WQ0042855_Application (FTSE)_20210910

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: WODIU 5S (to be completed by DWR)
All items must be completed or the atmilcation will be returned
1. APPLICANT INFORMATION:
I. Applicant's name: Orange Water & Sewer Authority (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utilit
❑ Federal ❑ State/County ❑ Municipal ® Other
3. Signature authority's name: Todd Taylor, P.E. per 15A NCAC 02T .0106(b)
Title: Executive Director
4. Applicant's mailing address: 400 Jones Ferry Road
City: Carrboro State: NC Zip: 27510-
5. Applicant's contact information:
Phone number: [phone] Email Address: naarker _,owasa.org
II. PROJECT INFORMATION:
I. Project name: Rosemary Street Parking Deck
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ00 _ and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Orange
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.914832" Longitude:-79.055326
5. Parcel ID (if applicable): 9788-37-4748:9788-37-6817
(or Parcel ID to closest downstream sewer)
Ill. CONSULTANT INFORMATION:
1. Professional Engineer: Dillon W. Smith License Number: 042542
Firm: Ballentine Associates, PA
Mailing address: 221 Providence Road
City: Chapel Hill State: NC Zip: 27514-
Phone number: [phone] Email Address: dilions(@bapa.engpro
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Mason Farm Wastewater Treatment Plant Permit Number: NC 0025241
Owner Name: OWASA
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
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I. Permit Number(s): WQ 'NA Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Number(s) (if applicable): WQCS00031
Owner Name(s): Orange Water & Sewer Authority ' Downstream main installed—1947; no permit # available
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FORM: FTA 04-16 Page 1 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 ❑No ®NIA
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEV) been attached?
❑ Yes ❑No ®NIA
3. If the Applicant is a Home/PropeM Owners' Association, has an Operational Agreement (FORM: HOA) been attached?
[—]Yes [—]No ®NIA
4. Origin of wastewater: (check all that apply):
❑ Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential Leased ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School i preschool i day care ❑ Medical!" 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: 100 % Domestic'Commercial % Commercial
% Industrial (See 15A NCAC 02T .0103(20))
�A ls there a Pretreatment Program in effect? ❑ Yes ® No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(f)? ❑ Yes ®No
➢ If Yes, provide a cony of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow"
No. of Units
Flow
Office
25 gal/employee/shift
60
5Q.00 GPD
Public Access Restrooms
325 gal?fixture
16
),40 -GPD
gal.'
GAD
gal:'
GPD
gal,'
GPD
gal.:
GPD
Total
6,700 GPD
1500 np
5200 np
a See 15A NCAC 02T .O114tbt. (d1(eVll and (eV21 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 ofthe 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.01141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 6,700 GPD (per 15A NCAC 02T .0114)
➢ 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 flow expected
❑ Other (Explain):
FORM: FTA 04-16 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (if Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
f A}
➢ 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
Vill. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: - °
3. Design flow of the pump station: millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): gallons per minute at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(I }:
❑ Standby power source or pump with 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
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .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: FTA 04-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T.0305(f)):
i. Does the project comply with all separations found in 15A NCAC 02T .0305(f) & (g)
➢ 15A NCAC 02T.0305(f) contains minimum separations that shall be grovided for sewer systems:
Storm sewers r utilities not listed below v
Water mains vert -water over sewer including i
Water mains {h9 ntal)
Reclaimed water.I$nes (vertical - reclaimed over se
'Reclaimed water. lines (horizontal - reclaimed over
"Any private or public water supply source, including any wells, WS-I waters of Class I or
Class II- impounied reservoirs used as a source of drinking water
"Waters classified WS (except WS-1 or WS-V), B, SA, ORW, HQW, or SB from normal
high water or tide elevation) and wetlands (see item IX.2)
"Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
Any building foundation _
Any basement
Top slope of embankment or cuts of 2 feet or more vertical hei t
Drainage systems and interceptor drains
® Yes ❑ No
ation Required
24 inches
18 inches
10 feet
18 inches
2 feet
100 feet
50 feet
10 feet I
10 feet
10 feet
5 feet
10 feet
Final earth grade (vertical) 1 36 inches
➢ 15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ "Stream classifications can be identified using the Division's NC Surface Water Classifications web a e
➢ If noncompliance with 02T.0305(f) or (g), see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes ❑ No
➢ See the Division's draft separation requirements for situations where separation cannot be meet
➢ No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with all setbacks found in the river basin rules per 15A NCAC 02B .0200? ® Yes [—]No
➢ This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project comply with an individual 404 Permit or any 401 Certifications? ❑ Yes ® No
➢ Wetland -related permits shall be requested, obtained, and adhered to for projects that impact wetlands or surface waters
➢ Information can be obtained from the 401 & Buffer Permitting Branch
5. 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 are 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.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NCAC 02T.0402, "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
➢ 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 ISA NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

.IV "vPl Offt% ronmental Quality
SFP 10 7821
X. CERTIFICATIONS:
I. Does the submitted system comply with 15A NCAC 02T, the Minimum Desi L`hr ire Stations
and Force Mains (latest version), and the Gravity SCwEr Minimum Design Cri - -version) as ap
® Yes ❑ No
If No, complete and submit the Variance.-Altemative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the request is required prior to submittal of the Fast Track Application and suoportine documents.
2. Professional Engineers Certification:
I Dillon W. Smith, PE
(Professional Engineer's name from Application Item 1I1.1.)
attest that this application for
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. 1 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 -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 143-215.613, 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 $10,000, as well as civil penalties up to $25,000 per violation.
North Carolina Professional Engineer's seal, signature, and date: 11�1tt1tlCl��,,////
o�. W `�2���
Q42542
N/ /ONIW-S�\\\`��
3. Applicant's Certification per 15A NCAC 02T .0106(b):
i, Todd Taylor, P.E., Executive Director _ _attest that this application for
(Signature Authority's name & title from Application Item I.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, andlor 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.
L_ Date: 9/10/2021
FORM: FTA 04-16 Page 5 of 5

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08 September 2021
Mr. Danny Smith
Director
NCDEQ Division of Water Resources
Raleigh Regional Office
1628 Mail Service Center
Raleigh, NC 27699-1628
Subject: Rosemary Street Parking Deck
Fast Track Sewer System Extension Cover Letter
Dear Mr. Smith,
B A L L E N T I N E
ASSOCIATES, PA
NC Dept of Environmental Quality
SF1 10 2021
lWaigh Regionat Office
The Rosemary Street Parking Deck project is a parking deck/office building located
along East Rosemary Street in Chapel Hill, NC. Existing gravity sewer mains are in East
Rosemary Street and travels under the existing building through our project site to the north
towards North Street. Approximately, 359 LF of sewer mains will be relocated in East
Rosemary street and around the new Parking Deck.
Please don't hesitate to call me should you have any questions or if you require additional
information.
Yours very truly,
BALLENTINE ASSOCIATES, PA
U ,�% - W.
Dillon W. Smith, P.E.
Engineering Team Leader
m Due Diligence a land Planning a Civil Engineering a Surveying
221 Prov Bence Road Eastowne office Park Chapel Hill, NC 27514 919.929.0481 www.bapa.eng.pro

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources INSTRUCTIONS FOR FORM: FTA 04-16 & 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 15A NCAC 02T and the Division's
Minimum Design Criteria and that plans, specifications and supporting documents have been prepared in accordance with, 15A
NCAC 02T, 15A NCAC 02T .0300, Division policies andgood 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 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 require an environmental assessment in accordance with 15A NCAC I .0100;
➢ Projects that do not meet any part of the minimum design criteria (Iv1DC) document;
➢ Projects that involve a variance from the requirements of 15A NCAC 2T;
➢ Pressure sewer systems utilizing septic tank -effluent pumps (STEPS) or simplex grinder pumps;
➢ 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 of Application and Supporting Documents
® Required unless otherwise noted
B. Cover Letter (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.
➢ If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Major Modification Application Packages):
® Submit a check or money order in the amount of $480.00 dated within 90 days of application submittal.
➢ Payable to North Carolina Department of Environmental Quality (NCDIiQ)
D. Fast Track (Form: FTA 04-16) Application (Required for All Application Packages):
® 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 1.2 is a partnership 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 .0I06
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).
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Pagel of 3

_ State of North Carolina
Department of Environmental Quality
Division of Water Resources
Division of Water Resources Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Orange Water and Sewer Authority
Project Name for which flow is being requested: Rosemary Street Parking Deck
More than one FTSE may be required for a single project if the owner of the fVTVTP is not responsible for all pump
stations along the route of the proposed wastewater flow.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Mason Farm Wastewater Treatment Plant
b. WWTP Facility Permit4: NCO025241
All flows are in MGD
c. WWTP facility's permitted flow 14.5
d. Estimated obligated flow not yet tributary to the WWTP 0.422
e. WWTP facility's actual avg. flow 7.600
f. Total flow for this specific request 0.007 (6,700 GPD)
g. Total actual and obligated flows to the facility 8.029
h. Percent of permitted flow used 55.4
H. 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 i pt7, Daily Flow, Daily Flow, Obligated Available
Number) MGD MGD MGD MGD Flow Capacity***
Rogerson r,,. 18.5 7.4 3.721 0.274 3.995 3.405
* 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): OWASA
Downstream Permit Number: WQCS00031
Page 1 of 6
FTSE 04-16

Ill. Certification Statement:
I Todd Taylor, P.E. 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 indicates acceptance of this wastewater flow.
Signing, Official Sid Lure
9/10/2021
Date
Page 2 of 6
FTSE 04-16

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