WQ0042670_Application (FTSE)_20210708

Letter of
Transmittal
To:
Water Quality Section
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
Piedmont Design Associates, P.A.
Suite 101 Westfield Center, 125 East Plaza Drive
Mooresville, NC 28115
Phone: [phone] Fax: [phone]
Email: cfoster(a1pdapa.com
Website: www.pdapa.com
NCBELS License #: 1007
Air r,,.
Job Number: 2021-06-03
Charleston Ridge Dr. — Charleston Meadow Loop
tnviroint
irnent of ?
'cal Quality
JUL p U 2021
Winston-Salem
Regional Office
DATE
July 6, 2021
COPIES
NO.
DESCRIPTION
1
Plans for Charleston Ridge Dr. — Charleston Meadow Loop
2
Fast Track Application
2
Maps of Property
2
Cover Letter
1
Check for Review Fee
These are transmitted
® For approval
❑ For your use
❑ As requested
® For review & comment
❑ FOR BIDS DUE:
REMARKS:
❑ Approved as submitted 0 Resubmit 0 copies for app.
❑ Approved as noted ® Submit 0 copies for dist.
❑ Returned for 0 Return 0 corrected prints
corrections
If you have any questions please conwt myself or Donald Munday of our office.
Signed:
1 Engineering Design Tech.
cc: Neff Wilson

PIEDMONT DESIGN ASSOCIATES, P.A.
125 East Plaza Drive, Suite 101 Engineering
Mooresville, NC 28115 Surveying
Telephone [phone] Fax [phone] Planning
NCBELS License # C-1007
Email: dmunday(cilpdapa.com
June 25, 2021
NCDEQ-DWR
Winston-Salem Regional Office, Water Quality Section
450 W. Hanes Mill Road
Suite 300
Winston-Salem, NC 27105
RE: Charleston Meadow Loop
Mocksville, Davie County, North Carolina
This a submittal for a new single family detached residential subdivision with thirty-eight lots located off of Charleston
Ridge Drive in Mocksville, Davie County North Carolina. The development will contain a mix of nineteen three
bedroom and nineteen four -bedroom homes with a daily design flow of 15,960 gallons/day. The development will be
served by an eight -inch gravity sewer line extension consisting of approx. 1,366 feet of 8" PVC pipe and eight
manholes.
Included with this submittal are the following items:
• Application fee of $480.00 payable to NCDEQ
• Completed Fast Track Application Form FTA 06-21
• 8.5-inch x 11-inch color copy of a USGS Topographic Map identifying the project area and closest surface
waters.
If you have any questions, comments or concems, please feel free to contact us at [phone].
Yours truly,
PIEDMONT DESIGN ASSOCIATES, P.A.
Donald L. Munday, PE
cc. Jeff Wilson

DW It
Division of Water Resources
State of North Carolina
Department of Environtnental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 06-21 & SUPPORTING DOCUMENTATION
Application Number (to be completed by MR)
All items ntust be completed or the application will be returned
1. APPLICANT INFORMATION:
1. Applicant's name: Town of Mocksville (company, municipality, /10A, utility, etc.)
2. Applicant type: 0 Individual
❑ Federal
0 Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
0 State/County ►/ Municipal 0 Other
3. Signature authority's name: Kenneth Gamble. per 15A NCAC 02T .0106(b)
Title: Town Manager
4. Applicant's mailing address: 171 South Clement Street
City: Mocksville State: NC Zip: 27028-
5, Applicant's contact information:
Phone number: [phone] Email Address: kgamble(rtniocksvillene.gov
TI. PROJECT INFORMATION:
I. Project name: Charleston Ridae Dr. - Charleston Meadotv Loop
2. Application/Project status:
® Proposed (New permit) ❑ Existing Permit/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: Davie
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.886985' Longitude: -80.551853'
5. Parcel ID (if applicable): 5748016116 (or Parcel ID to closest downstream sewer)
II[. CONSUL'TAN'F INFORMATION:
1. Professional Engineer: Donald L. MundayLicense Number: 017327
Firm: Piedmont Design Associates PA
Mailing address' 125 E. Plaza Dr. Suite 101
City: Mooresville
State: NC Zip: 28115-
Phone number; [phone] Email Address: (hnundaydbpdapa.cont
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Dutchman's Creek W1VTP Permit Number: NC0021491
Owner Name: Town of Mocksville
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
I. Permit Number(s): WQ
2. Downstream (Receiving) Sewer Inlbrnmtion: inch ❑ Gravity ri Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS_�,_
Owner Name(s):
FORM: FTA 06-21 Page 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 El N/A
3. lithe Applicant is a Home/Property Owners' Association, has an HOA/POA Operational Agree, tit (FORM: HOA) and
supplementary documentation as required by 15A NCAC 02T0115(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 0 Medical / dental / veterinary facilities
❑ Food and drink facilities 0 Church
❑ Businesses / offices / factories ❑ Nursing home
❑ Car Wash
❑ Hotel and/or Motels
❑ Swimming Pool/Clubhouse
❑ Swimming Pool/Filter Backwash
❑ Other (Explain in Attachment)
5. Nature of wastewater ; WO % Domestic %Commercial % Industrial (See 15A NCAC 02T .0103(201)
If Industrial, is there a Pretreatment Program in effect? 0 Yea❑ No
6. Has a flow reduction been approved under I5A NCAC 02T .0114(0? 0 Ycs El No
> If yes, provide a copy of Flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (sec 02T.0114(0)
Daily Design Flow °,4
No. of Units
Flow
Single family detached homes (3 bedrooms)
360 gal/day
19
6,840 GPI)
Single family detached homes (4 bedrooms)
480 gal/day
19
9,120 GPI)
gal
GPD
gal/
GPD
gal/
GPD
gat/
GPD
Total
15,960 GPI)
a See I5A NCAC 02T .0114021j4 (e)(O and(c)(2) for caveats to wastewater design Clow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilties located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway t be used as vacation rentals as defined
in G.S. 42A-4).
b Per I5A NCAC 02T .0114(c), design flow rates for establishments not identified [in table I5A NCAC 02T.01141 shall be
determined using available flow data, water using fixtures, occupancy of operation patterns, and other pleasured data.
8. Wastewater generated by project: 15 960 GPI) (per ISA NCAC 02T .0114)
➢ Do not include fott re flows or previously permitted allocations
If permitted flow is zero, please indicate why:
❑ Pump Station/Force Main or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line.
Please provide supplementary information indicating the approximate timc(rame for permitting upstream sewers with flow.
0 Flow has already been allocated in Permit Number: Issuance Date:
❑ Rehabilitation or replacement of existing sewers with nu ucw flow expected
❑ Other (Explain):
FORM: FTA 06-21
Page 2 of 5

VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
I. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
1365.77
Material
y Section II & III of the MDC. for Permitting of. Gravity Sewers contains information rota ed to design criteria
Y Section Ifl contains information related to minimum slopes for gravity sewer(s)
D Oversizing lines 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 TILES 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 clay (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
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
fcct total dynamic head (TDH)
Material
_ME
If any portion of the force stain is less than 4-inches in diameter; please identify the me hod of solids reduction per
MDCPSFtvt Section 2.0IC. Lb. ❑ Grinder Pump ❑ Mechanical Dar Screen ❑ Other (please specify)
6. Power reliability in accordance with l5A NCAC 02'1'.0305(1 )(1):
❑ Standby power source or ❑ Standby pump
> Must have automatic activation and telemetry - I5A NCAC 02T.0305(10(I)(13)_
9 Required for all pump stations with an average daily Clow greater than or equal to 15,000 gallons per day
i illust 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)(I)(C):
❑ Portable power source with manual activation, quick -connection receptacle and telemetry -
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry:
D Include documentation that the portable source is owned or contracted by the applicant and is compatible with the station.
Y 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 pump, including travel timcframcs, shall be provided
as part or this permit application in the case of a multiple station power outage.
FORM: PTA 06-21 Page 3 of 5

►X. SETBACKS & SEPARATIONS —(02B .0200 & 15A NCAC 02T .0305(1)):
I. Does the project comply with all separations/alternatives found in 15A NCAC 02T .0305(t) & (g)?
I SA NCAC. 02T 0305(D contains minimum separations that shall be provided for sewer systems:
ElYes ❑No
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
18 inches
'Water 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-1 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-1 or WS-V), B, SA, ORW, HQW, or S13 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 with02T.0305(f) or (g) see Section X.1 of this application
*I 5A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(fl, 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 0 No ❑ NIA
Y If no, please refer to 15A NCAC I8C.0906(0 for documentation requirements and submit a separate document,
signed/scaled 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: ® No
If yes, does the project comply with setbacks found in the river basin rules per I5A NCAC 02B .0200? ❑ Yes 0 No
This includes Trout Buffered Streams per I5A NCAC 213.0202
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/permitting status in the cover letter if coverage/authorization is required.
6. Does project comply with I5A NCAC 02T.0105(c)(6) (additional permits/certifications)? - ® Yes 0 No
Per I5A NCAC 0211010juj(6), directly related environment it permits or certification applications oust 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 0211A402, "high -priority sewer" means any aerial sewer, sewer contacting surface waters,
siphon, or sewers positioned parallel to streambanks 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).
Iligh priority lines shall be inspected by the permittee or its representative al least once every six -months and
inspections documented per ISA NCAC 02T.0403(a)(5) or the permittee's individual System -Wide Collection permit.
FORM: FTA 06-21 Page 4 of 5

X. CERTIFICATIONS:
I. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pum aj 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:
1, Donald L. Munday , attest that this application for Charleston Ridge Drive -Charleston Meadow Loop
(Professional Engineer's name from Application Item 111.1,) (Project Name from Application Item It.l)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans,
specifications, engineering ctttculations, and all other supporting documentation to the best of my knowledge. 1 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 Pomp 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 143-215.613, 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 510,000, 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 boar I. (21 NCAC 56.0701)
North Carolina Professional Engineer's seal, signature, and date:
0111111110
(N C ,,,, /
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J�LIJ.tF4Ny\\\\
3. Applicant's Certification per ISA NCAC 02T .0106(b): C.4 te4!I1' of ,'Y'�e /]rL/G "
[ trelr4" c s 'ys. ,� , attest that this application for le w? /"7 't'od ea/a�-^--�
(Signature Authority Name from Application Item 1.3.) (Project Name from Application Item 11.11
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 docunientatinn
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. 1 will make no claim against the Division
of Rater Resources should a condition of this permit be violated. 1 also understand that if all required parts of this application
package are not completed and that if all required supposing information and attachments are not included, this application
package will be returned to ate as incomplete.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.611, 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 Sj0,000as well as civil penles up to $25,000 per violation.
Signature:
Dale: e'd 2'4 Z
FORM: ETA 06-21 Page 5 of 5

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FEET
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