (STEPS) or simplex grinder pumps
STEP or simplex grinder pumps connecting to pressurized systems (e.g. force main);
Vacuum sewer systems.
General - when submitting an application, please use the following instructions as a checklist in order to ensure all required
items are submitted. Adherence to these instructions and checking the provided boxes NOi help produce a quicker review time
and reduce the amount of requested additional information. Failure to submit all required items will necessitate additional
processing and review time, and may result in return of the application. Unless otherwise noted, the Applicant shall submit
one original and one copy of the application and supporting documentation.
A. One Original and One Copy of Application and Supporting Documents
Required runless otherwise noted
D. Cover Letter (Required for All Application Packages):
El List all items included in the application package, as well as a brief description of the requested permitting arction.
lie specific as to the system type, number of homes served, flow allocation required, etc,
If necessary for clarity, include attachments to the application .form,
C. Application Fee (All New and Major Modification Application Packages):
Submit a check or money order in the amount of S480.00 dated within 90 days of application submittal.
Payable to North Carolina Department of Environmental Quality (NCDEQ)
D. Fast Track (Form: ETA 04-16) Application (Required for All Application Packages):
Submit the completed and appropriately executed application.
If necessary for clarity or due to space restrictions, attachments to the application may be made.
0 If the Applicant Type in Item 1.2 is a corporation or company, provide documentation it is registered for business with
the North Carolina Secretary of State.
C� II the Applicant Type in. Item 1.2 is a partnership or dfbia, enclose a copy of the certificate filed with the Register of
Deeds in the county of business.
(I The Project Name in Item 11.1 shill be consistent with the project name on the flow acceptance letters, agreements, etc.
The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North
Carolina licensed Professional Engineer.
The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T .0106(4
Per 15A NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation letter is
provided from a person who meets the criteria in 15A NCAC 02T .01 O6(b).
INSTRUCTIONS FOR FORM: VIA 04-16 & SUPPOR-TENG DOCUMENTATION Paige 1 of

E. Flow Tracking/Acceptance Form (Form: FTSE 04-16) (If Applicable):
® Submit the completed and executed FTSE form from the owners of the downstream sewers and treatment facility.
Multiple forms maybe required where the downstream sewer owner and wastewater treatment facility are different.
➢ The flow acceptance indicated in form FTSE must not expire prior to permit issuance and must be dated less than one
year prior to the application date.
• Submittal of this application and form FTSE indicates that owner has adequate capacity and will not violate G.S. 143-
215.67(a).
9 Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific FTSE.
F. Site Maps (All Application Packages):
® Submit an 8.5-inch x 1 1-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project
area and closest surface waters.
Location of the project (gravity sewer, pump stations & force main)
➢ Downstream connection points and permit number (if known) for the receiving sewer
(EI Include a street level map (aerial) showing general project area so that Division staff can easily locate it in the field.
G. Existing Permit (All Modification Packages):
❑ Submit the most recently issued existing permit.
❑ Provide a list of any items within the permit the Applicant would like the Division to address during the permit
modification (i.e., permit description, flow allocation, treatment facility, etc.).
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
O Per 15A NCAC 02T .0305(h)(1), submit documentation of power reliability for pumping stations.
➢ This alternative is only available for average daily flows less than 15,000 gallons per day
• It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is
compatible with the station. The Division will accept a letter signed by the applicant (see I5A NCAC 02T .0106(b)) or
proposed contractor, stating that "the portable power generation unit or portable, independently -powered pumping
units, associated appurtenances and personnel are available for distribution and operation of this pump 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
timeframcs, shall be provided in the case of a multiple station power outage. (Required at time of certification)
I. Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
O Per 15A NCAC 02T .0115(a)(1) provide the Certificate of Public Convenience and Necessity from the North Carolina
Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by
the sewer extension, or
Cd Provide a letter from the North Carolina Utilities Commission's Water and Sewer Division Public Staff stating an
application for a franchise has been received and that the service area is contiguous to an existing franchised area or
that franchise approval is expected.
J. Operational Agreements (Applications from HOA/POA and Developers for Tots to be sold):
❑ Home/Property Owners' Associations
0 Per 15A NCAC 02T .0115(c), submit the properly executed Operational Agreement (FORM: HOA).
0 Per 15A NCAC 02T .01 I5(c), submit a copy of the Articles of incorporation, Declarations and By-laws.
❑ Developers of lots to be sold
❑ Per 15A NCAC 02T .01 15(b), submit the properly executed Operational Agreement (FORM: DEV.
Fo1. more inf )rIIUIlion, visit the Division's collection sys/Cron website
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Pa«e 2 of 3

THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville 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
Water Quality Section
Fayetteville Regional Office
225 Green Street Suite 714
Fayetteville, North Carolina 28301-5094
[phone]
[phone] Fax
Anson, Bladen, Cumberland, Harnett, Hoke,
Montgomery, Moore, Robeson, Richmond,
Sampson, Scotland
Water Quality Section
Mooresville Reatonal Office
610 E. Center Avenue
Mooresville, North Carolina 28115
[phone]
[phone] Fax
Alexander, Cabarrus, Catawba, Cleveland,
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
Stanly, Union
Water Quality Section
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
Water Quality Section
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
Water Quality Section
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
[phone]
[phone] Fax
Brunswick, Carteret, Columbus, Duplin, New
Hanover, Onslow, Pender
Water Quality Section
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, North Carolina 27105
[phone]
Alamance, Allegheny, Ashe, Caswell, Davidson,
Davie, Forsyth, Guilford, Rockingham, Randolph,
Stokes, Surry, Watauga, Wilkes, Yadkin
Water Quality Section
INSTRUCTIONS FOR FORM: ETA 04-16 & SUPPORTING DOCUMENTATION Pate 3 0t' 3

LFi[aiL, Vl t 1tJL ala �-tl• lull Ll
Division of Water Resources
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: L4"L2 00 Y24�'4.3 (to becornpletcd by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
I . Applicant's name: Moore County Public Utilities (company, municipality, HOA, utility, etc.)
2. .Applicant type: L_J Individual [ Corporation El General Partnership ri Private] Owned Public Utility
EI Federal Q State/County .X Municipal
3. Signature authority's name: Randy G. Gould. PE, _Director per 1 A NcAC 02T ,0106(N:
Title: Director
4. Applicant's mailing address: .P404 Box 1.927
City: Carthage, State: NC
5. Applicant's contact information:
Phone number: (910) 947- 315 Email Address: rgouldvmoorecountync
IL PROJECT INFORMATION:
1. Project thine: Floyd Way
2. Application/Project status:
Zip: 28327-1927
Other
Proposed (New Permit) El Existing Permit Project
If a modification, provide the existing permit number. WQ00_ and issued date:
If new construction but part of a master plan, provide the existing permit number: WQOO
3. County where project is located: Moore
4. Approximate Coordinates (Decimal Degrees): Latitude: 35. 1655 Longitude: -79.4880
5. Parcel ID (if applicable): Parcel ID: 00052077. PIN: 855100457732
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
I. Professional Engineer: Kevin S. Lindsay License Number: 027502
Firm: Crawford Design Company
Mailing address: 230 West Pennsylvania Ave.. Suit C
City: Southern Pines State. NC Zip: 28387-
Phone number: (910) 0-76(1_ Email Address: kevtnlindsa ?crawforcldsn.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Moore County WPCP Permit Number: NC 0037 08
Owner Name: Moore Counts'
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than W'1�'4�TF):
1. Permit Number(s): WQCS00034 Downstream (Receiving) Sewer Size: 8 inch
System. Wide Collection 5ystem Permit Number(s) (if applicable): WQCS
Owner Name(s): Moore County Public Utilities
FORM: P T A 04 16 Page I of 5

VI. GENERAL REQUIREMENTS
1. lithe Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑No 11 N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEV) been attached?
❑ Yes ❑No I1 N/A
3. if the Applicant is a Home/Property Owners' Association, has an Operational Agreement (FORM: HOA) been attached?
❑ Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply):
® Residential Owned
❑ Residential Leased
❑ School / preschool / day care
0 Food and drink facilities
0 Businesses / offices / factories
❑ Retail (stores, centers, malls)
❑ Retail with food preparation/service
❑ Medical / dental / veterinary facilities
❑ Church
❑ Nursing Honie
❑ Car Wash
❑ Hotel and/or Motels
❑ Swimming Pool /Clubhouse
❑ Swimming Pool/Filter Backwash
❑ Other (Explain in Attachment)
5. Nature of wastewater : 100 % Domestic/Commercial % Commercial
% Industrial (See 1SA NCAC 02T .0103(20))
> Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T.0114(f}? [] Yes
> If ves, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
® No
Establishment Type (see 02T.0114(ti)
Daily Design Flow u,b
No. of Units
Flow
Single Family Horne
480 gal/home
11
5,280 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
GPD
a See 1SA 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-aocesss—fac-+ ocated near higl 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. 42A-4).
b Per 15A NCAC 02T .0114(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: GPD (per 1SA NCAC 02T .0114)
Do not include future flows or previously permitted allocations
If penn itted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
El Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-1 b
Page 2 of 5

Vll. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & i DC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
Sal 1
PVC-SDR26
➢ 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
ViI I. 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
5. Summarize the force main to be permitted (for this Pump Station):
feet total dynamic head (TDH)
Size (inches)
Length (feet)
Material
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1):
❑ Standby power source or pump with automatic activation and telemetry - I5A 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 it 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 Nvith plugged emergency pump connection and telemetiy - 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.
r 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 04-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(0):
1. Does the project comply with all separations found in 15A NCAC 02T .0305j1) & (g)
> I5A NCAC 02T.0305(t} contains minimum separations that shall be provided for sewer systems:
®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 1 or
Class 11 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 oft feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade (vertical)
36 inches
• 15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(0 cannot be achieved.
> **Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
> 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) El Yes ❑ No ❑ N/A
See the Division's draft separation requirements for situations where separation cannot be meet
> No variance is required lithe 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 02B .0200? 0 Yes 0 No ® N/A
> This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project require coverage/authorization under a 404 Nationwide or ❑ Yes No
individual permits or 401 Water Quality° Certifications?
> Information can be obtained from the 401 & Buffer Permitting.Bran9h
5. Does project comply with 15A NCAC 02T.0105(cX6) (additional pennits'cerlificati.ons)? ® 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 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 Z No ❑ NIA
➢ 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.0-103(a)(5) or the permitee's individual System -Vide Collection permit.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with I SA NCAC 02T, the Minimum Pe*ign Criteria for the, Permitting of Pump Stations
and Force Mains (latest version), and the Gravit Sewer Minimum Desi n Crite is latest version as applicable?
Yes [ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents
for review. Approval of the request is required prior to submittal of the Fast Track Application and supporting
documents.
2. Professional Engineer's Certification:
I, Kevin S Lindsay, PE
(Professional Engint'ei 's name from Application Item 111.1.)
attest that this application for
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 1 have reviewed this
material and havejudged it to be consistent with the proposed design.
NOTE In accordance with General Statutes 14-215.6A and 143-215.6BB, 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 tine not to exceed S10,000, as well as civil penalties up to $2 5.000 per violation.
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's tit ication per 15A NCAC 02T .0106 b
Ij fJ
J K/
*
re Or
(Six attire Authority's t ?te 8 title from Application Item 1.3.)
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attest that this application for
has been tev wed_hy nee a dis accurate and complete -to -the best of my knowledge. I understand that -if all requwret arts 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 %pill result in an immediate enforcement action that may include civil penalties,
injunctive relief, and./or criminal prosecution. 1 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 ofthis 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 we it penalties up to 5,000 per violation.
Date:
Lfr/r7
FORM: FTA 04-16
Page 5of>

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: Moore County Public Utilities
Project Name for which flow is being requested: Floyd Way
More than one FTSE may be required for a single project if the owner of the W'WTP is not responsible for all pump
stations along the route of the proposed wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Moore County Water Pollution Control Plant
b. WWTP Facility Permit #: NC 0037508
All flows are in MGD
c. WWTP facility's permitted flow 10.0000
d. Estimated obligated flow not yet tributary to the WWTP 0.79863
e. WWTP facility's actual avg. flow 5.40733
f. Total flow for this specific request 0.00528
g. Total actual and obligated flows to the facility 6.21124
h. Percent of permitted flow used 62.1124
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:
Pump Pump
Station Station Finn
(Name or Permit Capacity, *
Number) No. MGD
--1-3-2 0532
(A)
Design
Average
Daily Flow**
(Firm / pf),
MGD
(B) (C) (D)=(B+C) (E)=(A-D)
Obligated,
Approx. Not Yet Total Current
Current Tributary Flow Plus
Avg. Daily Daily Flow, Obligated Available
Flow, MGD MGD Flow Capacity * * *
0.2131 0.0484 0 0.0484 0.1647
10-3 2.1500 0.8600 0.7245 0 0.7245 0.1355
s 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 Iocated
between the project connection point and the WWTP where the Available Capacity is < O.
Downstream Facility Name (Sewer): Moore County Public Utilities
Downstream Permit Number: WQCS00034
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I Randy G. Gould, 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 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 I and II 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.
,,Signing Official igna
_are‘
Title of Signing Official
re
Page 2 of 6
FTSE 10-18

(ZION GROVE) a;•�Trlmble._
079° 30' 01.9843" W
(VASS)
035° 11' 18.5918" N
035° 08' 30.9893" N t 4
079° 30' 01.9843" W
(HOFFMAN)
Produced by Trimble Terrain Navigator Pro
Topography based on USGS 1:24,000
Maps
North American 1983 Datum (NAD83)
Declination
M�N
(PINEBLUFF)
SCALE 1:24000
0
SOUTHERN PINES QUADRANGLE
NORTH CAROLINA
TOPOGRAPHIC SERIES
079° 27' 37.2526" W
.4 035° 11' 18.5918" N
4,`A 103)
bpyright 201if Tri e'Navigation Lidnited
Printed: Tue Dec 08, 2020 035° 08' 30.9893" N
079° 27' 37.2526" W
1
0
Mile
0
1000
Yards
(MC CAIN)
35079-B3-TM-024
SOUTHERN PINES, NC
JAN 1, 1984
To place on the predicted North American
1927 move the projection lines 17M N and
22M E
GN 0.87° E
MN 8.62° W
Kilometer
CONTOUR INTERVAL 10 FT

Crawford
ue COMParlY
itra
TRANSMITTAL
Date
Reference
Contact
Company
Address
City & State
Subject: Fast -Track Sewer Permit for Floyd Way
Dear Trent,
Please find the attached items for this permit request:
e.A4
May++, 2021
Floyd Way
(CDC# 18014)
Trent Allen
Fayetteville Regional Office, WQS
224 Green St., Suite 714
Fayetteville, NC 28301-5084
• Permit Fee for $480.00
• Site Map and USGS Topographic Map
• Submittal Checklist
• Fast -Track Application FTA 08-13 (Certified by Owner and Engineer)
• Flow Tracking for Sewer Extension Application
MAY
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Brief Project Narrative:
The sewer system is being constructed to serve the proposed Floyd Way Subdivision. The collection system
will serve up to 11 single family homes. The project will connect to the Moore County collection system and
eventually be treated at the Moore County Water Pollution Control Plant.
The collection system for Phase 1 will include approximately 841 LF of 8" SDR-3 5 gravity main.
If you have any questions, please give me a call at [phone].
Thank-you,-
1
Kevin Lindsay, PE
LANDSCAPE ARCHITECTURE I FA GINOH,RII\ G PLANNING
116 North Cool Spring Street Fayetteville, NC 283011 Ph: 910-221-0033 Fax: [phone]