WQ0042920_Application (FTSE)_20211020

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. [ W(to be completed by DWR)
All items must be completed or the application will be returned
1. APPLICANT INFORMATION-
1 Applicant's name- Town of Benson (company, municipality, HOA, utility, etc.)
2_ Applicant type! ❑ Individual 0 Corporation ❑ General Partnership
❑ Federal ❑ State/County [a Municipal
3. Signature authority's name: Tim Robbins per 15A NCAC 02T .0106(b}
Title_ Public Utilities Director
4. Applicant's mailing address: 303 E. Church Street
City: Benson State: NC Zip: 27504-
5. Applicant's contact information:
Phone number: [phone] Email Address: trobbins(townofbenson.com
❑ Privately -Owned Public Utility
❑ Other
NC Dept of Environmental Quality
Raleigh Regional Office
II. PROJECT INFORMATION:
1. Project name: McLamb-Byrd Farms
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; 12hng2n
4. Approximate Coordinates (Decimal Degrees): Latitude- 35.382589' Longitude.-78.558342
5. Parcel ID (if applicable): 153913 04-9548 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: C._Scott_Brown, PE License Number- 27452
Firm: 4D Site Solutions, Inc
Mailing address: 409 Chicago Drive, Suite 112
City: Fayetteville State: NC Zip: 8306-
Phone number: [phone] Email Address: [e-mail]
1V. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Town of Benson WWTP Permit Number NCO020389
Owner Name: Town of Benson
V. RECEIVING DOWNSTREAM SEWER INFORMATION;
1. Permit Number(s): WQCS00109
2. Downstream (Receiving) Sewer Information: 8 inch 0 Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s): Town of Benson
FORM: FTA 06-21 Pagel 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 Agreemcni i FORM. DEVI been attached?
❑ Yes [—]No ® NIA
3. If the Applicant is a Home/Property Owners' Association, has an JiQ. 'PoA Operational Agreement (FORM: HOA) and
supplementary documentation as required by 15A NCAC 02T.0115(c) been attached?
[—]Yes El No ® N/A NC De'Pt of Environm�� Quality
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 / dental / veterinary facilities ❑ Swimn9l1lleA'
CC
❑ 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 % Industrial (See 15A NCAC 02T_.019;1.{20))
If Industrial, is there a Pretreatment Program in effect? ❑ Yes❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T_.0114( ? ❑ Yes ®No
)o 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 a 6
No. of Units
Flow
4 bedroom homes
480 gal/day/lot
177
84,960 GPD
gall
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
84,960 GPD
a See 15A NCAC 0210- AW, (11 mil) ono C (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 .0114(c), design flow rates for establishments not identified [in table 15A `UCA J.01 i4] shall
be determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data
8. Wastewater generated by project: 84.960 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 & MDC (Gravity Sewers);
1. Summarize gravity sewer to be permitted -
Size (inches) I Length (feet) I Material
1 8" 1 8,186 1 PVC & DI 1
➢ 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
VIII. 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
Pump station number or name. LS #1
2. Approximate Coordinates (Decimal Degrees). Latitude_ 35.3802061, Longitude:-78.561103
3. Total number of pumps at the pump station- 2
3. Design flow of the pump station: 0,08496 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): 220 9 gallons per minute (GPM) at40.6 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station).
Size (inches)
Length (feet)
Material
6
1,615
C900
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.I.b, ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6 Power reliability in accordance with 15A NCAC 02T .0305(h]l Il:
E Standby power source or ❑ Standby pump
➢ Must have automatic activation and telemetry - 15A NCAC 0210305(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 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.
FORM: FTA 06-21 Page 3 of 5

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 4 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(i)):
1. Does the project comply with all separations/alternatives found in 15A NCAC 02T .0305(ft & (8 ® Yes ❑ No
ISA 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
2Water mains (vertical - water over sewer preferred, including in benched trenches)
18 inches
2Water 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 II impounded reservoirs used as a source of drinking water, and associated wetlands.
100 feet
50 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)
**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
A If noncompliance with Q2T 0305 r ", see Section X. I of this application
* 15A NCAC 02T.0305fct1 contains alternatives where separations in 02T.0305(€} 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 N rface,WaterSI,ifi,Catiors_ebRaSae
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
A Please provide supplementary information identifying the areas of non-conformance.
➢ See the Division's €1_4q se ration 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: Cape Fear ® 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 I5A NCAC 2B.0202
5. Does the project require coverage/authorization under a 404 Nationwidelindividual 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 f2T,4105� 6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NC -AC' 02T.0105 )(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 interference/conflict 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 permtttee 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 5 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 1.5.A Nt AC 0� f, the Minbstan. Design G iteria for the Permitting of Putttp iations
and F rce Mains-(latest-vcrsion), and the 'ravii j)- Sewer Iylirtirnufl—i Desig ritetia ( 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 annroval of the nermit. and nroiects requirin2 a variance annroval may be subiect to longer
review times. For protects requiring two or more variances or where the variance is determinett_by_the Division to he
a significant portion of the proiect, the full technical review is required.
2. Professional Engineer's Certification:
I, C. Scott Brown PE , attest that this application for McLamb-B1yd Farms_
(Professional Lngineer's name from Application Item 11I.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,
Minimtt_m._Desip-n Criteria for Gravity Sewers t4gesi version], and the Minimum Design_ Criteria_ for the fast -Crack
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 seat 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. 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 licpsingiboofd. (21 NCAC 56.0701)
................� ... a r,.j.........................:
North Carolina Professional Engineer's seal, signature, and date: FES • 0 •/�,
,Q
NC Dept of Environmental Quality ' SEAL
027452
s0 . N• 0
i `
R4°� ga
Rdeigh �o a
3. Applicant's Certification per 15A NCAC 02T .0106(b):
1, Tim Robbins attest that this application for _McLamb-B rd Farms
(Signature Authority Name from Application Itent 1.3.) (Project Name from Application item 11.1)
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:
Date: 10 rlot r 'Z�4 Z-I
--
FORM: FTA 06-21 Page 6 of 5

y
Division of W,atef tte•4c�ur. c s
Entity Requesting Allocation: Town of Benson
State of North Carolina
Department of Environmental Quality
Division of Water Resources
FIow Tracking for Sewer Extension Applications
(FTSE 10-18)
Project Name for which flow is being requested: /y{ �a. 6 — Aw Es -runs
More than one FTSE may be requiredfor a slagle project if the owner of the WWTP is not responsible for all puny)
stations alarrg 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: lT__w+J of 099"So
b. WWTP Facility Permit 4: 00
All f rows are in MGD
c. WWTP facility's permitted flow _1.01
d. Estimated obligated flow not yet tributary to the WWTP 0.1_ o
e. WWTP facility's actual avg. flow 1.61
f. Total flow for this specific request O. DyI z
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used 71
0
c�
CD
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)
Design
Pump
Pump
Average
Station
Station
Firm Daily Flow*"
(Name or
Permit
Capacity, * (Firm / pf),
Number)
No.
MGD MGD
(B)
(C)
(D)-(B+C) (E)=(A-D)
Obligated,
Approx,
Not Yet
Total Current
Current
Tributary
Flow Plus
Avg. Daily
Daily Flow,
Obligated Availab:e
Flow, MGD
MGD
Flow Capacity"*
* The Firm Capacity (design flow) 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 pealdng factor
(pi) not less than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
** * 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):
Downstream Permit Number:
Page 1 of 5
FTSE 10-18

III. Certification Statement:
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 It 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.
Signing Official Signature _ ate
►sec-l-of- o'F mbi.G Wor k4
Title of Signing Official
Page 2 of 6
FTSE 10-18

October 19, 2021
NCDEQ
Raleigh Regional Office
Attn: Scott Vinson
3800 Barret Drive
Raleigh, NC 27609
RE: Sewer Application, McLamb-Byrd Farms, Benson, North Carolina
Trent;
Attached is the sanitary sewer application package for McLamb-Byrd Farms in Benson,
NC. A check for the $480 review fee is also enclosed. Below if the information as
required in Part B of the application.
McLamb-Byrd Farms is a 177 lot residential subdivision located in Benson, NC. The
requested flow 84,960 gpd (480 gpd/lot). The extension proposed is a gravity sewer
extension and new sewer lift station that will connect to an existing gravity sewer
owned and maintained by the Town of Benson. The requested extension will be owned
and maintained by the Town of Benson after construction and certification are
completed.
I look forward to working with you on this project. If you have any questions or
concerns, please contact me at your earliest convenience.
Sincerely,
41) Site Solutions, Inc.
Scott Brown, PE
sbrowpLoAdsftesolutions.corn
Enclosure
M Dept of Environmental Q,Uty
OCT 20 azi
Raleigh Rtcow l 01r=
409 Chicago Drive. Suite 112. Fayetteville, NC 28306
office - 910-426-6777 fax , 910-426-5777
On time, every time. wwwADsitesotutions.com

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