WQ0041851_Application (FTSE)_20210831

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Division of Water Resources l5A NCAC 02T .0300 -FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-15 & SUPPORTING DOCUMENTATION
Application Number. Ll%k00 qrJ� ri, be
11 iomp�cd by oWR)
tc s st m red or t�ac 1t Mtltlon Will turAcd
I. APPLICANT INFORMATION:
1. Applicant's name: T (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual
❑ Corporation ❑ General Partnership ❑Privately -Owned Public Utility
❑ Federal ❑ StatelCounty ® Municipal ❑ Other ,x
3. Signature authority's name: kbmpolca per 15A WaLLCMkjn
Title: Utilities Diregiord
b
4. Applicant's mailing address: �35 EaslStreetStreet
0 o
City: Ltttsboro Stale: &C Zip: 273I2-_ �n
5. Applicant's contact information: u31 M
Phone number. ff 42-2510 Email Address. ' t a ittsb c, ov O a
If. PROJECT INFORMATION:
L Project name: N W O
B
2. Application/Project status: ❑ Proposed (New Permit) ® Existing permidpro}ect
If a modification, provide the existing permit number, WQ00418S I and issued date: 09 -01-200
If new construction but part of a inter plan, provide the existing permit number: WQ00
3. County where project is located: him
4. Approximate Coordinates (Decimal Degrees): Latitude: 35,753385 Longitude:-29.1680 3
5. Parcel ID (if applicable): 6723
(or Parcel ID to clm=t downstream sewer)
III. CONSULTANT INFORMATION:
I . Professional Engineer. LVIILULAZO-31 License Number Q243332
Firm: CfiGroup, Inc.
Mailing address: 3Ql GlMwoodAvenue,
City: alei State: NQ Zip: 22ffio -
Phone number: (9-0 3 ,7-gam Email Address; [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: ToMM of Piltsboro lywaler Treatemrnt Facil tlr Permit Number. NCO020354
Owner Name: 1wn of Pittsbere
W. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
I. Permit Number(s). WQ0 = Downstream (Receiving) Sewer Size: 8 inch
$,item W-t0LQJkLiqQ A-- 061_ WQCS -
Owner Name(s): TpmM of Piwibgro
FORM: FTA 04-1 b
Page 1 or5
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 ONO ON'A
2. If the Applicant is a Developer of lots to be sold, has a
.I fi>llBftJXY! been attached?
❑ Yes ONO ®N'A
3. If the Applicant is a, �
d8(- iL1 Q QAI been attached?
❑ Yes ONO ON . -A
4. Origin of wastewater: (check all that apply):
❑ Residential Owned Retail (stores, centers, malls) ❑Car Wash
[® Residential Leased ® Retail with food preparationlservice ® Hotel and/or Motels
] School / preschool / day care ❑ Medical i dental , veterinary facilities ❑ Swimming Pool,'Clubhouse
® Food and drink facilities ❑ Church
Businesses / offices / factories ❑ Swimming Pool/Fiher Backwash
[� Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater : IQO v. Domestic/Commercial _ _ % Commercial
% Industrial
1 Is there a Pretmatmcnt Program in effect? ❑ Yes ® No
6. Has a flow reduction been approved under ? ❑ Yes ® No
1- 1fXMnr9vIdea.SoDyorf1oiv r u don a rove! letter
7. Summarize wastewater gcnerated by project:
Establishment Type (see 2l�7'.DII4fi11
Gas Station (with Restrooms)
Shopping Centers with Food Service
Stores with Food Service (Retail)
Daily Design Flotiv
of Units
Flow
250 galtFixture2
#5c,800
500 GPD
130 gaV1,000 SF
6,610 GPD
130 ga1/1,000 SF
8,400
1,100 GPD
Sall
GPD
gal/
GPD
gal/_
GPD
Total f 8,2 10 GPD
a See 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 `q1,
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A 8,C Sa LL4j shaIl be
determined using available flow data, water using fixtures, occupancy or operation patterns, attains, and other measured data.
B. Wastewater generated by project: #, M GPD (per U4_hC F 0
1: Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new now expected
❑ Other (Explain):
FORM: FTA 04-16
Page 2 of 5

VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - t2T.030A & MDr, (GravitySewers):
1. Summarize gravity sewer lobe permitted:
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 requirement is not allowed and a violation of the MDC
VIIL PUMP STATION DESIGN CRITERIA (If Applicable) & — 5 �T.030 MQC (Coma Station slFarc4,Mains)
:
gom LETg FOR EACH PUMP STATIONASIUDED IN im PROJECT
I. Pump station number or name: NoMwood ML1PD Lift Station
2. Approximate Coordinates (Decimal Degrees): Latitude: 15,756695 Longitude:-79.168053
3. Design flow of the pump station: Q& millions gallons per day (firm capacity)
4. Operational points) of the pump(s): 427 gallons per minute at §j feet total dynamic head (TUW)
5. Summarize the force main to be permitted (for this Pump Station):
Size (Inches) I Leagth (feel) I Materiai
994 j PVC
6. Power reliability in accordance with
Standby power source or pump with 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
Or if the pump station has an average daily flow less than 15,00D gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - I SA NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02r .0305(h)(1)(C):
It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station.
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.
FORM: PTA04-16
Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & I5A NCAC 02T .0305(Q);
I . Does the project comply with all separations found in t 5A [�(' "n�
i A lJI+ ^ n..�.. w-. _.. _ ® Yes
l8i
"Any private or public water supply source, including any wells, WS-1 waters of Class I or
Clacr 11 imnnund...4
"Waters classified WS (except WS-1 or WS-V), B. SA, ORW, HQW, or SB from normal
"Arty other a mem, lake, impoundment, or ground water lowering and surface drainage
ditches
10
or
35 inchet
fJA NCAC 02T.0 0 W contains alternatives where separations in 02T.03UM cannot be achieved.
z •'Stream classifications can be identified using the Division's NC �S st,r �r5ju
D If noncompliance with a; _@�iiLar_L see v Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ®Yes D Seethe Division's drat} separation requirements for situations where separation canrtot bt meet ❑ No ❑ N A
D No variance is required if the alternative design criteria specified is utilized in design and construction
As built documents should rzference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15 0? ❑ Ycs ❑ No O N A
>✓ This would include Trout Buffered Streams per i #,rk NgZ,%f Q;
4. Does the project require coveragelautharization under a 404 Nationwide or
individual permits or 401 Water Quality Certifications? Yes ®No
)~ information can be obtained from the lkU P_mrUju—S WSh
5. Does project comply with (additional permits/cenifications)? ® Yes ❑ No
Per iA NCB , directlyrelated environmental permits or certification a lieations are being been applied for, or have been obtainedIssuance of this permit is contingent on issuance of dependent prepared, have
sedimentation control plans, slormwater management plans, etc.), p permits (erosion and
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per # NSAC A2T.M02, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ yes ® No ❑ N A
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 permitlee or its representative at least once every six -months and inspections
documented per ISA NCAC 02T.0403(a)(5) or the permiter's Individual System -Wide Collection permit.
FORM; FTA 04-16
Page 4 of 5

X. CERTIFICATIONs.
Does the submitted system comply with 15A NCAC 02T, the
ti�tld Face r and the -ewer 1
1�lcria.#��,giLv as applicable?
® Yes ❑ No
If No, complete and submit the variance/Ahemadve Design Request application (VADC 10-14) and supporting documents for
review. AP.RrovolotibL-reguestisreqUiredIDr to submittal orlhe t Track l n r n d u eats.
2. Professional Engineer's Certification:
Z_ - - ` 6WA1 attest that this application for
(Professional Engineer's name from Application Item Ill.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, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Trask Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of time 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 143-215.68, 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.
North Carolina Professional Engineer's seal, signature, and dole: GArlgOf/i,�
ES8l0•.�
1
?ate SEAL r ;
3. Applicant's Certification per 15A NCAC 02TA10b(b):
FMFI�T 101,k tipattest that this application forI, (Anature uthOdt 's na �� title tram Application Item [.3.}
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 141.215 j and LUX5 g, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
! * a
v , Y�y 1�7)
FORM: FTA 04-16
Page 5 of 5

State of North Carolina
4)-W Department of Environmental Quality
Division of Water Resources
-DIvlslon of Water Resources Flow Tracking for Sewer Extension Applications
UISE 10-m
Entity Requesting Allocation: Town of Pittsboro
Project Name for which flow is being requested: Northwood h41JPD
Mare than one FTSE nray be required far a single project !f the owner of the 1Y11rTP & not responsible for all pump
stollens along the route of the proposed rvastelvaterJlowv
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Town of Pittsboro WWTP
b. WWTP pacility Permit #: NCO020354
c. WWTP facility's permitted flow AMaws are in MCb
d. Estimated obligated flow not yet tributary to the WWTp
C. WWTP facility's actual avg. flow
f. Total flow for this specific request 0
g. Total actual and obligated flows to the facility �.
h. Percent of permitted flow used
c�
z
n
b
'a
0
to
ed
ed
Complete this section for each pump station you are responsible for along the route of thipropc�gd
wastewater flow. „_
OList pump stations located between the project connection point and the WWTP: ,p
ca c
Pump
Pump
Station
Station
(Name or
Pcnnit
Number)
No;
(A)
(�)
Design
Average
Approx.
Firm Daily Flow"
Current
Capacity,(Firm / p0,
Avg. Daily
MOD MOD
flow, MGD
(C)
(D)a(H+C)
tz
(E)" (A-D
Obligated,
Not Yet
Total Current
Tributary
Flow Plus
Daily Flow,
Obligated
Available
MOD
Flow
Capacity•••
* The Firm Capacity (design flow of an - — ----
p ty � g ) y pump station is defined as the maxitrnam pumped flaw �-
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
(PI) not less than 2.5, per Section 2.02(A)(4)(e) of the Minimum Desiga Criteria,
*** A planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WIVTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): Town of Pittsboro WWTP
Downstream Permit Number: N00020354
Page I of 6
FT'S E i 0-18

111. Certification statement:
I John Poteat 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 rcceiving
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 1 and 11 plus all attached planning assessment addendums for which 1
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.
TWO
Signature
Signing Official
Page 2 of 6
U {r 3aoz-
Date
USE 10-IS

0
�
�
xm
�■

August 31, 2021
NCDEQ1DWR
Water Quality Section
Fast Track Unit
512 North Salisbury Street
Raleigh, NC 27604
Re: Northwood MUPD — Phase 2
Sanitary Sewer Extension Modification #2
Please find attached the following information for the requested extension permit:
Application Fee: $480
- Fast Track Sewer System Extension Application (FTA 04-16)
Flow Tracking/Acceptance Form (Form: FTSE 04-16)
USGS Topographic Map
Vicinity Map
Final Permit for Northwood
S
Existing Downstream Permit
- Technical Specifications (Remains unchanged from original permit — hard copies not included)
Lift Station Calculations (Remains unchanged from original permit-- hard copies not included)
Electronic CD (Above Info)
The above information is provided as required for processing of the requested permit application for Northwood
MUPD — Phase 1 & 2 Infrastructure plans, consisting of fifteen (15) proposed residential and commercial lots.
This submittal is to add 1,758 LF of 8" DIP sanitary sewer main to the existing permit. There is no additional flow
being requested with this modification. The estimated Daily Design Flow is listed in the calculations as 120,000
GPD. The site will require a lift station to connect to the existing forcemain on the east side of 15-501, the
calculations for which have already been approved.
Respectfully Submitted,
CE Group, Inc.
Mitch Craig, PE
Principal/Project Manager
301 Glenwood Avenue I Raleigh, NC 27GO3 1 019) 3G7-8790 I www.cegroupinc.com
z
0
b

TO: NCDENR -- DWQ
Raleigh Regional Office
3800 Barrett Drive
Raleigh, NC 27609
ATTENTION: Permitting
CE GROUP
301 GLENWOOD AVENUE, SUITE 220
RALEIGH, NC 27603
Phone: [phone]
E-Mail: loe(abcoaroupinc.com
Transmittal
DATE: 08131 /2021
PROJECT NO: 200-1 1 1
Northwood MUPD — Phase 2
Pittsboro, NC
Quantity
Drawing No.
Description
2
1 Original/1 Copy
Fast Track Sewer System Extension Application (FTA 04-16)
2
1 Originalll Copy
Flow Tracking/Acceptance for Sewer Extension Application (FTSE 04-16)
1
Check
Check # 113 for $480 for Application Fee
1
Copy
Cover Letter
1
Copy
USGS Topographic Map
1
Copy
Vicinity Map
1
Copy
Prior Permit Modification (WQ0041851-MOD)
1
Copy
Existing Downstream Permit (W00010602)
1
CD
Electronic Information (Including Previous Technical Specifications n LS Calcs) $'
EFd
o
.{3
REMARKS Please let us know if you require any additional information. c -
Signed
_ CE Group, Inc.
M. Craia. PE