WQ0042799_Application (FTSE)_20210816

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 06-21 & SUPPORTING DOCUMENTATION
Application Number: U/Qb0 NZ 7Q q (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Town of Woodland (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State.'County ® Municipal ❑ Other
3. Signature authority's name: David Cooper per I5A NCAC 02T .0106(b)
Title: Mayor Pro Tern
4. Applicant's mailing address: 123 East Main Street
City: Woodland State: NC Zip, 27897 {�nvitom"",Quad
U to
5. Applicant's contact information: 'NC eP
Phone number: 2�) 587-7161 Email Address: [e-mail] ; ,1 it
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H. PROJECT INFORMATION:
1. Project name: Collection System., ImRrovements. 2020 k ,
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: Northampton
4. Approximate Coordinates (Decimal Degrees): Latitude: 36.33513' Longitude:-77.21729'
5. Parcel ID (if applicable): 5924-55-0666 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: M. Blaine Hum hre License Number: 22987
Firm: Rivers and Associates, Inc.
Mailing address: P.O. Box 929
City: Greenville State: NC Zip: 27835
Phone number. L52) 752-4135 Email Address: bhumphrey(a-)riversandassociates.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name. Town of Woodland WWTF Permit Number: W00004910
Owner Name: Town of Woodland
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ0004910
2. Downstream (Receiving) Sewer Information: 8 inch _ Gravity ® Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCSD00}0
Owner Name(s): Town of Woodland
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 ® N, A
3. If the Applicant is a Home.:Property Owners' Association, has an HOA.IPOA 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) ❑ Car Wash
® Residential (Leased) ® Retail with food preparation;'service ❑ Hotel and/or Motels
® School preschool day care ® Medical i dental.," veterinary facilities ❑ Swimming Pool/Clubhouse
® Food and drink facilities ® Church ❑ Swimming Pool/Filter Backwash
® Businesses offices!' factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 67 % Domestic 33 % Commercial 0 % Industrial (See 15A NCAC 02T .W03(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' b
NIA gaV
gall
gall
gaV
gat/
gal/
No. of Units
Flow
0 GPD
GPD
GPD
GPD
GPD
GPD
Total
0 GPD
a See 15A NCAC 02T .01 14(b), (d). (e)(l) 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 .01 M(c), design flow rates for establishments not identified [in table 15A NCAC 02T.01 141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 0 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 permitted in subsequent permits 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:
® Rehabilitation or replacement of existing sewers with no new flow expected
❑ Other (Explain):.___
FORM: FTA 06-21 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDCf Gravity ewer
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
10
37
PVC
12
20
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 lines to meet minimum slope requirements is not allowed and a violation of the MDC
V1I1. 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: Litt Station # 1
2. Approximate Coordinates (Decimal Degrees): Latitude: 36.33513' Longitude:-77.21729'
3. Total number of pumps at the pump station. 2
3. Design flow of the pump station:.432 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): 300 gallons per minute (GPM) at 88.2 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
6 80 DIP
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 I SA NCAC 02T .0305(h)([ :
® Standby power source or ❑ Standby pump
➢ Must have automatic activation and telemetry - 15A NCAC 02T.0305(h)(1)(13)_
➢ 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.
FORM: FTA 06-21 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
I. Does the project comply with all separations/alternatives found in 15A N.CA.0 02T .0305(fl.&IS) ® Yes ❑ No
15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems:
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
18 inches
ZWater mains (vertical - water over sewer preferred, including in benched trenches)
18 inches
'Water mains (horizontal)
10 feet
Reclaimed water lines (vertical - reclaimed over sewer)
18 inches
Reclaimed water lines (horizontal - reclaimed over sewer)
2 feet
**Any private or public water supply source, including any wells, WS-1 waters of Class I or
Class 11 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 (01 see Section X.1 of this application
* 15A NCAC 02T.0305W contains alternatives where separations in 02T.005(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 we a e
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.
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 15A NCAC 02B .0200? ❑ Yes ❑ No
➢ This includes Trout Buffered Streams per 15A NCAC 213.0202
5. Does the project require coverage..'authorization under a 404 Nationwiderindividual 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 15A NCAC 02T.0105(c)(6) (additional permits. -:Certifications)? ® Yes ❑ No
Per 15A NCAC 92T.0I05(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.).
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 streambanks that are subject to erosion that undermines or deteriorates the sewer.
Siphons and sewers suspended through interferencelconflict 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 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Desien Criteria for the Permitting, of Pump Stations
and Force M;iins (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 besubiect 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 proiect, the full technical review is required.
2. Professional Engineer's Certification.
1, M. Blaine Humphrey , attest that this application for Collection System Improvements 2020
(Professional Engineer's name from Application Item III.1.) (Project Name from Application Item 11.1)
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 141.215.6131, 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 S 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: ��•� VA CA
offs
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3. Applicant's Certification per 15A NCAC 02T .0106(b):
1, David Cooper , attest that this application for Collection System Improvements 2020
(Signature Authority Name from Application Item 13.) (Project Name from Application Item II.I)
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 information and attachments are not included, this application
package will be returned to me as incomplete.
NOTE In accordance with General Statutes 143-215.6A and 143-215.6B, 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.
Signature: P_UJ_ �4 _ Date;
FORM: FTA 06-21 Page 5 of 5

J-4PIthe s ENGINEERS PLANNERS SURVEYORS LANDSCAPE ARCHITECTS
& ASSOCIATES. INC.
n0anue::\�rl
TO: DWR- Raleigh Regional Office
CC: Raymond Eaton, Public Works Dire,
Stephen Reece, E.I., Rivers and Associates
FROM: Blaine Humphrey, P.E. 'tonal Uffice
DATE: August 13, 2021
Rale'g�' Reg
SUBJECT: Fast -Track Application Narrative
Town of Woodland - Lift Station 91 Replacement
File 2020093 D
The purpose of this memorandum is to provide a narrative of the Town of Woodland's Lift
Station #1 Replacement project to accompany the project's Fast -Track Application.
This project's proposed improvements to be permitted include complete replacement of the
existing pump station with similar capacity pump station on the same site. The project will also
include approximately 37 LF of 10" and 20 LF of 12" Gravity Sewer, approximately 80 LF of 6"
DIP force main, two new manholes, a manual bar screen vault and new emergency generator.
These improvements are being installed to replace the existing 40-year-old pump station and
portions of gravity sewer installed in the 1940's.
The peaking factor for the pump station is assumed to be 2.5 based on previous pump station
capacity. The wet well volume and pump flow rate were designed to have a flow of
approximately 300 GPM, maintaining existing pump station capacity with no increase in flow.
Pumps will operate with a total dynamic head of 88 ft. The Permit Application is requesting zero
(0) additional flow, since funding for the project will not allow an increase pumping capacity.
This pump station pumps directly to the Town of Woodland's WWTP.
VC Dcpt afEviviFARmfR itl Qu11
AUG 16 2021
Raleigh Regional Offi00 -
107 E. Second Street, Greenville, NC 27858 ■ PO Box 929, Greenville, NC 27835 ■ Phone- 252-752-4135 • Fax, 252-752-3974
NCBELS Lic. No- F-0334 www.riversandassociates.com NCBOLA Lic. No. C-312

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fivers ENGINEERS
& ASSOCIATES, INC.
Mr. Jason Robinson, P.E.
NCDEQ Division of Water Resources
Raleigh Regional Office
3800 Barrett Drive
Raleigh, North Carolina 27609
PLANNERS
August 13, 2021
SUBJECT: Town of Woodland Lift Station #1 Replacement
Fast Track Application and Permitting
Rivers File 2020093-D
Dear Mr. Robinson:
SURVEYORS LANDSCAPE ARCHITECTS
NC A pt A fEDVirQDMCRtAl Quality
AUG 16 202,
Raleigh Regional pffie8
On behalf of the Town of Woodland, we are submitting a Fast -Track applications for the Lift Station # 1
Replacement Project. This project will include the installation of new gravity sewer, a new pump station,
and force main which will tie into an existing force main. Specifics for the improvements are included in
the Application Narrative.
Enclosed are the following required documents:
• One (1) check in the amount of $480.00 for the application fee
• Two (2) copies of the project narrative
• One (1) original and one (1) copy of the executed application form
• Two (2) maps showing the location of the proposed improvements (one (1) Quad map and one (1)
aerial map)
Should you have any questions or if we can provide any additional information that will provide a
favorable review, please do not hesitate to contact our office at [phone].
Respectfully,
Blaine Humphrey,
Project Manager
cc: Raymond Eaton, Town of Woodland
Stephen Reece, E.I., Rivers and Associates
File 2020093-D
P: -Muni, Woodland Lift Station_No! Replacement 201009YADMI.VD.-PermittingTast Track Cover Letter.doc
107 E. Second Street, Greenville, NC 27858 ■ PO Box 929, Greenville, NC 27835 ■ Phone: [phone] ■ Fax. [phone]
NCBELS Lic. No, F-0334 www.riversandassociates.com NCBOLA Lic, No. C-312