WQ0041010_Regional Office Historical File Pre 2018

DWision crf re'>'r„
State of North
of Environmental
sou of Water Resources
1S'i NCAC 02T .0300 FA:S"T TR CK SEWFR " "t'E: XTF ; 1StOlti APPLICATION
FTA 04• 16 & SUFI'()RTtN( DOCUMENTATION
All items rr
APPLICANT INFORMATION.
I. Applicant's name: I'ilkof r iuccluton (company, into
Applicant type.
Signature authority's trtG
Title: City Mani?e
Appli
rnai liar
ideal L! corporation
C StatelCourity
•ve Zickefoose per
address:. (•m`.1,)..,..go;C 6 ➢ 7
City: l,,i t oli�ori State: NC
Applicant's contact irtfot'tn t
Phone number:
09?-
u , orthea1 9)licrmtia rr, will be rei
General -
Vl rat°t ia�; i pal
j 736-8980 Entail Address: sttevc a?lincolrnttionc.org
H. PROJECT INFORMATION:
l . Project name Sprin rtat Lithia Jura
Application/Project status: l raaposed (New Permit) xistia g'
If a modification, provide, the existing permit. irurnber: 'W'Q00 and isd date:
If new construction. but part of a master plan, provide the existing permit number : WQ
3. County where pr°oject
1 Approximate Coordina
located: Lincoln
(f)t,citnal Degrees)' Latitude:: .35 4 Longitude: -
Parcel. It} (if applicable). (i
(or Parcel ID to closest downstrcaar
III. CONSULTANT INFORMATION:
1. Professional Engineer: Miles A.
Firm Wft h't &Associates
Mailing address:
City: Conover
Phone number: ( l8i) t35: 2
Ave SouEh
NC: Zip:;2Sii3.
Eras i 1 ,Address. tr1
)i and;a
IV. WAS'TEWAT'ER TItFA"TMENT FACILITY (WWTF) INFORMATION:
Facility Name: Lrncolnwn 14V 'P Perr°nit'Nurnber: NCO (
Owner Name. City of Lincoluton
so Number
VRECEIVIN+I.® DOWNSTREAM SEINER. INFORMATION (if' different than WWTF):
Permit Number( ): WO
Owner Name-(
Downstream (Recc
Sewer Sias:
'W QCS.p_
Other
/Project
49.�a
Ublic Utility
FOP M FTA 04- 1 G
Page I of

VI GENERAL REQUIREMENTS
1, If the Applicant is a Privately -Owned. Public Utility, has a Certificate of Public Convenience and Necessity been attached?
© Yes M' No ON/A
2, If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreetxtent(F I M: DEV)
D Yes M iNo ON/A.
pelf`. Owners' _Msxxiatisln, has an OPerational. Agreertt (FARM: HOB been attached?
0 Yes NNo DN/A
e Ap
4. Origin of wastewater: (check alt ti
►� Residential Owned
0 Residential Leased
Q School / preschool ( day care
Food and drink, facilities
0 Businesses / offices / factories
apply):
Q Retail (stores, centers, malls)
0 Retail with food preparation/service
Medical / dental / veterinary facilities
© Church
0 Nursing Horne
Nature of wastewater : 100 % Domestic/Commercial
1.10 Cornmercral.
h
Car Wash
o Hotel and/or Motels
Swimming Pool /Clubhouse
Swimming Pool/Filter Backwash
Q Other (Explain in Attachment)
% Industrial (See 15A NCAC 02T .0I03(20))
there a Pretreatment Program in effect? Yes © No
6. Has a flow reduction been approved under 15A NCAC,", 02T ,01 }4(fl?
➢ if yeti tar vide a copy of flow reduction annroval letter
7. Summarize wastewater generated by project,
stablisbment Type (see 02T.0114(f))
(3 BR) Townhome Units
Yes
Daily Design Flow'"
360 gal/day
No
No. of Units
Flow
gal/
gal/
33
gall'
gall
1880 GPI
GPD
GPD
gal/
Twat
GPD
GPD
GPD
GPD
a See 15A NCAC 2T 4 d t`e)() and (e)(?) 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 ,01 14(c), design flow rates for establishments not identified [in table l5A NCAC 02T.01 l4J shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other treasured data.
wastewater generated by project: 11880 GPD (per 15A NCAC 02T
A Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
D Purnp Station or Gravity Sewer where flow will be permittedsubsequent pe its that connect to this line
0 Flow has already been allocated in Permit Number.
Rehabilitation or replacement ofexistine sewer with no new flow expected
aOther (Explain):
FORM; FTA 04-1 6
Page 2of5

VIE
'ITY S°
1. Su co rnariz.e t,
ER DESIGN' CRITERIA I RIA (It Applicable) -
sewer to be, permitted:
Sectioia tl & III o
.lie
:= Section Ili contains
Y Oversizing tines to meet minima
tt
ed to
lope ref
ravityr Sewers cotlt.e
"n sic
V[ll. PUMP Si ATION DESIGN CRITERIA (if Applicable) _
COMPLETE. FOR EACH PUMP STA"T'IQI
Pump station number or name:._
Approximate Coordinates (Decimal Derws), l atittr Longitude:
3. Design flow of the pump station. nlihiicaras thens per day (fin capacity)
4. Operational point(s) of the pump(s): _ gallons per minute at. _ taat total d5
.5. Summarize the force main to be permitted (for this Pump. Station):
r gravity ssew
allowed a
viol Lion
Size (ltrchcs) Length (feet)
Power reliability in accordar°icevitha
Standby power source or pump mit'
Required. for gall t7
Must be pernaaei
Or if the pui;rp station has an average alail
.1 Portables power source with manual a
.0305(h)(1)(C)
or
Portable prri ag,irag rttrit >viila) tt
t rm<tttt, acfii
s with an avcrtigt. daily
to (lest
(TDH)
ria
and telemetry - 15A NCAC. t02T .03055(li}(1)t',B1
gatate than or'equal to 1:5,000 gal Ions per day
ss tlaatr 15,00t`i
grucP-cannrc
ceptac.Le anc'1 te.
'NCAC, 02T
pump connection and telemetry - 15A NCAC 02T .0305(.h
y� it shall be denicrrtstrated to tits Division that the parable sotwee is owned or contracted by the applicall
and is compatible with the station.
If the portable power source or pump is dedicated to multiple putop stations, an evaluat?ca of all the pump sta it t'as" ton e
capacities and the rotation schedule of the portable power source or pump, including travel time'fraenes, shall be provided
in the case of a multiple station power outage..
FORM: FTA 04-16 Page 3 of 5

R
IX, SETBACKS & S I PARA'TIONS --- (02B ,0200 & 15A.. NCAC 02'1.0305(0):
Does the project c urr
NCAC t":
ru ins (vest
Over" GV
'a er manns (hox-izotitalj
ec.laiitted water lines
(ve t3 ai -s°
ciaittaed water 1ines (hori✓onial
ny private ci public vatei stif
lass 11 mipounded roservait risrr
high w
Any oth
ditches
^tnyr building fuuiadaticon
n�v basement
'or
Fv
t°1
belcaw�€°ticalj
clai:iia in betic heal
ed over serve
iiae l ovvei : es'ei`)
WS-1 wat
.,oft drinking sat
(crept ` `'S-I of 'S-V), B, S{1, OM,.
luvation) and wetlands (see i�tciii lti `.,2)
mop s a e of embankment or cuts o
Dra rtag
Any s1�9mi
FInal ea
e
eni.s and interceptor
rth grade
"Sti•eam classiticati
if noncompliance with
it
s alternatives where separations
iii be iclent?ere1 using the Division's '';
Section X of this application
e1
l0 feet
5 fret
i 0 feet_____.
5 feet
....,.
annot be achieved.
2. Does the project comply artition .grib anaents for wetlands? (50 feet of separationEl Yes l
» See the Division's draft separat.ion.requireo ents 'or situations where separation cannot be meet
➢ No variance is required if the alternative desi 'i criteria specified is utilized in design and construction
As built documents should reference the loccat°iot'i of areas effected
Does the project comply with setback found in the river basin rules per
'This would include Trout Buffered Streain_, per-.`..t.
. Does the project reder a 40.4
iraeliv icier l permits or 401 Wi,itei-
on can be obtained from the
project comply
en applied
ation
Doe,
Per
post
dditional lierriaatsr'ceri:i
;, directly related) envirorirnental per'rnits or curb.
Ti olataiited. Issuance of dos hermit n c oiitiitgesnit o
ns, stori'uwater management plans,
1aro.4ect incliirk an
parallel tc
nicht
ti©n applivatiuiis
suaoce a ;, i et ends
gh-pri+, rit '?"
ines or deter
El Yes El No LI N/A
ticla line, iuciudirii tape
e'A
No
�eang prepared, have
permit (erosion and
aters, siphon„
High priority lines shall be inspected by the Irernrittee or its representative at (east once every six -months an inspections
documented per IS.A NCAC 02T,0403(a)(:) or the permitee's individual System -Wide Collection permit.
FORM. FTA 04-1 t

X. d.."E°,l T1FIC'A'TIONVS:
Does the subinitte,
[i Nc,
if No, ootrtplert, atad uhmit the Variance!, ive Design Bequest ;tpplic.at.ion (VA -2 t0 1 ) and sop
reviraw. proval c'-he request is required EC'ipr'tosubm11tal01 t e ast'1°rack Appliea l rt a d
Pick siunal Enginety "s Certification:
by" me and is accaratc, complete and consistent tM
and ail other Supporting documentation to tit hesi o
the proposed design has been prepared in accordance wi
'a tbr Gravity Sewers (latest version), and the Minimum Design
p Statiotas ratlt,l lrarce fsains i1,tlt.est ver iutij, Although other professionals may have
"-tat package, inclusion of these materials under my signature and seal signifies that
judged. it to be consistent with the proposed design.
d crc a tt1e
vity Sewer
Track Permitting
of°this
an(
NOTE -- in taccrlarlratacc with General Statutes 143-215.OA. and k:I.3-217.0B, any person who knowingly makes any false
statement, repres. titat:itsn, or certification in any application package shall he guilty o' a Class 2 t`rtis ietatt.atlaar, wf11c t aaaray
include a fine. not to exeeed $1.0,000, tis 'swell as civil penalties up to $25,000 per violatiaon.
North Carolina Professional Engineer's seal, signature, and date:
Applicant's Cc.:tif atictn per 1 tiA N(',4C: 02T .0 ! 06(b):
d by me and is acctu°ne and complete to th
t application are neat completed and that if ail required support.
application pack is subject to being returned as incomplete.. 1 in
discharge system. to sua°latr tvatuts ot° t1°to lsancf
ivorelief, an.d!or c.rirni
be violated. 1
equired supporting in'loi
o understand tiara
NOTE - itt accordance with G
statement, representation, or certification
include a fine not to exceed $10,000 as %ve1`i as
Signature
application for
kno wlcdg . 1 unda.z�straod that if al➢ required parIs of
and altacdrtrents ue 'not included, this
any discharge aat titi>astewaateax bona this non-
itn.t action that may frt.cl role czvil petral1
o'Miter Resources shotlrl a condition
package are not completer and that i f
nts are not .lneluded, dais appli atic~rrt package will be scanned to na . as
who knowingly snakes any tilts
Class 2 misdemeanor, which may
FORM: ETA 04-1 o
Page 5 of 5

tlC7 SVNOf
GAVE "Vil
448, s dry,
wirwastga',

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow/ Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Reques i g Alit ation:
Project Name for which flow is being requested: CC Villas of Lincal¢tto
More than one FTSE rnrryy be required for a single profecl if the owner of the WWTP is
stndaus along the /Mute of the proposed wastewater flaw.
( ornplete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Lincolnton WWTP
b. WWTP facility Permit #: NC0025496
c. WWTP facility's permitted :flow
6.0
dM Estimated obligated flow not yet tributary to the WWII' 1.26
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
2.0
0.0119
3.272
54,53%r
Complete this settian for each pump station you are responsible for along the route oaf this proposed
wastewater flow.
List pump stations located be
Pump Pump
Station Stations
(Name or Permit
Number) No.
Firm
Capacity, '0
MGD
The Firrtt Capaci
that can be achieved
e project
(A)
Design
Average
Daily Floor"
(Firm /
MOD
onnection point and the WWTP:
(8)
Approx.
Current
Avg, Daily
Flow, MGD
(C) (D)(a+C) (E) °(A-D)
Obl igated,
Not Yet Total Current
Tributary Flow Plus.
Daily Ftc,v, Obligated Available
MOD Flow Capacity
ow) of any pump statlo'tt is defined as the maxirnutrt pumped flow
gest pump taken out of service.
Design Average Daily Flow is the .firm capacity of the pump station divided by a peaking factor
(pi) not less than 2.5, per Section 2.f2(A)(4)(c) of the Minimum Design. Criteria,
4 " 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): City of Lincolnton WWTP
Downstream Petnnit Number: NC0025496
Page 1 of 6
fTS1. 10-18

Vt. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Ow
Public Utili
a Certificate of Public Convenience and Necessity been attached?
0 Yes No EIN/A
2. if the Applicant is a Developer of lots to be sold, has a Deve ) erational
Ei Yes ENo DN
3. If the Applicant is a Home/Property Owners" Association
El Yes
4.
Origin of wastewater: (check all that apply):
Residential Owned
Residential Leased
El School / preschool / day care
0 Food and drink facilities
Businesses / offices / fac
s an
nt DEV
d?
tional Agreement (FORM: 140&) been attached?
res, centers, malls)
tth food preparation/service
edical / dental veterinary facilities
El Church
0 Nursing Horne
5, Nature ofwastewaLi. 00 % Doinestic/Corrunercial
Comm.ercial
% Industrial. (See 1.5A NCAC 2T ,0.103
L *Is there a Pretreatment Program in
'on been approved under 15A NCAC 0,2T .0114
vide a copy of flowreduction approval letter
ummarize wastewater generated by project.
Establishment Type (see 02T.0114(
R) Townhome Units
a Se
dw
y Design Flow
CAC 02T .01 14(b), (d), (e)(1) and (e)(21 for
proposed unknown non-residential developnie
idential property located south or east of the At
.S. 42A-4).
15A NCAC 021 .0114(c), design flow ra
determined using available flow data, wat
'tewater generated by project: 11880 GP
Do not include future flows or previ
lf permitted flow is zero, indicate
0 Pump Station or Gravity Sew
0 Car Wash
El Hotel and/or
o
Swimmin
0 Swim
0 0
Yes 0 No
Ye VANo
1 /Clubhouse
g Pool/Filter Backwash
(Explain in Attachment)
No. of Units
Total
0 GPD
GPD
11880 GPD
a as to wastewater design flow rates minimum flow per
uses; public access facilities located near high public use areas,
c Intracoastal Waterway to be used as vacation rentals as defined
establishments not identified [in tabde 15A NCAC 02T.0114] shall be
g fixtures, occupancy or operation patterns, and other measured data.
(per 15A NCAC 02 LOIL4)
y permitted allocations
ill be permitted in subsequen
Flow has already been. al cated in Permit Number:
Rehabilitation or re acement of existing sewer with no new flow expected
El Other (Exp
permits that connect to this line
FORM* FTA 04-16
Page '2 of 5

III. Certification Statement:
I Steven Zickefoose 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.
/ .,0317 71/9
Signing Official Signature ate
Title qf Signin Official
Page 2 of b
l'TSE 10-18

GIIT
A ES
209 l" Ave. South • Conover, NC 28613 • [phone]
5/15/19
NCDEQ
Water Quality Section
610 E. Center Ave..
Mooresville, NC 28115
Re: Country Club Villas of Lincolnton
Attached are the following for the above referenced project.
1) One Original and One Copy of the application
2) Application Fee ($480)
3) 8.5x11 color USGS Topo Map
4 Aerial Map
5 deldrd FTS °Poore t
if you have any questions or need any additional information, please let me know.
Thank you,
Miles A. Wright, PE
WOROS
CIVIL ENGINEERS SURVEYORS