WQ0043056_Application (FTSE)_20211129

DocuSign Envelope ID: 7C4D8ED8-8247-4AA6-A06F-58EF8DD23C4A
D, Wr, R
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: WON (to (to be completed b*W"ept of Env►rnn menta l Ot'.,11 i"
All items must be comuleted_or the aualication will be returned
1. APPLICANT INFORMATION: NOV 2 9 MI
1. Applicant's name: TowI3 ul-HollyS rr'ngs ,
2. Applicant type: ❑ Individual Corporation General Partnership Priva ely-Owned Public Utility-
❑ Federal ❑ State.'County ® Municipal ❑ Other
3. Signature authority's name: Kendra D. Parrish PE per 15A N['AC U2T .0106(b)
Title: Executive Director of Utilities & Infrastructure Service
4. Applicant's mailing address: 128 South Main Street PO Box 8
City: Holly Springs _ State: NC Zip: 27540
5. Applicant's contact information:
Phone number: [phone] Email Address: Kendra.parrish@,holIvspringsne.gov
11. PROJECT INFORMATION:
I. Project name: Holly Springs Business Park Tract 3
2. Application/Project status: ® Proposed (New Permit)
❑ Existing Permit/Project
IT 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: Wake
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.3906 Longitude:-78.5141
5. Parcel 1D (if applicable) : 0649124571 (or Parcel I to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: _Mike Roselli. PE License Number: 40769
Firm: Underfoot Engineering, Inc.
Mailing address: 1 149 Executive Circle Suite C
City: Cary State: NC Zip: 27511
Phone number: [phone] Email Address:: mroselli(@,underfootengineering.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Utley Creek Water Reclamation Facility Permit Number: NCO063096
Owner Name: Town of Holly Springs
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ00 15664
2. Downstream (Receiving) Sewer Information: _-8 inch N Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00192
Owner Name(s): Town of Holly Springs
FORM: FTA 06-21 Page 1 of 5

DocuSign Envelope ID: 7C408ED8-8247-4AA6 AO6F 5BEF8DD23C4A
VI. GENERAL REQUIREMENTS
I. If the Applicant is a Privately -Owned Public l.tility, 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 vl�e elapgt*s Operational Agreement i FORA4: UEV i been attached?
❑ Yes ❑ No ®N' A
3. If the Applicant is a Home: Property Owners' Association, has an HOA,'PO.A Operati greemen# (FORM: RQA 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) ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential (Leased) ❑ Retail with food preparation"service ❑ Hotel and/or Motels
❑ School ? preschool day care ❑ Medical ' dental i 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 : 0 Rio Domestic 100 %Commercial 0 % Industrial (Swe 15A NCAC 02T _0103(M))
If Industrial, is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T 0 1 I ? ❑ Yes ❑ No
➢ If yes. iprovide a copy of flow reduction approval letter with this goplication
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow 8,b
No. of Units
Flow
Laboratory
25 gall person
192
4,800 GPD
Flex Space
100 gall bays
17
1,700 GPD
Office flex Space
25 gal/person
52
1,300 GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
7,800 GPD
a See 15A N 02T 4 b b 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.0114] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project...7,800 GPD (per.1_E1 NCAC 02T .Ol 14)
➢ 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

DocuSign Envelope ID. 7C4D8ED8-8247-4AA6-AO6F-5BEF8DD23C4A
VI1.
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-inch
120
PVC
8-inch
427
DIP
➢ 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
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
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude:
3. Total number of pumps at the pump station:
3. Design flow of the pump station: 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): gallons per minute (GPM) at: feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
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.1.b. [:]Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
Power reliability in accordance with Ir
❑ Standby power source or ❑ Standby pump
➢ Must have 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 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

DocuSign Envelope ID- 7C4D8ED8-8247-4AA6-A06F-5BEF8DD23C4A
IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
I. Does the project comply with all separationslalternatives found in I SA NC.AC 02T103050) & ip)? ® Yes []No
15A NCAC 02T.0305(fl contains minimum separations that shall he nrovided 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)
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 1 or
Class 11 impounded reservoirs used as a source of drinking water, and associated wetlands.
100 feet
"Waters classified WS (except WS-1 or WS-V), B, SA, ORW, HQW, or SB from normal
high water (or tide elevation) and wetlands associated with these waters (see item 1X.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 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
➢ If noncompliance with 02T.0305(0 or (g), see Section X.I of this application
" UA _NCAC 02T.0contains alternatives where separations in 02T.0305(f) 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 S ru face Wsjur Classifications wc:b
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,
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 ❑ N-A
➢ Please provide supplementary information identifying the areas of non-conformance.
➢ See the Division's draft separation MQuinmenis 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 t 5A NCAC 02B -0200? ® Yes ❑ No
➢ This includes Trout Buffered Streams per I SA NCAC 2B.0202
5. Does the project require coverage; authorization under a 404 Nationwidc.f individual 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 1J&_tJCAC 02.T,0145(e}E6) (additional permits/certifications)? ® Yes ❑ No
Per 156 N ',AC 02T.0l"rJ(§, 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 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 interferencelconflict 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 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 4 of 5

DocuSign Envelope ID: 7C4D8ED8-8247-4AA6-A06F-5BEFSD023C4A
X. CERTIFICATIONS:
I. Does the submitted system comply with 15A NC'AC 02T, the ,Minimum Design Ctiteria for the Permitting of Ponx. lio
and Force Mains (latest versionj• and the Graviiy Sewer Minimum Desigttrrhaia (latc3t 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. Aw)roval of the request will be issued
concurrently with the approval of the permit. and pro2ects reguiring a variance anproval may be subject to longer
review times. For ro'ects reguiring two or more variances or where the variance is determined by -the Division to be a
significant portion of the proiect. the full technical review is re wired.
2. Professional Engineer's Certification:
I, Mike Roselli, PE _ , attest that this application for Holly Springs Business Park Tract 3
(Professional Engineer's name from Appltcation Item Ill. l ) (Project Name from Appttea'ion 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,
Minimum (>esigo Critcria fnr (;ravity ScwenS ( latest versign), and the M inimum Dcsign Criteria for the fgsj-Track Perm' ing
i2f eump SLgioas and For_er Maifts Oal" 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 143-215.6B, 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 ofthe 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)
......... _........ _.............................................
\ +�11111117J��� North Carolina Professional Engineer's seal, signature, and date: �N C,q RO'/,i
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3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, _ Kendra D. Parrish. PE , attest that this application for Holly Springs Business Park Tract 3
(Signature Authority Name from Application Item 13 ) (Project Name from Application Item [I.?)
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. 1 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'�15.0, 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 ascivil penalties up to $25,000 per violation.
Signature: L414—a�urarx:.w.. Date: 11/12/2021
FORM: FTA 06-21 Page 5 of 5

DocuSign Envelope ID: 7C4D8ED8-8247-4AA6-A06F-5BEF8DD23C4A
DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation- Town of Holly Springs
Project Name for which flow is being requested: Holly Springs Business Park Tract 3
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for al1 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: Utley Creek Wastewater Treatment Plant
b. WWTP Facility Permit #: NC 0063096
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
£ Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
All f1'ows are in MGD
6.0
0.644
2.426
0.008
3.078
51.3%
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:
Pump
Pump
Station
Station
Firm
(Name or
Permit
Capacity,
Number)
No.
MGD
HS Bus
WQ0031620
2.506
(A)
(B)
(C)
(D)=(B+C)
(E)=(A-D)
Design
Average
Approx.
Obligated,
Daily
Current
Not Yet
Total Current
Flow**
Avg. Daily
Tributary
Flow Plus
(Firm / po,
Flow,
Daily Flow,
Obligated
Available
MGD
MGD
MGD
Flow
Capacity***
1.002
0.095
0.044
0.139
0.863
* 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 peaking factor
(pf) 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): HS Business Park
Downstream Permit Number: WQ0031620
Page 1 of 6
FTSE 10-18

DocuSign Envelope ID: 7C4D8ED8-82474AA6-AO6F-5BEFSDD23C4A
111. Certification Statement:
I Kendra Parrish 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 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.
Signing Official
Exec Director of Utilities and infrastructure
Title of Signing Official
11/12/2021
Date
Page 2 of 6
FTSE 10-18

DocuSign Envelope ID: 7C4D8ED8-82474AA6-AO6F-5BEF8DD23C4A
"",,4411111111111
underfoot
ENGINEERING
Town of Holly Springs
128 South Main Street
Holly Springs, NC 27540
Re:
To whom it may concern,
1149 Executive Circle - Suite C-1, Cary, NC 27511
919.576.9733 1 NCBELS C-3847
October 18. 2021
Via Email
Holly Springs Business Park Tract 3 (20-DP-08)
Sanitary Sewer Permit Application
Enclosed is our sanitary sewer permit application for the above referenced project, which
includes 120 LF of 8" PVC, and 427 LF of 8" DiP public sanitary sewer main.
• FTA 06-21
• FTSE 10-18
• Site Map
• USGS Topo Map
• Aerial Map
Respectfully:
Mike Roselli, PE
Principal
Forward Thinking. Grounded Design.
www.underfootengineering.com

11 9

DocuSign Envelope ?D 7C4D8ED8-8247-4AA6-Ao6F-5BEF8DO23C4A
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: HOLLY SPRINGS BUSINESS PARK TRACT 3
Design Engineer: UNDERFOOT ENGINEERING.INC. I MIKE ROSELU, PE
Address: 1140 EXECUTIVE
Phone Number: 919.61—s7o
SUITE C, CARY NO 27511
_rpv
01A
Date Complete Application Package Received by Town: N
Date Approved: 11/9/2021 (by Rill q 11/12/2021 (by KDP �% {by 1�
As design engineer for this project, 1 certify the following (please check (x) each applicable box):
Email:
El 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;
❑ That each of the following items are completed and enclosed for submittal to the State for
a sewer extension permit:
❑ One cover letter that includes a project narrative
❑ A check in the amount of $480.00 to NC DEQ
❑ A check in the amount of $200.00 to the Town of Holly Springs
❑ One State of North Carolina form FTA 04-16 Fast Tract Sewer System
Extension Application
❑ One FTSE 10-18 Flow Trackingfor Sewer Extension Applications
❑ One color copy of an 8.5-inch by 11-inch portion of a 7.5-minute
USGS Topographic Map showing project area
❑ One copy of a street level map showing all relevant project areas
❑ One copy of the locally -required Design and Application Certification
(this form)
Design Engineer's Signature Date wisa1
Please contact Theresa Randall at [phone] or theresa.randall�4,holl +s ringsnc,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.hollyspringsne.gov
S

DocuSign Envelope ID: 7C4D8ED8-8247-4AA6-Ao6F-5BEF8DD23C4A
n *N n
Y.
= T;" THE TOWN Or 01 nn,
November 8, 2021
Director, Division of Water Resources
Raleigh Regional Office
Water Quality Operation Section
3800 Barrett Drive
Raleigh, NC 27609
Re: Application for Sewer Extension Permit
Project: Holly Springs Business Park -Tract 3
Dear Sir or Madam:
NC Dept of Environmental Quality
NOV 2 9 20
Raleigh Regional Office
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
o 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 copies of FTSE 04-16 Flow Tracking/Acceptance Form
0 Two color copies of a 8.5-inch by 11-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
Feel free to contact me at 919-577-3 l 50 should you have any questions or need additional
information in order to process this application.
Sincerely,
IDS
11/9/2021
Ken ram. �'arrish, P.E., CFM Rachel Ingham
Executive Director of Utilities and Infrastructure Utility Engineer
KP/tr
cc: Project Consultant Engineer, Mike Roselli, PE
Rachel Ingham, Utility Engineer
Drew Johnson, Development Construction Manager
Theresa Randall, Utility Permitting Specialist
Project file/Correspondence #41938
3002
04.17.2018
Utilities and Infrastructure Services
P.O. Box 8 • 128 S. Main Street • Holly Springs, NC 27540 • www.hollyspringsnc.gov