WQ0030814_Application (FTSE)_20211012

DocuSign Envelope ID 4033A9AA-588E-46FD-8726-9758BBDE3F3A
DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 06-21 & SUPPORTING DOCUMENTATION
Application Number: I/v etUO30 8� 1 `1 (to be completed by DWR)
All items must be completed or the pplication will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Town of Holly Springs (company, municipality, HOA, utility. etc.)
2. Applicant type: 0 Individual 0 Corporation 0 General Partnership 0 Privately -Owned Public Utility
0 Federal 0 State/County ® Municipal ❑ Other
3. Signature authority's name: Kendra D. Parrish, P.E. per 15A NCAC 021 .010(0)
Title: Executive Director of Utilities and Infrastructure
4. Applicant's mailing address: P.O. Box 8
City: Flolly Sprints State: NC Zip: 27540-
5. Applicant's contact information:
Phone number: [phone] Email Address: [e-mail]
I1. PROJECT INFORMATION:
I. Project name: jwelve Oaks Pump Station Expansion
2. Application/Project status: ❑ Proposed (New Permit)
® Existing Permit/Project
Ifa modification, provide the existing permit number: WQ0030814 and issued date: September 27, 2006.
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: Wake
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.6626' Longitude:-78.8860`
5. Parcel ID (if applicable): 0639368075 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
I. Professional Engineer: John F. Phillips, P.E.
Firm: Diehl & Phillips, P.A.
Mailing address: 1500 Piney Plains Road, Suite 200
City: Cary State: NC Zip: 27518-
Phone number: [phone] Email Address: [e-mail]
License Number: 10130
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
I. Facility Name: Utley Creek WRF Permit Number: NC0063096
Owner Name: Town of Holly Springs
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ N/A — 16- inch force main permitted under WQ0030814 discharges at WRF
2. Downstream (Receiving) Sewer Information: 16- inch 1 Gravity CO Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00I22
Owner Name(s): Town of Holly Springs
FORM: FTA 06-21
aa33O Ieuo!Sa.1 gdlop3x
Page 1 of 5

DocuSign Envelope ID 4033A9AA-588E-46FD-8726-9758BBDE3F3A
VI. GENERAL REQUIREMENTS
1. Ifthe Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑ No ® N/A
2. lithe Applicant is a Developer of lots to be sold, has a De\eloper's ?perationa l Agrceincrit (FORM: DIN) been attached?
❑ Yes ❑ No ® NIA
3. Ifthe Applicant is a Home/Property Owners' Association, has an 110 A:i ).1 Operational A recmcnt (1 0121\4: 110A 1 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)
❑ Residential (Leased)
O School / preschool r' day care
O Food and drink facilities
0 Businesses / offices / factories
® Retail (stores, centers, malls)
® Retail with food preparation/service
❑ Medical / dental f veterinary facilities
❑ Church
❑ Nursing Home
To'
t14
❑ Car Wash 71
❑ Hotel and/or Motels fro
❑ Swimming Pool/Clubhouse p'
❑ Swimming Pool/Filter Back4sh
❑ Other (Explain in AttachmertQ
5. Nature of wastewater : 90% Domestic I O °o Commercial °ro Industrial (See 15A NCAC 02 i 0103(200
If Industrial, is there a Pretreatment Program in effect? 0 Yes❑ No
6. Has a flow reduction been approved under 15A NCAC 021 .01 14(0? ❑ Yes 0 No
D If yes. provide a copy of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.O114(f))
Daily Design Flow"
No. of Units
Flow
gal/
GPD
gal/
GPD
gall
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
GPD
n
a See 15:A NCAC 021 .01 11(h). td). (e)(I 1:and 1012 j 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 (.'N. •I2A #).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15_\C::\C 021.0114] 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 021 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:
O Rehabilitation or replacement of existing sewers with no new flow expected
® Other (Explain): Project is a modification to increase a regional nump station's pumping capacity. This project does not
add any flow to the Town's wastewater system.
FORM: FTA 06-21
Page 2 of 5
NC Dept of Environmental Quality

DocuSign Envelope ID: 4033A9AA-588E-46FD-8726-97586BDE3F3A
VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (GraNity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
➢ Section II & 1II 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) — 021 .0305 & MDC (Pump StationslEorce Mains):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: Twelve Oaks Pump Station
2. Approximate Coordinates (Decimal Degrees): Latitude: 35.6626' Longitude:-78.8860'
3. Total number of pumps at the pump station: 4: 2 existing pumps will be replaced & 2 pumps will be added by this proiect
3. Design flow of the pump station: 4.14 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): 1.663 gallons per minute (GPM) at 242 (single pump operation) feet total dynamic head
(TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
NA
EXISTING
16" FORCE
MAIN
TO
BE
USED
If any portion of the force main is less than 4-inches in diameter, please identify the me hod of solids reduction per
MDCPSFM Section 2.0IC.I.b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with 15A NCA.(' 021 .0305jhJLl ):
® Standby power source or ❑ Standby pump
➢ Must have automatic activation and telemetry - 15A NCAC 02T.0305(h)(1)(B)1
➢ 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

DocuS gn Envelope ID. 4033A9AA-588E-46FD-8726-9758BBDE3F3A
IX. SETBACKS & SEPARATIONS (02B .0200 & 15A NCAC 02T .0305(0):
I. Does the project comply with all separation&'alternatives found in 15A NCAC 021 .0305:1) /t l: l ' ® Yes ❑ No
l5A 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
'Water mains (vertical - water over sewer preferred, including in benched trenches)
18 inches
'Water mains (horizontal)
I0 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-I waters of Class 1 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 oft 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 02 1.0305(1) or t 1. see Section X.l of this application
*15A NCAC 021.03305(+2.) contains alternatives where separations in 021.0305th 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 ivebpagc
2. Does this project comply with the minimum separation requirements for water mains? ® Yes ❑ No ❑ NiA
> Ifno, please refer to 15A NCAC I8C.0906(t) for documentation requirements and submit a separate document.
signedisealed by an NC licensed PE, verifying the criteria outlined in that Rule.
3. Does the project comply with separation requirements for wetlands? ® Yes ❑ No ❑ NA
> Please provide supplementary information identifying the areas of non-conformance.
➢ See the Division's draft seVaration 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 0213 .0200? ® Yes ❑ No
➢ This includes Trout Buffered Streams per 15A Nt.'A(. 213.0202
5. Does the project require coverageiauthorization under a 404 Nationwidv individual permits ❑ Yes ® No
or 401 Water Quality Certifications?
➢ Please provide the permit numberpermitting status in the cover letter if coveragerauthorization is required.
6. Does project comply with I5A NCAC 021.0I0ktc116) (additional permitslcertifications)? ® Yes ❑ No
Per 15A NCAC 02"1.0105(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.).
7. Does this project include any sewer collection lines that are deemed "high -priority?" ❑ Yes ® No
Per 15A NCAC 021.0402, "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 permittee or its representative at (east 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
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DocuSign Envelope iD 4033A9AA-588E-46FD-8726 9758BBDE3F3A
X. CERTIFICATIONS:
1. Does the submitted system comply with I5A NCL 5. 021, the Minimum Design C'ribLria ktr the Permitting of Purim Staiiiims
old force 1wlain5_1111cs1 %er iun), and the Gra%it% So%cr Minimum Design Criteria (latest \ erN ion 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 be subject 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 project, the full technical review is required.
2. Professional Engineer's Certification:
1, John F. Phillips, P.E., attest that this application for Twelve Oaks Pump Station Expansion
(Professional Engineer's name from Applcation Item III I ) (Project Name from Application Item I:. I )
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 (tr,t‘ its Sep%crs ( late.,t %er.,iont, and the Minimum Design Criteria for the I`ast-Track Permitting
of Pump Sta ions and Force Mains (latest versions. 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 General Statutes I43-215.6A and I43-215.6B, 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. 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:
•
10/5/2021
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, Kendra D. Parrish, P.E. attest that this application for Twelve Oaks Pump Station Expansion
(Signature Authority Name from App:lcauon 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.
1 understand that if all required parts of this application are not completed and that Wall 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. 1 will make no claim against the Division
of Water Resources should a condition of this permit be violated. 1 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 1•43-215.611, 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:
LxOuby�
O Oflt 1_,a40:
Date:
10/5/2021
FORM: FTA 06-21 Page 5 of 5

DIEHL & PHILLIPS, P.A.
CONS' I TING ENGINEERS
1500 Piney Plains Rd., Suite 200
Cary, North Carolina 27518
Telephone (9I9) 467-9972 Fax [phone]
September 30, 2021
Mr. Jason Robinson, P.E.
Water Quality Regional Operations - Raleigh Regional Office
3800 Barrett Drive
Raleigh, NC 27609
RE: Fast Track Sewer System Extension Application
Modification of Permit WQ0030814
Capacity Increase for Twelve Oaks Regional Pump Station
Town of Holly Springs
Dear Mr. Robinson:
WILLIAM C DIEHL, P.E
JOHN F PHILLIPS, P.E
ALAN R KEITH, P E
The referenced sewer system extension application is submitted for the permitting of an
expansion of the pumping capacity of the Twelve Oaks Regional Pump Station. The
station is to be expanded by the addition of a second wetwell, valve vault, and two
additional pumps. The two pumps in the existing wetwell will be replaced with two new,
larger pumps. The four new pumps will be identical 168 horsepower submersible pumps.
The existing 16-inch diameter force main (18,250 LF), which extends from the pump
station to the Town's Water Reclamation Facility (Permit No. NC0063096), will not be
altered by this project. The existing standby power generator and automatic transfer
switch are adequate to start and operate the three new pumps required to deliver the
peak flow of the upgraded pump station. The projected firm capacity (three pumps
operating) for the upgraded pump station is 4.14 MGD (2,875 gallons per minute).
The project will also include a replacement of the hydraulic drive system for the station's
solids grinder with an immersible electric motor, and the addition of a carbon adsorption
odor control system. The carbon adsorption odor control system will treat the air from
the headspaces in the two wetwells, The station will continue to have audible and visual
high water alarms, in addition to the existing radio telemetry SCADA system.
Thank you for your assistance with this project.
Enclosures:
Original and copy of Form FTA 06-21
Two copies of Permit WQ0030814
Cc: Ms. Rachel Ingham, PE
Yours very truly,
Diehl & Phillips, P.A.
1
John F. Phillips, P.E.

NEW HILL QUADRANGLE
NORTH CAROLINA �4
7.5 MINUTE SERIES (TOPOGRAPHIC) 4`L
APEX QUADRANGLE
' NORTH CAROLINA-WAKE CO.
7.5 MINUTE SERIES (TOPOGRAPHIC)

DocuSign Envelope ID: 4033A9AA 588E-46FD 8726-9758BBDE3F3A
THE TOWN OF
October 5, 2021
Director, Division of Water Resources
Raleigh Regional Office
Water Quality Operation Section
3800 Barrett Drive
Raleigh, NC 27609
bily j'rings
Re: Application for Sewer Extension Permit
Project: Twelve Oaks Pump Station Expansion and Modification
Dear Sir or Madam:
Please find enclosed the following items in application for a sewer extension permit to the Town of
Holly Springs existing sewer distribution system:
0 One original and one copy cover letter including a project narrative
co A check in the amount of $480.00
0 One original and one copy of the State of North Carolina Fast Track Sewer System
Extension Application (FTA 04-16)
0 Two color copies of a 8.5-inch by I I -inch portion of a 7.5 minute USGS Topographic
Map showing project area
0 Two copies of a street level map showing all relevant project areas
0 One copy of the locally -required Design and Application Certification
0 Previous approved Twelve Oaks Pump Station and Force Main Sewer Permit
Feel free to contact me at 919-577-3150 should you have any questions or need additional
information in order to process this application.
Sincerely,
(-DecuSlipreod
4710.14—
Kendra D. Parrish, P.E., CFM
Executive Director of Utilities and Infrastructure
KP/tr
cc: Project Consultant Engineer, John F. Phillips, PE
Rachel Ingham, Utility Engineer
Drew Johnson, Development Construction Manager
Theresa Randall, Utility Permitting Specialist
Project file/Correspondence #41924
3002
04.17 2018
DS
10/5/2021
Rachel Ingham
Utility Engineer
aoowo puo!2ag gAtapm
Utilities and 111frtrstructure Services
P.O. Box 8 • 128 S. Main Street • Holly Springs, NC 27540 • www.hollyspringsnc.gov
NC Dept of Environmental Quality

DocuSign Envelope ID 4033A9AA-588F-46Ffl- 726-9758BBDF:3F:1A
DO NOT SUBMIT SEWER EXTENSION APPLICATIONS UNTIL
CONSTRUCTION DRAWINGS HAVE BEEN APPROVED BY STAFF!
Sewer Design and Application Certification
Note: This form must be submitted with the Fast Tract Application for extension to the Town of
Holly Springs Sewer System
Project: Twelve Oaks Pump Station Expansion and Modifications
Design Engineer: John F. Phillips. P.E. - Oiehl & PhlIUps, PA
Address: 1500 Piney Plains Road, Suite 200
Phone Number: 019-467-9872 x 5 Email: JFPhnllpsta ellsoulh.net
Date Complete Application Package Received by Town: 07/22121
Date Approved: r 10/5/2021 (by RI 10/5/2021 (yy A DSi's 10/5/2021 roy DJ)
As design engineer for this project, l certify the following (please check (x) each applicable box):
D That the design of the project is in complete conformance with the Town of Holly
Springs Engineering Design and Construction Standards and NC DEQ Sanitary Sewer
Design Regulations;
fa That each of the following items are completed and enclosed for submittal to the State for
a sewer extension permit:
d One cover letter that includes a project narrative
o A check in the amount of $480.00 to NC DEQ
o A check in the amount of $200.00 to the Town of Holly Springs
se One State of North Carolina form FTA 04-16 Fast Tract Sewer System
Extension Application
❑ One FTSE 10-18 Flow Tracking for Sewer Extension Applications
One color copy of an 8.5-inch by 1 I -inch portion of a 7.5-minute
USGS Topographic Map showing project area
d One copy of a street level map showing all relevant project areas
iia- One copy of the locally -required Design and Application Certification
(this form)
Design Engineer's Signature
Date 09/3 '21
Please contact Theresa Randall at [phone] or theresa.randall{a.hollyspringsnc.gov if you
have any questions.
2003 Sewer Design Application Certification
01.14.21
Utilities and Infrastructure Services
P.O. Box 8 • 128 S. Main Street • Holly Springs, NC 27540 • www.hollyspringsnc.gov