WQ0036030_Application (FTSE)_20120727

2
0
F
a
g
0
LL
Z
Z
a
J
a
IL
a
Q
Z
0
1--
a
0
U.
Z
r2
W
IL
4s
USE THE TAB KEY TO MOVE FROM FIELD TO FIELDI Application Number: (to
/' /1 ..
(to be completed by DWQ) (!/ (/Q3&")J0
1. Owner/Permittee:
la. Cityof Southport
Full Legal Name (company, municipality, HOA, utility, etc.)
1 b. Pat Thomas City Manager
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials!)
1 c. The legal entity who will own this system is:
❑ Individual ❑ Federal ® Municipality ❑ State/County ❑ Private Partnership ❑ Corporation ❑ Other (specify).
1d. 201 E Moore Street le. Sou
Mailing Address City
1f. North Carolina 1g.
State
1 h. 910-457-7936 1 i. tj.
Telephone Facsimile
Zip Code
E-mail
2. Proiect (Facility) Information:
2a. Highland Park SYw[r- 2b. Brunswick
Brief Project Name (permit will refer to this name) County Where Project is Located
3. Contact Person:
32. Garry S. Pape, P.E. —GSP Consulting
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b. 910-"2-7870 3c. [e-mail]
Phone Number E-mail
1. Project is ® New ❑ Modification (of an existing permit) If Modification, Permit No.:
2. Owner is Z Public (skip to Item B(3)) ❑ Private (go to Item 2(e))
2a. If private, applicant will be 2b. If sold, facilities owned by a (must choose one)
❑ Retaining Ownership (i.e. store, church, single office, etc.) or ❑ Public Utility (Instruction C)
❑ Leasing units (lots, townhomes, etc. - skip to Item B(3)) ❑ Homeowner Assoc./Developer (Instruction D)
❑ Selling units (lots, townhomes, etc. - go to Item B(26))
3. Brunswick County
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
4a. Brunswick County - West Brunswick Regional WRF 4b. W 00023693
Name of WWTF 1MNTF Permit No.
_ South - :Receiving S.... _. _...._ ty___
5a. City of Southport ;56 ® Grave bc.
Owner of Downstream Sewer ', g ewer Size 0 Force Main I Permit M of Downstream Sewer (instruction E) -
6. The origin of this wastewater is (check all that apply):
® Residential Subdivision
❑ Apartments/Condominiums
❑ Mobile Home Park
❑ School
❑ Restaurant
❑ Office
❑ Retail (Stores, shopping centers)
❑ Institution
❑ Hospital
❑ Church
❑ Nursing Home
❑ Other (specify):
% Domesbc/Commercial
% Industrial (attach
description.)
(RO: contact your Regional Office
Pretreatment staff)
% Other (specify):
7. Volume of wastewater to be allocated or permitted for this particular project: 1,440 gallons per day
`Do not include future flows or previously permitted allocations
8. If the permitted flow is zero, indicate why:
❑ Pump Station, Outfall or Interceptor Line where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit No.
❑ Rehabilitation or replacement of existing sewer with no new flow expected (see 15A NCAC 02T .0303 to determine if a
permit is required)
FTA12/07

Q
W
7
Z
Z
O
U
v
Z
_0
Q
O
LL
Z_
H
W
a
ii
9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2T .0114 for
the value in Item B(7) AND/OR the design flow for line or pump station sizing if a reduced or zero flow is being requested in
Item B(7). Values other than that in 15A NCAC 2T .0114 (b) and (c) must be supported with actual water or wastewater use
data in accordance with 15A NCAC 2T .0114 (f).
6 single family lots x 3 bedrooms/unit x 80 gpolbedroom =1,440 gpd
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches)
8" DIP
Length (feet) New Gravityor Additional
Force Main
367.7' Gravity
11. Summary of Pump Stations w/ associated Force Mains to be Permitted (attach additional sheets as necessary)
Pump Station Location ID (self chosen - as shown on planslmap for reference)
Design Flow Operational Point Power Reliability Option
(MGD) GPM @TDH 1 -permanent generator w1ATS; Force Main Size Force Main Length
2 - portable generator w1MTS
Pump Station Location ID (self chosen -as shown on planslmap for reference)
Design Flow Operational Point Power Reliability Option
(MGD) GPM @TDH 1 -permanent generator w/ATS; Force Main Size Force Main Length
2 - portable generator w1MTS
Pump Station Location ID (self chosen - as shown on plans/map for reference)
Design Flow Operational Point Power Reliability Option
(MGD) GPM @TDH 1 -permanent generator WATS; Force Main Size Force Main Length
2 - portable generator w/MTS
12. Will the wastewater flow in the proposed sewer lines or pump stations be able to be directed to another treatment facility?
❑ Yes ❑ No If Yes, permit number of 2n° treatment facility
(RO — if "yes" to B,12 please contact the Central Office PERCS Unit)
13. Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force
Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC Chapter 2T as
applicable?
® Yes ❑ No If No, please reference the pertinent minimum design criteria or regulation and indicate why a
variance is requested. SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS
PERTINENT TO THE VARIANCE WITH YOUR APPLICATION
wit im
r7i

14. Have the following permits/certifications been submitted for approval for the system or project to be served?
Wetland/Stream Crossings - General Permit or 401 Certification? ❑ Yes ❑ No ® N/A
Sedimentation and Erosion Control Plan? ® Yes ❑ No ❑ N/A
Stormwater? ® Yes ❑ No ❑ N/A
-15. Does this project include any high priority lines, [see 15A NCAC 02T .0402 (2)] involve aerial lines, siphons, or interference
manholes)? These lines will be considered high priority and must be checked once every six months
Check if Yes: ❑ and provide details
it . Owner/Permittee's Certification: (Signature of Signing Official and Project Name)
i 1, Pat Thomas , attest that this application for Highland Park Subdivision has been reviewed by me
and is accurate and complete to the best of my knowledge, I understand that it all required parts of this application are
not completed and that N all required supporting documentation and attachments are not included, this application
package is subject to being returned as incomplete. Note: In accordance with North Carolina General Statutes 143-
215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or certification in any
application 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.
Signing Off icia'(Signaiure Date
ENGINEERING DESIGN DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL OF THIS
APPLICATION. THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR PROXIMITYI
toll TO OTHER UTILITIES, DESIGN CALCULATIONS. ETC. REFER TO 15A NCAC 02T .0305
Z
O
Q2. Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
:1 1, Garry S. Pane. P.E. , attest that this application for Highland Park Subdivision has been reviewed by me
LL and is accurate, complete and consistent with the information in the engineering plans, calculations, and ail 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
W Gravity Sewers adopted February 12, 1996, and the Minimum Design Criteria for the Fast -Track Permitting of Pump
0 Stations and Force Mains adopted June 1, 2000 and the watershed classification in accordance with Division guidance.
U Although. other professionals may have developed certain portions of this submittal package, inclusion of these materials
under my signature and seal signifies that 1 have reviewed this material and have judged it to be consistent with the
proposed design. Note: In accordance with NC General Statutes 143-215.6A and 143-215.6B, any person who knowingly.
makes any false statement, representation, or certification in any application 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.
2a. Garry S. Pape, P.E.
Professional Engineer Name
2b. GSP Consulting, PLLC.
Engineering Firm
2c. 6626 Gordon Road, Unit C _ 031315
Mailing Address
°N
2d. Wilmington - ;2e. NC 2f. 28411 wi t;• G+IN 1 I .N�
City State Zip ////9R101 �IZO \Z
2g. 910-442.7870 2h. 910-799-6659 2i. 9pape®gsp-consulting.com a y' r
Telephone Facsimile E-mail NC PE Seal, Signature & Date
FfAl2/07

ATFR State of North Carolina
OG Department of Environment and Natural Resources
Division of Water Quality
%Ow Flow Tracking/Acceptance for Sewer Extension Permit Applications
dwp� (FTSE—10/07)
Project Applicant Name: Southport Development Associates
Project Name for which flow is being requested: Hiahland Park Subdivision
More than one FTSE-10107 maybe required for a single project if the owner of the WWTP is not responsible for all
pump stations along the route of the proposed wastewaterflow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: West Brunswick
b. WWTP Facility Permit #: WQ 0023693
All flows are in MGD
c. WWTP facility's permitted flow 6.00
d. Estimated obligated flow not yet tributary to the WWTP 5.384
e. WWTP facility's avg. flow 1.104
f. Total flow for this specific request .0012
g. Total actual and obligated flows to the facility 6.489
h. Percent of permitted flow used o
1.08 /o
II. 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
Pump Station Name Approx. Capacity, MGD Approx. Current Avg.
(Firm/Design) Daily Flow, MGD
Park Avenue 432,000 79,920
III. Certification Statement:
I, Marty Lawing , certify that, to the best of my knowledge, 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. 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 11 for which I am the responsible party. Signature of this form indicates
acceptance of this wgsttewa%ter flow.
/o-2y-
Signing
Date

III
�I
I I
I
r
it II
I
I
=RVI
*(I R
D
MII
I
IT1P
SEVYER O
I
I
LEMOUT10,00o sf
1
(TO)__
II II
J
_
II II
I> I
QI
I
I 2
I
I
10.00000sf
J
II �II
PR(
DAN
V.
I I 1 I
1 \ I
1 1 I
1 11 1
I
I \ I
1
IMA91::CMEI
12,0000 sf 0�
11,250 sf I I 10,500 11`', 10,500II�
I V41
I I I I I I I I I
I I jj
I I 1 1 11 li
L _SEJ L I J L� _J L --rlf�4I" Pic IVATER 5'
�rR CE (TW) M�E Anp
COMMON AREA
1.39 AC. +/- \\
A, 11
10.200
III Y
I I I I I
O II ®\ 1a�l 1 9O
los0oo I � 1 10.500 I "�,�, I o.700
I it
10,214
I I I I \ I
\
—W W W W
9
F17,ffi�
�IRF — -Mp55XEX. 20 PA LENENT SER�PAPoC A YDRANT RIM=19.50PMORLTV�_Iev. 2147
nv In Ele 15.20
Inv Oul Elev 15.10
alI Ilxl I I I I L, I. I
HFl
old"
III I I I I I b� I I
I I
I
C.V.