WQ0043009_Application (FTSE)_20211115

DocuSign Envelope ID: Al2FE074-SA53-4346r8086-F47BC547D4F8
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: %_e-�( GM600"\ (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: CITY OF SANFORD (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State/County ® Municipal
3. Signature authority's name: PAUL WEEKS. PE per 15A NCAC 02T .0106 b
Title: CITY ENGINEER
4. Applicant's mailing address: PO Box 3729
City: SANFORD State: NC Zip: 27331-3729
5. Applicant's contact information:
Phone number: (jU9 777-1119 Email Address: paul.weeksRsanfordnc.net
II. PROJECT INFORMATION:
1. Project name: BRANTLEY PLACE PHASE I
❑ Privately -Owned Public Utility
❑ Other
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/ProjecIV
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: LEE U?,
0
4. Approximate Coordinates (Decimal Degrees): Latitude: 2'tXfl ° Longitude: -8 . 7°
5. Parcel ID (if applicable): 9631-86-5489-00 ITV_WLK% -Ic► .'1.0g0111 p
(or Parcel ID to closest downstream sewer)
r
h
111. CONSULTANT INFORMATION:
1. Professional Engineer: KEN W BRIGHT. PE License Number: 17585
Firm: KEN BRI HT ASSOCIATES PLL
Mailing address: PO BOX 553
City: SANFORD State: NC Zip: 27 1-0553
Phone number: [phone] Email Address: KWBRIGHT(&,KENBRIGHTENGINEERINQ,COM
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: BIG BQFFALO WASTEWATER TREATMENT PLANT Permit Number: 0024147
Owner Name: CITY OF SANFORD
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
I. Permit Number(s): WQ Downstream (Receiving) Sewer Size: 8 inch
System Wide Coll ermit Nuttibc s .(if applicable): WQCS00047
Owner Name(s): CITY OF SANFORD
FORM: FTA 04-16 Paget of 5

DocuSign Envelope 10: Al2FE074-8A53-4346.8086-F47BC547D4F8
VI. GENERAL REQUIREMENTS
L 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 evelooer's Operational A reement f FORM: D ; V} been attached?
❑ Yes [-]No ®NIA
3. If the Applicant is a Home Prorsert OwnersAssc iatim has an Operational Ayreement (FOR T: HOAJ 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 1 preschool / day care ❑ Medical / dental r veterinary facilities ❑ Swimming Pool /Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses 1 offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % DomesticlCommercial _% Commercial
% Industrial (See 15 A NCAC 02T .0103{2Q
bIs there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T .0l 14(f)? ❑ Yes ®No
➢ If yes, provide a_ cony of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114f fax
Daily Design Flow'-b
No. of Units
Flow
RESIDENTIAL - 4 BEDROOM HOMES
480 gaVUNIT
70
33,600 GPD
gal/
GPD
gal/
GPD
gall
GPD
gal/
GPD
gal/
GPD
Total
11,040 GPD
a See l 5A 1CAC 02T .Q1,1.4(bl. (d), {e](I) an�,�c�� 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 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: 33.600 GPD (per 15A NCAC 02T .01 14)
➢ 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

DocuSign Envelope ID: Af 2FE074-BA53-4346.8086-F478CS47D4F8
VII.
VIII.
GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
3,050
PVC
8
230
DIP
➢ Section I1 & 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
PUMP STATION DESIGN CRITERIA (If Applicable)-02T .0305 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
L 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
to
PCs'
c9
ur.
0
O
6. Power reliability in accordance with 15A NCAC 02T.,0305(h]( I ):
Y p pump try - 15A NCAC 02T .0305 cn
❑ Standby power source or um with automatic activation and telemetry (h�l)(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
n
C
o *
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(1XC):
➢ 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

DocuSign Envelope ID: Al2FE074-8A534346-8088-F478C547D4F8
IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations found in l�A_N C 02T
➢ 15A NCAC 02T.0305 contains minimum se arations that shall be provided for sewers stems•
® Yes [:]No
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below vertical
24 inches
Water mains vertical -water over sewer including in benched trenches
18 inches
Water 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-I waters of Class I or
Class 11 impounded reservoirs used as a source of drinking water
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 see item IX.2
50 feet
"Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
10 feet
To 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
➢ I SA NCAC 02T.0305(a) contains alternatives where separations in 02T.0305(fl cannot be achieved.
➢ "Stream classifications can be identified using the Division's NC Surface Wager Classificatq2gLWebpaie
➢ If noncompliance with 02T_0305(t) it L, see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ❑ Yes [--]No ® NIA
➢ 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 setbacks found in the river basin rules per 15A NCAC- 025 .0200 ' ❑ Yes ❑ No ® NIA
➢ This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project require coverage/authorization under a 404 Nationwide or ❑ Yes ® No
individual permits or 401 Water Quality Certifications?
➢ Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCA t12T.0 M(c)[6) (additional permits/certifications)? ® Yes ❑ No
Per]{Perj{& NCAC 02T.O105)(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 ❑ 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 perm ittee or its representative at least once every six -months and inspections
documented per 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

DocuSi n Envelope ID: Al 2FE074-8A53-4346-8086-F47BC547D4F8
X. CERTIFICATIONS:
1. Does the submitted system comply with 1-5A NCAC 02T, the Hnimum i)csimn Criteria for_ hit permill j"2 of Firms st9tio•ns
nd Force Main, latest version and the G rp y ity Sewer M inim m Des i n Crit vcmion as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. ARoroval of the rgguesj Is required nrlor to submittal of the,Fj1J Track Application and sulaggrUng documents.
2. Professional Engineer's Certification:
Ken W. Bright, PE _ attest that this application for
(Professional Engineer's name from Application Item I11.1.)
Brantley Place Phase 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 -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:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
Paul Weeks, PE
1, --
i" CAR
AL
17585
r
attest that this application for
(Signature Authority's name & title from Application Item 1.3.)
Brantlev Place Phase 1
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 143-215.6 , 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.
DoeuSlpnd by:
Signature: CARC39rW678"B9Date:
11/12/2021
FORM: FTA 04-16 Page 5 of 5

DocuSign Envelope ID: Al2FE0748A53-4346-8086-F47SC647D4F8
i6r, OfElavironmental Quality
NOV 15 2M
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Raleigh Regional off, -Co Flow Tracking for Sewer Extension Applications
Blvision of Water Resource (FTSE 10-18)
Application Number: I FT-333
Entity Requesting Allocation: City of Sanford
Project Name for which flow is being requested: Brantley Place
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility name: Big Buffalo Wastewater Treatment Plant
b. WWTP Facility Permit #: NCO024147
AAf ows are in MGD
c. WWTP facility permitted flow: 12.0000
d. Estimated obligated flow not yet tributary to the WWTP: 1.1365
e. WWTP facility's actual average flow: 6.0970
f. Total flow for this specific request: 0.01104
g. Total actual and obligated flows to the facility: 7.2446
h. Percent of permitted flow used: 60%
II. Complete this section for each pump station you are responsible for along the route of this proposed
List pump stations located between the protect connection point and the WWTP.
(A) (B) (C)
(D)=(8+C)
(E)(A-D)
Pump
Pump Firm Design Approx. Obligated,
Total Current
Available
Station
Station Capacity° Average Current Not Yet
Flow Plus
Capacity'
(Name or
Permit Daily Flow' Avg. Daily Tributary
Obligated
Number)
Number (Firmint) Flow, Daily. Flow,
Flow
MGD MGD MGD MGD
MGD
MGD
#NIA 0,0083 #N/A #N/A #N/A
#N/A
#N/A
#NIA
#N/A #NIA #NIA #N/A
#N/A
#N/A
#N/A
#N/A #NIA #N/A #NIA
#NIA
#N/A
#N/A
#N/A #N/A #NIA #N/A
#N/A
#NIA
#N/A
#N/A #NIA #N/A #N/A
#N/A
#N/A
#N/A
#N/A #N/A #N/A #N/A
#N/A
#N/A
1. 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.
2. Design Average Flow is the firm capacity of the pump station divided by the peaking factor (pi) not
less than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
3. 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:
Cartage Colonies Ph 4C
WQ0034827
Page 1 of 6 FTSE 10-18

DocuSign Envelope ID: Al2FE074-SA534346-8086-F478C547D4F8
I11. Certification Statement
1, Paul Weeks, Jr. PE, 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 1 and 11 plus all attached planning
assessment addendums for which I 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.
IP
OoeuSlpr�d by:
si. k. kAS
BBC39E66678409
Signing Official Signature
City Engineer
Title of Signing Official
10/07/21
Date
Page 2 of 6 FTSE 10-18

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BRANTLEY PLACE- USGS MAP

KEN BRIGHT ASSOCIATES, PLLC
November 12, 2021
Mr. Ted Cashion
North Carolina Division of Environmental Management
Division of Water Quality
1628 Mail Service Center
Raleigh, NC 27699-1628
Re: Brantley Place Phase I Sewer Extension
Lee County
Dear Ted:
Enclosed please find the following documents:
1. The fast track sewer application.
2. Form FTSE 04-16
3. A check for the amount of $ 480.00.
4. A Color copy of a USGS Topographic map.
5. A Street level map.
N1CDept oi'Environrnental Qu
ahti
NOV 15 20
e�gh Regional OfJc"
The project consists of the extension of approximately 3,280 LF of 8" PVC & DIP pipe
to serve a residential subdivision..
If you have any questions please feel free to contact me.
I would appreciate your reviewing these as soon as possible. If you have any questions
please feel free to contact me.
Sincerely,
)(�� V. &az",.'�
Ken W. Bright, PE
File.project1010/Brantley Place I/Sewer/Letter sewer appl Brantley Place Phase I-11-12-2021.doc
P.O Box 553 Phone: [phone]
2305 Carthage Street
Sanford, NC 27330 e-mail: [e-mail]