WQ0040868_Regional Office Historical File Pre 2018

Division
of Water Resources
State of North Carolina
)epartment of Environmental Quality
Division of Water Resources
15A NCAC 0 T :030 — . 'AST TRACK SEWER SYSTEM EXTENSION APPLICATION
ETA 04-16 & SUPPORTING DOCUMENTATION
Applicari01 NUmber N'he completed by DWIZ)
Alt items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: City of Belmont. (company, municipality, 1-10A, uttlity, etc,)
2. Applicant pe J hidividual I: Corporation El General Partnership El Privately -Owned Public Utility.
Ej Federal El State/County
Municipal Ej Other
3, Signature authority's..irame: Adrian Miller per 1.5A„NC,AC 021 .0 IW(h)
Title: City Manager
4 Applicant's mailing address: EQ,431
City: Belmont State: NC Zip: 28012-
5. Applicant's contact information:
Phone number: (704) 825-5,586, Email Address: amiljerf(.kcjtvotbelmo.nt.og
IL PROJECT INFORMATION
I. Project name: Dogwood Drive Sewer Extension
2, Application/Project. status:
, Proposed (New Permit) LJ Existing Permit/Project
If a modification, provide the existing permit number: WQ00_ and issued date:
IC new construction but part of a master plan, provide the existing permit number: WQ00_
: County where projectis located: Gaston
4, Approximate Coordinates (Decimal Degrees): Latitude: 35,234Longitude: -8J,054,"
Parcel ID (if applicable): 187072
(or Parcel 1.D to closest downstream sewer)
CONSULTANT INFORMATION:
.1. Professional Engineer :fames W...Heller Jr. License Number: 01.6.10
Firm: Carolina Land Solutiorts,, PLLC
Mailing address: 'Pc) Box 4911(
City: Charlotte State; NC Zip: 28277-
Phone number: [phone], Lmail Address: litudcarolinalandsolutions.net
IV: WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1, Facility Name: Easle R.oad. WW1P Permit Number NC000603„3.
Owner Name: 'FwgRiyers Utilities
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
I. Permit Number(s): Downstream (Receiving) Sewer Size 8 inch
System Wide Coliecti(m System Permit Numbqf ;Wif vplicablq): OCS
Owner Name(s)
4
FORM: LTA 04.-16 Page I of 5

VI. GENERAL REQUIREMENTS
1. tftlxe Applicant is a Privately -Os ned Public f,.ltih
If the Applicant is a Developer of lot
c Applicant is a I I+Th4,_.Pi t/pL .i (3w nes..s,`.,"
grn of wastewater:
eck all that ap
Z Residential Owned 0 Retail
0 Residential Ceased 0 Retail
0 School / preschool / day care 0 Medica
.Food and drink facilities © Church
0 Businesses / offices / factories [ Nursing
1as a t.,
ificatc of Public C
0 Yes [INo ZN/A
o be sold, has a )cpcf ?per s
0 Yes No
ar
Yes
ZN/A
, centers, mabs,)
bod preparationlservice
dental / veterinary facilities
ve
Nature of wastewater : 100 % Domestic/Commercial 9,7 Commereial
% industrial (See 15A N( C 021".0l t) 3(r20))
Is to a Pretreatment Program in effect? [ Ye
Iaas a floss reduction been approved under l 5 A wNt AC Cif:( ti 1 },_4U)? 0 Yes Z No
If ye provide a copy of Clow reduction approvao letter
Seunrnarize wastewater generated by project:
blishment Type (see
Single Family lot
gal/day
gag
gal/
gal/
d Necessi r
ched?
n attached'?
Car Wash
[] Hotel a►ndlor Motels
Swimming Pool /Clubhouse
© Swimming Poollfilter Backwash
Other (Explain in Attachment)
No
No. of Units
Flow
85 GPD
GPI)
GPD
H P D
GPI:)
GPD
a Sce ( NCIA(,' 0 ") ('t .alkfrj _ k)(U and1012) for caveats to wastewater design flow rates (Le„ tniniimum flow per
dwellmg; proposed unknown non-residential development uses; public access facilities located near hh public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in
b Per I5A NCA(::' 02T ,01.14(c), design flow rate fcrr estalalishments not identified [in table I wA, Nl A(. 1 t il ..1 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data,
a, water generated by project: 285 GPF) (per
1)o not' include future flows or previously permitted alto
If permitted flow is zero, indicate why:
Purnp Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
[0' Flow has already been allocated in Permit Number
Rehabilitation or replacement of existing sewer with no rreev flttvv expected
0 Other (f.;xplain):
FURM. ETA 04-16
Page 2 of 5

CRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T JIJ .',;(1.1"(,iravity Sew
1, Summarize gravity sewer to be permitted:
Size (inches)
8
1
Section 11 & 11.1 of the IVIDC for Permitting of Gravity Sewers contains information related to design criteria
Section 111 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 MD(
VIII, PUMP STATION DESIGN CRITERIA (if .Applicable)— 021A305 & INIDCiptlitna Stations/Force 'Vairisli
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1, Pump station -number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: 1„,ongitude:
3, Design flow of the pump station: millions gallons per day (firm. capacity-)
4, Operational point(s) of the pump(s): gallons per minute at feet total dynamic head (MD)
5, Summarize the force -main to be permitted (for this Pump Station):
s) Length (feet) Material I
6, Power reliability in accordance with 15,.„NciNcY2LQ36)5kb)flji:
Li Standby power source or pump with automatic activation and telemetry - 5A NCAC 02T .0305(h)(1)(B);
74> Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
[11 Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02'1
,0305(h)( 1)(C)
Or
Portable pumping unit with. plugged emergency pump connection and telemetry1.5A 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,
lithe 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 pwnp, including travel tirnetrames, shall he provided
in the case cif a multiple station power outage.
FORM: VIA 04-16 Page 3 of 5

IX, SETBACKS & SEPARATIONS — (02,B .0200 ti?z, :I5A NCAC 02T .0305(1)):
Does the project comply with all separations found in 15.A 'NCA(: 02T ..0305(t)
15.A NCAC 02T,03050f contains minimum separations that shall be provided for sewer systems: _
Setback parameter* L SgarationRequired
Storm sewers anduther utilities not listed below (vertical) 24 inches,
Water mains (vertical -water over sewer including in benched trenchesf,
Water mains (horizontal'
Reclaimed water lines (vertical - reclaimed over sewer)_
Reclaimed water lineschorizontal - reclaimed over sewer),
**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
**Waters classified WS (except WS-1 or WS-V), 13, SA, OR.W„ HQW, or SB from normal
high witterir tide elevation) and. wetlands (see item IX.2)
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
Any building foundation
Any, basement
Trip slope of embankment or cuts of 2 feet or more vertical height
Drainage systems and interceptor drains.
Any swimming pools
Final earthg-rade vertical
El Yes Li No
18 inches
10 feet
18 inches
2 feet
100 feet
50 feet_
1.0 feet
5 feet
10 feet
10 feet
5 feet
10 feet
36 inches
15A_NcAC9,2.11,93(5(.g) contains alternatives where separations in Wir,0,1050) cannot he achieved,
▪ **Stream classifications can be identified using the Division's Nc:Smid"..4q...W41:cr c.:1401Ic4timsli:gkpur
• If noncompliance with 021I0J0511LorAgl see Section X of this application
2, Does the project comply with separation requirements for wetlands'? (50 feet of separation) Ves Lil No Z N/A
See the Division.'s draft separation requirements for situations where separation cannot be meet
„';'•' No variance is required if the alternative design criteria specified is utilized in design and construction.
• As built documents should reference the location of areas effected
3. Does the project comply with setbacks (band in the river basin rules per 1,5A NCA.0 02B .0200? Ej Yes El NoZ N/A
• 'Ellis would include 'front Buffered Streams per 15A NCAC 213.0202
4, Does the project require coverage/authorizationunder a 404 Nationwide or
individual permits or 401 Water Quality Certifications?
• Infm-mation can be obtained from the tO & Buffer PennittingBranch
Li Yes ENo
.5... Does project comply with 15A . 'CAC 021-A1105100J (additional permits/certifications)? Yes No
Per 1.5A. NCAC 021.0105(c)01, 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 d.ependent permits (erosion and
sedimentation control plans, storinwater management. plans, etc.).
O. Does this project include any sewer collection lines that are deemed "high -priority?"
Perl5ANCACNT,04P2,, "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 El 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 ISA NCA.0 02T.0403(05) or the permitees individual System -Wide Collection permit,
FORM: ETA. 04-16 Page .4 of 5

X. CERTIFICATIONS:
I. Does the submitted system comply with 15 kjN CA2TE, the :Minimarri_Design(.riterja, forAhePerittittine O1 FuittpStAttop5
and Force Ma nsitatest version), and the t„Irayity„,!iewer_f)".4initimini_DesignSitterialltitest crsion) as applicable?
El Yes DNo
If No, complete and submit the Variance/Alternative .Design Request application (VADC 1.0-14) and supporting documents. for
review. Approval of thereq nest is required prior to submittal (Attie Fast Track Application and supporting documents,
2, Professional Engineer's Certification:
I, 34
(Professional Engineer's narne tfom"Applicatnrn. Item 111„1..)
attest that this application 'or
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans., speeifications,„„
engineering calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable 'regulations, Gravity Sewer
Minimum Design Criteria. for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my .signature and seal signifies that I have reviewed this material and
havejudged it to be consistent with the proposed design.
NOTE -- In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000., as well as civil penalties up to $25,000 per violation.
,A.14.1.114-6,y7
‘‘‘'
North Carolina. Professional Engineer's seal, signature, and date: C AR()
3. Applicant's Certification per I.5A NCAC 02T .0106(b):
/61.1;11'...'14_1') ( (
(Signature Authority s name & trrie front Application Item L3.)
has been reviewed by .me and is accurate and complete to the best of my knowledge. 1 understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this.
application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal. prosecution. I will make no claim against the Division of Water Resources should a. condition
of this permit be io1aIed 1 also understand that if all required parts of this application package are not completed and that if
all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
NOTE -- In accordance
statement, representation,
include a fine not to exc-
Signature:
attest that this application for
General Statutes 1 32156A and t4.1721.564, any person who knowingly makes any false
•ertification in any application package shall be guilty of a Class 2 misdemeanor, which may
0,000 as well as civil penalties up to $25,000 per violation.
Date: /
FORM: ETA. 04-16
Page 5 of 5

TWO RIVERS
We ore TR U to our cusforners!
May 6, 2019
Adrian Miller, City Manager
City of Belmont
P 0 Box 431
Belmont, North Carolina 28012
Subject: Flow Acceptanceo 'ood Drive Sewer Extension
Dear Mr. Miller:
The City of Gastonia (Two Rivers Utilities) and the City of Belmont have an existing Sanitary
Sewer Service Utility Agreement dated November 4, 1996 for a sewer connection to the Two
Rivers Utilities (TRU) sewer collection system on Eastwood Drive, Carolina Land Solutions,
LLC has submitted plans for a sewer extension to serve Dogwood Drive serving one (1) dwelling
units. The flows from this project WIII be treated at the Eagle Road WWTP.
The plans indicate the total projected flow for the Project of 285 gallons per day. The contract
has a maximum daily flow limit of 280,000 gallons per day. The average daily flow for the past
12 months is 72,603 gallons per day. There is capacity available within the limits of the contract
for the additional flow from this development. There is also additional capacity available at the
Eagle Road \\TWTP for the projected flows from this project.
The flows from the City of Belmont Metering Point are treated at the Two Rivers Utilities Eagle
Road WWTP, NPDES Permit Number --- NC0006033. Two Rivers Utilities will not own or
.maintain any portions of the proposed project's sewer collection system.
The commitment to serve is contingent upon the project complying with all local and state
regulations and the customer being on line within twelve. (12) months from the date of this letter.
Please contact Mr. Mike Bynum, PE, Planning and Research Manager at [phone] if you
have any questions or need additional information,
erely,
e Albright
Director of Public Utilities
PC:
Mike Bynum, Division Manager TRU Engineering
Stephanie Scheringer Division Manager Wastewater Treatn
P. O. Box 1748
Gastonia, N,C, 28053

Chuck Flowers, 1 tilities i r° tors City rrt B main
J s Heller, Jr., Carolina :1 and Solution , I
P. O. Box 1748
Gastonia, C, 28053

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: City of Belmont
Project Name for which flow is being requested: Dogwood Drive Sewer Extension
More than one FTSE may he required for a single project if the owner of the WWTP is not responsible for allpftmp
stations along the route of the proposed wastewater flow.
Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Eagle Road WWTP,
b. WWTP Facility Permit #: NC0006033
Ailflows are in MGD
c. WWTP facility's permitted flow 4.0
d. Estimated obligated flow not yet tributary to the WWTP 0.359
e. WWTP facility's actual avg. flow
f Total flow for this specific request
g. 'fotal actual and obligated .flows to the facility
h. Percent of permitted :flow used
0.856
0.000285
1.2153
30.4%
11. 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 'onnection point and the WWTP:
(A) (B) (C) (D)-(B+C) (E)=(A-D)
Design Obligated,
Pump Pump Average Approx. Not Yet Total Current
Station Station Firm. Daily Flow** Current Tributary Flow Plus
(Name or Permit Capacity, * (Firm / p1), Avg. Daily Daily Flow, Obligated Available
Number) No, MG D MGD How, MGD MGD Flow Capacity***
N/A
* 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 ofservice.
** 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 2.0.2(04)(c) of the Minimum Design Criteria.
*** A Planning Assessment Addendum shall be attached for each pu.nip station located
between the project connection point and th.e WWTP where the Available Capacity is < O.
Downstream Facility Name (Sewer): Eastwood Outfall
Downstream Permit Number: Unknown
Page 1 of 6

III, Certification Statement:
I Joe Albright 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 ploccdures using the best available data. This certification applies to
those items listed above in Sections 1 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
WO s has adequate capacity to transport and treat the proposed new vvastewater.
igning Officla Lignam
DIRECTOR OF PUBLIC UTIL1
Title of Signing. Official
Date
Page 2 of 6

la-

olina land solutions
taking your project full circle
concept to completion
May 13, 2019
Division of Water Resources
Mooresville Regional Office
Water Quality Section
610 E, Center Avenue
Mooresville, North Carolina 28115
Re: Dogwood Lane Sewer Extension
Belmont, North Carolina
USPS PRIORITY MAIL
I have enclosed the following documents in support of the permit application for a sewer system
extension to serve one residential lot located at 714 Dogwood Lane (PID#187072) in Belmont,
North Carolina,
One original and one copy of the following
o Fast Track Sewer System Extension Application Form FTA 04-16
o Two Rivers Flow Acceptance Letter dated May 6, 2019
o Flow Tracking for Sewer Extension Application Form FTSE 10-18
o Color clip from 2016 USGS Belmont. Quad Map showing the location of the
property
o Google Earth aerial image showing the location of the property
o Sewer Extension Plan -- Sheet C1.0 signed and sealed May 13, 2019
Application fee.....BMH, Inc. check number 20397 in the amount of $480.00
Please feel free to call me if you have questions regarding the re -submittal or need anything
else from me at this time.
Sincerely,
im Helle
Carolina Land Solutions, PLLC
rp.co)carpli n n c pIy to o t fi€fit
ENCLOSURES
PO Box 49116 .Charlotte, NC 28277
PH [phone] FAX [phone]

4
k 615
Printed Name, Trtle
FAST TRACK SEWER NGINEERING copuovrioN
PERMITTEE: City of Belmont
PERMIT #: WQ0040868
PROJECT: Dogwood Drive Sewer Extension
ISSUE DATE: June 6, 2019
This project shall not be considered complete nor aliowed to operate in accordance with Condition 7 of
this permit until the Division has received this Certification and all required supporting documentation.
it should be submitted in a manner that documents the Division's receipt. Send the required
documentation the Region& Supervisor, Water Quality Regional Operations Section at the address at
the bottom.
Any wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Certification shall be considered a violation of the permit and shall subject the Permittee to
appropriate enforcement actions. The Permittee is responsible for tracking all partial certifications up
until a final certification is received. A Final Certification shall be a complete set of record drawings and
design calculations regardless of whether partials have been submitted.
PERMITTEes CERTIFICATION(
the undersigned agent for the Permittee, hereby state that this project has been constructed pursuant
to the applicable standards & requirements, the Professional Engineer below has provided applicable
design/construction information to the Permittee, and the Permittee Is prepared to operate & maintain
the wastewater collection system permitted her or portions thereof.
Lit't 119,1 : 144
Signature
ENGIN rs CERTIfICATIQN
as a dul registered Professional En sneer in the State of North Carolina,
having been authorized to observe 4 periodically, weekly, full time) the construction of the
project name and location as reference above for the above Permittee hereby state that, to the best of
my abilities, due care and diligence was used in the observation of the following construction:
-407544 linear feet of 8-inch gravity sewer; such that the construction was observed to be built within
substantial compliance of this permit; 1SA NCAC 02T; the Division of Water Resources' (Division) Gravity
Sewer Minimum Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design
Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as
applicable; and other supporting materials.
North Carolina Professional Engineer's Seal w/signature & date:
F
nal 0 Partial (include description)
Certification Cornments/Qualifiers (attach if necessary):
State of North Carolina 1 Environmental Quality I Water Resources I Water Quality Reu,3 Operations
Mooresville Regiocal Office{ 610 East Center Avenue, Suite 301 I Mooresville, 1.1ce-th Carolina 2E1 13
704 663 1699

CERTIFICATION CHECKLIST
To be completed by the certifying engineer prior to operation of the permitted sewers, per 15A NCAC 02T.0116
Certifying Engineer: JAPAc..-... \A_) .-0
Certification Review Date:
Project Name: 7):. \MOQ crE
WQOO 4-05 Ce.ert Project County:
1) Has permittee information changed since the permit was issued (or last modified): change of mailing address,
change of ownership, transfer from developer to HOA/POA, etc D Yes No
If yes, please provide either a change of ownership form or new contact information. Note that transfer of
permits from the developer to the HOA/POA must occur with the first certification.
2) Have the as -built drawings have been signed, sealed, and dated by an N.C. PE? Yes I I No
3) Final Engineering certification?
No
If Partial Engineering certification, provide detailed narrative including what is being certified in the current
phase, what was previously certified (if applicable), and what is left to be certified.
4) Adequate information related to sewer lines: Yes ri No
N/A
• Three feet minimum cover has been provided for all sewers unless ferrous pipe was installed.
• Minimum diameters for gravity sewers are 8-inches for public lines and 6-inches for private lines,
• Manholes have been installed: At the end of each line, at all changes in grade, size, or alignment, at all
intersections, and at distances not greater than 425 feet; minimum diameter shall be 4 feet (48-inches).
5) Adequate information related to pump stations: Yes No N/A
• Ensure power reliability option was selected per 15A,INcAC ON.
6) Was project construction completed in accordance with all of the following: Yes .0 No 0 N/A
• 15A NCAC 02T, Minimum Deszp. 7:r . .MD) for the perPlatti9g of Grav;ty Sewers (latest version), and mpc
fa the Permittiu of Pump Statiops and Fore Mains (latest version)?
If not, a variance approval is required in accordance with 15.A hicA( 021-.010„5, prior to certification and operation.
• Contact the Central Office to discuss the variance to determine a course of action.
• Applicant must submit two copies of the variance request form, plans, specifications, calculations, and any other
pertinent information to the Central Office (one hard copy, one digital copy).
• The central office will review the variance request, and if approvable, specific language regarding the variance
will be incorporated into the permit, either via a special condition or a supplementary letter. A copy of the
reissued permit with variance language or the variance letter must be maintained with the original documents,
7) Does the project contains high priority lines (15A NCAC O., I 0.102(2)1? Yes No
• If yes, ensure that the permit already contains the necessary condition related to high priority lines 15A NCAC
02T.0403 (a)(5). If the permit does not include this language, the Fast Track reviewer will reissue the permit with
the appropriate language.
8) Are Permit rnodifications are required for any changes resulting in non-compliance with this permit (including but not
limited to pipe length changes of 10% or greater, change in flow, pump station design capacity design change of 5©% or
greater, and/or change in the number/type of connections)? fl Yes r4 No
• If yes, a permit modification request must be submitted to the appropriate Regional Office, and a modified
permit with revised certification must be issued prior to certification and operation.
Stale or North Carolina I Environmental Quality Water R.esotuaies '‘Vater Quality Regional Operations
\Ior Ik Regional Officei 610 1711$1: C27nter Sthite 301 Mooresville, North Carolina ?SI 15
704 MO 1699