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WQ0042708_Application (FTSE)_20210729
STROUD ENGINEERING, P.A. 102-D Cinema Drive Wilmington, NC 28403 ICA CAI ©7 LaGJ�G�a `�La� TO (910) 815-0775 DATE 1 2-7 J 213 2( JOB NA.) ®� .)1 V g ti ATTENTIO ��✓,� /�n�l/� L/�� RE: / H in /C, - d U,-II4,e >' n v WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via the follow! ry items: C°ciy >j/ Rips ❑ Shop drawings ❑ Prints ❑ Plans �❑ Specit! 443s 9 ❑ Copy of letter ❑ Change order ❑ /ya9jo /'Lr e e() , shj "aid e, �9to oet met ❑ Samples COPIES DATE NO. DESCRIPTION �aj�OCtj /S-#) ,� f e -- —i �-Yie,,L��las-�. y Cl ceiJ1 "1-1C..0 b-v - 5 - 41 f 'too THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ For your use ❑ As requested ❑ For review and comment ❑ ❑ FOR BIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS ❑ Approved as submitted ❑ Approved as noted ❑ Returned for corrections ❑ Resubmit ❑ Submit ❑ Return copies for approval copies for distribution corrected prints COPY TO SIGNED: If enclosures are not as noted, kindly notify us at once. TERROIR DEVELOPMENT LLC PO BOX 15025 WILMINGTON, NC 28408 Pay to the Order of For HSLATE BAN SoutFStateBB an'k-c0m . lur A' Harland Glance �9�✓) Date 1310 67-98/532 8^®CHECK ABNE9R so-ttl Dollars ra Sate oepos:te 94. Project Narrative Highlands Village Apartments Camden Square Drive, New Bern The 5.25 acre site is located near the intersection of SR 1278 (Trent Road) and Camden Square Drive (Private) within the City of New Bern in Craven County, NC. The site and adjoining properties are zoned C-4. Proposed improvements are consistent with this zoning and include 60 apartment units and associated amenities. The site is presently vacant and is vegetated with a stand of 5" - 15" pine trees. Few significant trees are located onsite. The site is primarily drained via an outfall ditch along Camden Square Drive along the north side of the site. This ditch drains to the east and ultimately under Trent Road to Lawson Creek. Access to the site is proposed by a full -movement driveways off of Camden Square Drive. Internal drive aisle widths are sufficient to allow fire apparatus access. Water and sewer service will be provided by extensions of City of New Bern mains in Camden Square Drive. The daily sewer flow is calculated to be 16,560 GPD based on NCDEQ 02T rules. A single water meter will be installed at each building. No submetering is proposed. Stormwater runoff will be collected by inlets and conveyed via RCP to a wet pond designed to treat and release the 1.5" storm in 2-5 days per NCDEQ Coastal Stormwater requirements. This treatment volume is released across a level spreader and 50' vegetated filter at a rate that does not exceed the 1 year, 24 hour predevelopment runoff rate. Runoff in excess of the NCDEQ design storm up to the 10 year storm is detained and released at a rate which does not exceed the predevelopment rate. Erosion control is accomplished through the temporary use of a gravel construction entrance, silt fence, and hardware cloth and gravel inlet protection. The stormwater pond will be used as a skimmer basin during site construction and will be converted to a stormwater basin once the site is stabilized. Riprap aprons will be installed and left in place at all pipe outlets. A_. Division of Water Resources State of North Carolina Department of Environmental Quality Division of Water Resources FAST TRACK SEWER SYSTEM EXTENSION APPLICATION INSTRUCTIONS FOR FORM: FTA 06-21 & SUPPORTING DOCUMENTATION This application is for sewer extensions involving gravity sewers, pump stations and force mains, or any combination that has been certified by a professional engineer and the applicant that the project meets the requirements of 1SA NCAC 02T and the Division's Minimum Design Criteria (Gravity Sewer & Pump Stations/Force Mains) and that plans, specifications and supporting documents have been prepared in accordance with 15A NCAC 02T, 15A NCAC 02T .0300, Division policies, and good engineering practices. While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02T .0305(b), design documents must be prepared prior to submittal of a fast track permit application to the Division. This would include plans, design calculations, and project specifications referenced in 15A NCAC 02T .0305 and the applicable minimum design criteria. These documents shall be immediately 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. Projects not eligible for review via the fast track process (must be submitted for full technical review): > Projects that do not meet any part of the minimum design criteria (MDC) documents; > Projects that involve more than one variance from the requirements of 15A NCAC 02T; > Pressure sewer systems utilizing simplex septic tank -effluent pumps (STEPS) or simplex grinder pumps; > Simplex STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mains); ➢ 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 will 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 (second copy may be digital) of Application and Supporting Documents ❑ Required unless otherwise noted. Signatures on original must be "wet ink" or secure digital signatures. Please do not submit engineering design plans with the application unless specifically requested. B. Cover Letter/Narrative Description (Required for All Application Packages): ❑ List all items included in the application package, as well as a brief description of the requested permitting action. ➢ Be specific as to the system type, number of homes served, flow allocation required, etc. ➢ Include the permit number/status of any other required sewer permits (downstream/upstream) ➢ If necessary for clarity, include attachments to the application form. C. Application Fee (All New and Modification Application Packages): ❑ Submit a check or money order in the amount of $480.00, dated no more than 90 days prior to application submittal. > Payable to North Carolina Department of Environmental Quality (NCDEQ) D. Fast Track Application (Required for All Application Packages, Form FTA 05-21): ❑ Submit the completed and appropriately executed application. > If necessary for clarity or due to space restrictions, attachments to the application may be made. ❑ 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. ❑ If the Applicant Type in Item I.2 is a pal lnership or d/b/a, enclose a copy of the certificate filed with the Register of Deeds in the county of business. ❑ The Project Name in Item II.1 shall 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(b). 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 .0106(b). TNNT12TTPTT(11\T.Q F(1R 'R(1RM• FTA M_)1 Rr CTTPP(1RTT1\T(; TlffTTAifP1'TTATT(IN PaoP 1 nf� E. Flow Tracking/Acceptance Form (Form: FTSE 04-16) (If Applicable): ❑ Submit the completed and executed FTSE fonn 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). > 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 11-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project area, including the closest surface waters. > General location of the project components (gravity sewer, pump stations, & force main) > Downstream connection points and permit number (if known) for the receiving sewer ❑ Include an aerial location map showing general project area (such as street names or latitude/longitude) so that Division staff can easily Locate it in the field. G. Existing Permit (Application Packages for Modifications to an Existing Permit): ❑ Submit a copy of the most recently issued existing permit. ❑ Include a descriptive and clear narrative identifying the previously permitted items to remain in the permit, items to be added, and/or items to be modified (the application form itself should include only include items to be added/modified). The narrative should also include whether any previously permitted items have been certified. ❑ The narrative should clearly identify the requested permitting action and accurately describe the sewers to be listed in the final permit. H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station): ❑ 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 15A 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 timeframes, 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): ❑ 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 ❑ 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 lots to be sold): ❑ Home/Property Owners' Associations ❑ Per 15A NCAC 02T .0115(c), submit the properly executed Operational Agreement (FORM: HOA). ❑ Per 15A NCAC 02T .0115(c), submit a copy of the Articles of Incorporation, Declarations and By-laws. ❑ Developers of lots to be sold El Per 15A NCAC 02T .0115(b), submit the properly executed Operational Agreement (FORM: DEV). For more information, visit the Division's collection systems website TTTQTDTTPTT(l1.TQ 1 (\D T:(IDTR• RTA (1S_')1 R, QTraDnRTTT\T(: F r'TTT4TRNNTTATT(VTT Parr,' 7 of 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 28778-8211 (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 Water Quality Section Fayetteville Regional Office 225 Green Street Suite 714 Fayetteville, North Carolina 28301-5095 (910) 433-3300 (910) 486-0707 Fax Anson, Bladen, Cumberland, Harnett, Hoke, Montgomery, Moore, Robeson, Richmond, Sampson, Scotland Water Quality Section Mooresville Regional Office 610 E. Center Avenue Mooresville, North Carolina 28115 (704) 663-1699 (704) 663-6040 Fax Alexander, Cabarrus, Catawba, Cleveland, Gaston, Iredell, Lincoln, Mecklenburg, Rowan, Stanly, Union Water Quality Section Raleigh Regional Office 3800 Barrett Drive Raleigh, North Carolina 27609 (919) 791-4200 (919) 571-4718 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 (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 Water Quality Section Wilmington Regional Office 127 Cardinal Drive Extension Wilmington, North Carolina 28405 (910) 796-7215 (910) 350-2004 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 (336) 776-9800 (336) 776-9797 Fax Alamance, Alleghany, Ashe, Caswell, Davidson, Davie, Forsyth, Guilford, Rockingham, Randolph, Stokes, Surry, Watauga, Wilkes, Yadkin Water Quality Section 1TTQTRTT('TTr TC' PM? 1 nDNR• RTA flt_91 Rr QTTPA(1PTITTC.TI(lfTTASP-KITATT(1T\T Pacra T nfq Division of Water Resources State of North Carolina Department of Environmental Quality Division of Water Resources FAST TRACK SEWER SYSTEM EXTENSION APPLICATION FTA 06-21 & SUPPORTING DOCUMENTATION Application Number: (to be completed by DWR) All items must be completed or the application will be returned I. APPLICANT INFORMATION: 1. Applicants name: City of New Bern (company, municipality, HOA, utility, etc.) 2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility ❑ Federal ❑ State/County ® Municipal 3. Signature authority's name: Foster Hughes per 15A NCAC 02T .0106(b) Title: Interim City Manager 4. Applicant's mailing address: 300 Pollock Street City: New Bern State: NC Zip: 28560- 5. Applicant's contact infounation: Phone number: (252) 636-4000 Email Address: hughesf@newbernnc.gov II. PROJECT INFORMATION: 1. Project name: Highlands Village Apailinents 2. Application/Project status: ® Proposed (New Permit) ❑ Other ❑ Existing Peunit/Project If a modification, provide the existing permit number: WQ00 and issued date: For modifications, also attach a detailed narrative description as described in Item G of the checklist. If new construction, but part of a master plan, provide the existing permit number: WQ00 3. County where project is located: Craven 4. Approximate Coordinates (Decimal Degrees): Latitude: 35.099°Longitude: -77.083° 5. Parcel ID (if applicable): 8-044-009 (or Parcel ID to closest downstream sewer) III. CONSULTANT INFORMATION: 1. Professional Engineer: David L. Menius License Number: 35677 Firm: Stroud Engineering, P.A. Mailing address: 102 D Cinema Drive City: Wilmington State: NC Zip: 28403- Phone number: (910) 815-0775 Email Address: lmenius@stroudengineer.com IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION: 1. Facility Name: New Bern WWTP Permit Number: NC0025348 Owner Name: City of New Bern V. RECEIVING DOWNSTREAM SEWER INFORMATION: 1. Permit Number(s): WQ 2. Downstream (Receiving) Sewer Information: 8 inch Ox Gravity ❑ Force Main 3. System Wide Collection System Peiniit Number(s) (if applicable): WQCS Owner Name(s): City of New Bern FORM: FTA 06-21 Pa (Yet 1 of 5 VI. GENERAL REQUIREMENTS 1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached? ❑ Yes ❑ No ®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 N/A 3. If the Applicant is a Home/Property Owners' Association, has an HOA/POA Operational Agreement (FORM: HOA) and supplementary documentation as required by 15A NCAC 02T.0115(c) been attached? ❑Yes ❑No ®N/A 4. Origin of wastewater: (check all that apply): ❑ Residential (Individually Owned) ❑ Retail (stores, centers, malls) ® Residential (Leased) ❑ Retail with food preparation/service ❑ School / preschool / day care ❑ Medical / dental / veterinary facilities ❑ Food and drink facilities ❑ Church ❑ Businesses / offices / factories ❑ Nursing Home ❑ Car Wash ❑ Hotel and/or Motels El Swimming Pool/Clubhouse ❑ Swimming Pool/Filter Backwash ❑ Other (Explain in Attachment) 5. Nature of wastewater : 100 % Domestic % Commercial % industrial (See 15A NCAC 02T .0103 (20)) If Industrial, is there a Pretreatment Program in effect? ❑ Yes ❑ No 6. Has a flow reduction been approved under 15A NCAC 02T .0114(f)? ❑ Yes ® No ➢ If yes, provide a copy of flow reduction approval letter with this application 7. Summarize wastewater generated by project: Establishment Type (see 02T.0114(f)) Daily Design Flow a,b No. of Units Flow 1-Bedroom Units 240 gal/ dwelling unit 9 2,160 GPD 2-Bedroom Units 240 gal/ dwelling unit 33 7,920 GPD 3-Bedroom Units 360 gal/ dwelling unit 18 6,480 GPD gal/ GPD gal/ GPD gall GPD Total 16,560 GPD a See 15A 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 access facilities located near high 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: 16,560 GPD (per 15A NCAC 02T .0114) > Do not include future flows or previously permitted allocations If permitted flow is zero, please indicate why: ❑ Pump Station/Force Main or Gravity Sewer where flow will be peiuiitted in subsequent peinuits that connect to this line. Please provide supplementary information indicating the approximate timeframe for permitting upstream sewers with flow. ❑ Flow has already been allocated in Permit Number: Issuance Date: El Rehabilitation or replacement of existing sewers with no new flow expected El Other (Explain): VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers): 1. Summarize gravity sewer to be peuuitted: -Size (inches) Length (feet) Material 8 300 PVC > 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 Iines to meet minimum slope requirements is not allowed and a violation of the MDC VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains): PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT 1. Pump station number or name: 2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: - . 3. Total number of pumps at the pump station: 3. Design flow of the pump station: millions gallons per day (firm capacity) > This should reflect the total GPM for the pump station with the largest pump out of service. 4. Operational point(s) per pump(s): gallons per minute (GPM) at feet total dynamic head (TDH) 5. Summarize the force main to be permitted (for this Pump Station): Size (inches) Length (feet) Material If any portion of the force main is less than 4-inches in diameter, please identify the method of solids reduction per MDCPSFM Section 2.01C.1.b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify) 6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1): ❑ Standby power source or ❑ Standby pump > Must have automatic activation and telemetry - 15A 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 and may not be portable Or if the pump station has an average daily flow less than 15,000 gallons per day 15A NCACO2T.0305(h)(1)(C): ❑ Portable power source with manual activation, quick -connection receptacle and telemetry - or ❑ Portable pumping unit with plugged emergency pump connection and telemetry: > Include documentation that the portable source is owned or contracted by the applicant and is compatible with the 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 timeframes, shall be provided as part of this permit application in the case of a multiple station power outage. IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)): 1. Does the project comply with all separations/altematives found in 15A NCAC 02T .0305(f) & (g)? 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems: ® Yes ❑ No Setback Parameter* Separation Required Stoiui sewers and other utilities not listed below (vertical) 18 inches 2Water mains (vertical - water over sewer preferred, including in benched trenches) 18 inches 2Water 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-I waters of Class 1 or Class II impounded reservoirs used as a source of drinking water, and associated wetlands. 100 feet **Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal high water (or tide elevation) and wetlands associated with these waters (see item IX.2) 50 feet **Any other stream, lake, impoundment, or ground water lowering and surface drainage ditches, as well as wetlands associated with these waters or classified as WL. 10 feet Any building foundation (horizontal) 5 feet Any basement (horizontal) 10 feet Top slope of embankment or cuts of 2 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 > If noncompliance with 02T.0305(f) or (g), see Section X.1 of this application *15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(f) cannot be achieved. Please check "yes" above if these alternatives are used and provide narrative information to explain. **Stream classifications can be identified using the Division's NC Surface Water Classifications webpage 2. Does this project comply with the minimum separation requirements for water mains? ® Yes ❑ No ❑ N/A > If no, please refer to 15A NCAC 18C.0906(f) for documentation requirements and submit a separate document, signed/sealed by an NC licensed PE, verifying the criteria outlined in that Rule. 3. Does the project comply with separation requirements for wetlands? ® Yes ❑ No ❑ N/A > Please provide supplementary information identifying the areas of non-conformance. > See the Division's draft separation requirements for situations where separation cannot be met. > No variance is required if the alternative design criteria specified is utilized in design and construction. 4. Is the project located in a river basin subject to any State buffer rules? ® Yes Basin name: Neuse ❑ No If yes, does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ® Yes ❑ No > This includes Trout Buffered Streams per 15A NCAC 2B.0202 5. Does the project require coverage/authorization under a 404 Nationwide/individual permits ❑ Yes ® No or 401 Water Quality Certifications? > Please provide the permit number/peiuiitting status in the cover letter if coverage/authorization is required. 6. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No Per 15A NCAC 02T.0105(c)(6), directly related environmental permits or certification applications must be 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.). 7. Does this project include any sewer collection lines that are deemed "high -priority?" ❑ Yes ® No Per 15A NCAC 02T.0402, "high -priority sewer" means any aerial sewer, sewer contacting surface waters, siphon, or sewers positioned parallel to streambariks that are subject to erosion that undermines or deteriorates the sewer. Siphons and sewers suspended through interference/conflict boxes require a variance approval. > 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.0403(a)(5) or the permittee's individual System -Wide Collection permit. FORM: FTA 06-21 PatrPdof5 X. CERTIFICATIONS: 1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteria (latest version) as applicable? ® Yes ❑ No If no, for projects requiring a single variance, .complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for review to the Central Office. Approval of the request will be issued concurrently with the approval of the permit, and projects requiring a variance approval may be subject to longer review times. For projects requiring two or more variances or where the variance is determined by the Division to be a significant portion of the project, the full technical review is required. 2. Professional Engineer's Certification: I, David L. Menius, P.E. , attest that this application for Highland Village Apartments (Professional Engineer's name from Application Item III.1.) (Project Name from Application Item II.1) 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, 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 have judged 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. Misrepresentation of the application information, including failure to disclose any design non-compliance with the applicable Rules and design criteria, may subject the North Carolina -licensed Professional Engineer to referral to the licensing board. (21 NCAC 56.0701) North Carolina Professional Engineer's seal, signature, and date: �\\.�k1 0 �ii R 1.7;•Q SEAL�: _•'35677;—�' •• GiNE. J� „`� 3. Applicant's Certification per 15A NCAC 02T .0106(b): -, $/ '`z_j I, 7 Lell4QL-HFS , attest that this application for Air_(4cL)4.L s i r A (Signature Authority Name from Application Item I.3.) (Project Name from Application Item II.1) attest that this application 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. 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 violated. I also understand that if all required parts of this application package are not completed and that if all required supporting infornation 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 143-215.6B, any person who knowingly makes any false statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which inay include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation. Signature: Date: 1JQ.,),1 vrIDTir. t rA r14' 01 State of North Carolina Department of Environmental Quality Division of Water Resources Flow Tracking/Acceptance for Sewer Extension Applications (FTSE 04-16) Entity Requesting Allocation: City of New Bern Project Name for which flow is being requested: Highland Village Apartments More than one FTSE may be required for a single project if the owner of the WWTP 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: City of New Bern b. WWTP Facility Permit #: NC0025348 All flows are in MGD c. WWTP facility's permitted flow 6.500 d. Estimated obligated flow not yet tributary to the WWTP 0.579 e. WWTP facility's actual avg. flow 4.794 f. Total flow for this specific request 0.016 g. Total actual and obligated flows to the facility 5.389 h. Percent of permitted flow used 82.9% 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: (A) (B) (C) (D)=(B+C) (E)=(A-D) Design Obligated, Pump Average Daily Approx. Not Yet Total Current Station Firm Flow* * Current Avg. Tributary Flow Plus (Name or Capacity, * (Firm / p f), Daily Flow, Daily Flow, Obligated Available Number) MGD MGD MGD MGD Flow Capacity*** LS No. 19 0.288 0.115 0.108 0.044 0.060 0.055 * The Firm Capacity 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. *** A Planning Assessment Addendum shall be attached for each pump station located between the project connection point and the WWTP where the Available Capacity is < 0. Downstream Facility Name (Sewer): New Bern WWTP Downstream Peuniit Number: NC0025348 Page 1 of 6 FTSE 04-16 III. Certification Statement: I Foster Hughes, Int. City Manager 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 perfotiiied 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 indicates acceptance of this wastewater flow. Signing Official Signature aN Date Page 2 of 6 FTSE 04-16 PLANNING ASSESSMENT ADDENDUM (PAA) Submit a planning assessment addendum for each pump station listed in Section II where Available Capacity is < 0. Pump Station (Name or Number): Given that: a. The proportion and amount of Obligated, Not Yet Tributary Daily Flow (C) accounts for % and MGD of the Available Capacity (E) in Pump Station ; and that b. The rate of activation of this obligated, not yet tributary capacity is currently approximately MGD per year; and that c. A funded Capital Project that will provide the required planned capacity, namely is in design or under construction with planned completion in ; and/or d. The following applies: Therefore: Given reasonably expected conditions and planning information, there is sufficient justification to allow this flow to be permitted, without a significant likelihood of over -allocating capacity in the system infrastructure. I understand that this does not relieve the collection system owner from complying with G.S. 143- 215.67(a) which prohibits the introduction of any waste in excess of the capacity of the waste disposal system. Signing Official Signature Date Page 3 of 6 FTSE 04-16 Instructions for Flow Tracking/Acceptance form (FTSE) and Planning Assessment Addendum (PAA) Section I a. WWTP Facility Name: Enter the name of the WWTP that will receive the wastewater flow. b. WWTP Facility Permit #: Enter the NPDES or Non -Discharge number for the WWTP receiving the wastewater flow. c. WWTP facility's permitted flow, MGD: From WWTP owner's NPDES or Non -Discharge permit. d. Estimated obligated flow notyet tributary to the WWTP, MGD: This includes flows allocated to other construction projects not yet contributing flow to the collection system. Flows allocated through interlocal agreements or other contracts not yet contributing flow to the collection system are also included. For POTWs that implement a pretreatment program, include flows allocated to industrial users who may not be using all of their flow allocation. Please contact your Pretreatment Coordinator for information on industrial flow tributary to your WWTP. As of January 15, 2008 the POTW should have reviewed flow allocations made over the Last two years and reconciled their flow records, to the best of their ability, so it is known how much flow has been obligated and is not yet been made tributary to the WWTP, in accordance with local policies and procedures employed by the reporting entity. e. WWTP facility's actual avg. flow, MGD: Previous 12 month average. f. Total flow for this specific request, MGD: Enter the requested flow volume. g. Total actual and obligated flows to the facility, MGD Equals [d + e + f] h. Percent of permitted flow used: Equals [(g / c)*100] For example: On January 15 a POTW with a permitted flow of 6.0 MGD, reported to the Regional Office that there is 0.5 MGD of flow that is obligated but not yet tributary. The annual average flow for 2007 is 2.7 MGD. There is a proposed flow expansion of 0.015 MGD. The first Form FTSE submitted after January 15, 2008 may have numbers like this: c. = 6.0 MGD d. = 0.5 MGD e. = 2.7 MGD £ = 0.015 MGD g. = 3.215 MGD h. = 53.6 % The next Form FTSE may be updated like this with a proposed flow expansion of 0.102 MGD: c. = 6.0 MGD d. = 0.515 MGD e. = 2.73 MGD f. = 0.102 MGD g. = 3.349 MGD h. = 55.8 % Each subsequent FTSE form will be updated in the same manner. Page 4 of 6 FTSE 04-16 Section 11 List the pump station name or number and approximate pump station firm capacity, approximate design average daily flow (A) approximate current average daily flow (B), and the obligated, not yet tributary flow through the pump station (C) for each pump station that will be impacted by the proposed sewer extension project. Calculate the total current flow plus obligated flow (D=B+C) and the available capacity (E=A-D). Include the proposed flow for this project with other obligated flows that have been approved for the pump station but are not yet tributary (C). Firm capacity is the maximum pumped flow that can be achieved with the largest pump out of service as per the Minimum Design Criteria. Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor (pf) of not less than 2.5. If the available capacity (E) for any pump station is < 0, then prepare a planning assessment for that pump station if the system has future specific plans related to capacity that should be considered in the permitting process. (A) (B) Design Firm Average Pump Station Capacity Daily Flow (Name or Number) MGD (Firm / pf) Kaw Creek PS 0.800 0.320 Approx. Current Avg. Daily Flow, MGD (C) (D)=(B+C) (E)=(A-D) Obligated, Not Yet Total Current Tributary Flow Plus Daily Flow, Obligated Available MGD Flow Capacity* 0.252 0.080 0.332 -0.012 Valley Road PS 1.895 0.758 0.472 0.135 0.607 0.151 Page 5 of 6 FTSE 04-16 Planning Assessment Addendum Instructions Submit a planning assessment addendum for each pump station listed in Section II where available capacity is<0. A planning assessment for Kaw Creek PS (see example data above) may be performed to evaluate whether there is significant likelihood that needed improvements or reductions in obligated flows will be in place prior to activating the flows from the proposed sewer extension project. If the system decides to accept the flow based on a planning assessment addendum, it is responsible to manage the flow without capacity related sanitary overflows and must take all steps necessary to complete the project or control the rate of flow to prevent sanitary sewer overflows. The planning assessment may identify a funded project currently in design or construction, or a planned project in the future not yet funded but in a formal plan adopted by the system. The system should carefully weigh the certainty of successful timely project completion for any expansion, flow management diversion or infiltration and inflow elimination projects that are the foundation of a planned solution to capacity tracking and acceptance compliance. For example: Given that: a. The proportion and amount of obligated, not yet tributary flow accounts for 24 % and 0.080 MGD of the committed flow in Pump Station Kaw Creek; and that b. The rate of activation of this obligated, not yet tributary capacity is currently approximately 0.01 MGD per year; and that c. A funded capital project that will provide the required planned capacity, namely is in design or under construction with planned completion in ; and/or d. The following applies: The master plan and ten year capital plan contain recommended scope and funding for a capital project entitled Kaw Creek Pump Station upgrade with funding planned in July 2014. This project is planned to add 0.100 MGD to the firm capacity of the pump station by October 2015. Inclusion of this proposed capital project as a condition of this Flow Tracking/Acceptance for Sewer Extension Permit Application elevates this project's priority for funding and construction to be implemented ahead of the activation of obligated, not yet tributary flows in amounts that exceed the firm pump station capacities identified in Section II above. Therefore: Given reasonably expected conditions and planning information, there is sufficient justification to allow this flow to be permitted, without a significant likelihood of over -allocating capacity in the system infrastructure. Page 6 of 6 FTSE 04-16