WQ0043050_Application (FTSE)_20211122

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: t Q qit`- * as4 (In be :nmpleted by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Broadstone Walk, LLC (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership E Privately. Owned Public Utility
❑ Federal ❑ State.County El Municipal E Other
3. Signature authority's name: Yolanda Winstead per I5A NCAC
02T .0106(b) Title: President NC.Dept of Environmental Quality
4. Applicant's mailing address: 113 S. Wilmington St
City: Raleigh State: NC Zip: 27601- NOV 2 2
5. Applicant's contact information:
Phone number: [phone] Email Address: [e-mail] Raleigh Regional Office
I1. PROJECT INFORMATION:
I. Project name: Broadstone Walk
2. Application/Project status:
® Proposed (New Permit) El 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 exiting permit number: WQ00 _
3. County where project is located: Wake
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.716377' Longitude:-78.846950"
5. Parcel ID (if applicable): 0741552784, 0741553280 (or Parcel ID to closest downstream sewer)
II1. CONSULTANT INFORMATION:
1. Professional Engineer: Chris Bostic License Number: 032582
Firm: Kimley-Hom and Associates, Inc.
Mailing address: 421 Fayetteville St STE 600
City: Raleigh State: NC Zip: 27601-
Phone number: [phone] Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Middle Creek Water Reclamation Facility Permit Number: NC0064050
Owner Name: Town of Apex
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ0032543
2. Downstream (Receiving) Sewer Information: 8 inch 21 Gravity LJ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s):
FORM: FTA 06-21
Page 1 of 5

VI. GENERAL REQUIREMENTS
I. If the Applicant is a Privately -Owned Public Utility, 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 Developer's Operational Agreement (FORM; DEV) been attached?
❑ Yes ❑ No ®N/A
3. If the Applicant is a Home. Property Owners' Association, has an HOA/POA Operational Agreement (FORM: HOA) and
supplementary documentation as required by 15A NCAC 02T.0I 15(c) been attached?
❑ Yes No ®N.•A
4. Origin of wastewater: (check all that apply):
❑ Residential (Individually Owned) ❑ Retail (stores, centers, malls)
❑ Residential (Leased) ❑ Retail with food preparation/service
❑ School preschool day care ❑ Medical dental veterinary facilities
❑ Food and drink facilities ❑ Church
❑ Businesses / offices . factories ['Nursing Home
LI Car Wash
❑ Hotel and/or Motels
❑ Swimming Pool.:Clubhouse
❑ Swimming Pool,. Filter Backwash
❑ Other (Explain in Attachment)
5. Nature of wastewater : 100_°o Domestic ° o Commercial _ °fo Industrial (See 15A NCAC 02T .0103(20))
If Industrial, is there a Pretreatment Program in effect? ❑ Yes❑ No
6. Has a flow reduction been approved under I5A NCAC 02T ,0114(1)? ❑ Yes ® No
> if yes, provide a copy of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(1))
Daily Design Flow a,b
Residential
120 gal/bedroom
gal/
gal/
gal/
gal/
gal/
No. of Units
Flow
144
17,280 GPD
GPD
GPD
GPD
GPD
GPD
Total
17,280 GPD
a See 15A NCAC 02T .01 14(b1,1dl (0(11 and (e)(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 I5A NCAC 02T .0114(c), design flow rates for establishments not identified [in table I5A NCAC 02T.01 14] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 17,280 GPD (per I5A NCAC Q2T_.0.1,14)
> 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

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers);
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
605
PVC
> 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
Vlll_ PUMP STATION DESIGN CRITERIA (If Applicable)—02T.0305 & MDC (Pump Stations/Force Mains):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PIMP 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 Tess than 4-inches in diameter, please identify the me hod of solids reduction per
MDCPSFM Section 2.0IC.1.b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with 15A NCAC 02T _03054141):
❑ Standby power source or LJ Standby pump
> Must have automatic activation and telemetry - I5A 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 Tess 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

1X. SETBACKS & SEPARATIONS..- (02B .0200 & I5A NCAC 02T .0305(1)):
I. Does the project comply with all separations/alternatives found in I5A NCAC 02T .0305(f) & (g)?
I5A NCAC 02T.0305{f) contains minimum separations that shall be Drovided for sewer systems:
® Yes ❑ No
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 I or
Class II 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 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(f) or (0, see Section X. I of this application
*15A NCAC 02T.0305(g) contains 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 Surface Water Classifications webpage
2. Does this project comply with the minimum separation requirements for water mains? ® Yes ❑ No ❑ N. A
> If no, please refer to 15A NCAC 1 8C.0906(f) for documentation requirements and submit a separate document,
signed/sealed by an NC licensed PE, verifying the criteria outlined in that Rule.
3. Does the project comply with separation requirements for wetlands? El Yes ❑ No ® N A
> Please provide supplementary information identifying the areas of non-conformance.
> See the Division's draft separation 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: ® 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 I 5A NCAC 2B.0202
5. Does the project require coverage.authorization under a 404 Nationwide..'individual permits El 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 I5A NCAC 02T.0105(c)(6) (additional permits.'certifications)? ® Yes ❑ No
Per 15A NCAC 02T.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 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 permittee or its representative at least once every six -months and
inspections documented per I5A NCAC 02T.0403(a)(5) or the permittee's individual System -Wide Collection permit.
FORM: FTA 06-21 Page 4 of 5

X. CERTIFICATIONS:
Does the submitted system comply with 15A NCAC 02T, the Minimum Desk!) Criteria for the Permitting of Pump Stations
and Force Mains (latest version). and the Gravity Sewer Minimum Design Criteria )latest versionl as applicable?
® Yes ❑ No
If no, for projects requiring a single variance, complete and submit the VarianceiA]temative 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:
I, 0114040114 D,_ i C , attest that this application for
(Professional Engeer's name from Application Item III.1.) (Project Name rom Application Item II.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 Gravity Sewers ( latest version), and the Minimum Desgn Criteria for the Fast -Track Permittinm
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 I43-215.6A 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 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: `\\\ \k CARp//
-•g •�i��.
NC Dept of Environmental Quality SEAL r
032582 • z
NOV 2 2 2021
Raleigh Regional Office
3. Applicant's Certification per 15A NCAC 02T .0106(b):
�
I, (0LAtitk W104t d4 , attest that this application for fbl016 +t W4\ . _
(Signature Authority Name from Application Item 1.3.) (Project Name from Application Item IL1)
•
�, NGINE- •.;.� \\�.j
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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 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.
Signature:
FORM: FTA 06 21
Date: /Ai
Page 5 of 5

4' ert arm ir4-►nmental Quality
NoV 2 2 2021 State of North Carolina
Department of Environmental Quality
'R.aletgh Regional Office Division of Water Resources
Division of Water R&.Sources
Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Broadstone Walk, LLC
Project Name for which flow is being requested: Broadstone Walk
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.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Town of Apex Middle Creek Water Reclamation Facility
b. WWTP Facility Permit #: NC0064050
All flows are in MGD
c. WWTP facility's permitted flow 3.6
d. Estimated obligated flow not yet tributary to the WWTP 0.088
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
1.283
0.039
1.410
39.2%
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:
(A) (B) (C) (D)—(B+C) (E)=(A-D)
Design Obligated,
Average Daily Approx. Not Yet Total Current
Pump Station Firm Flow** Current Avg. Tributary Flow Plus
(Name or Capacity, * (Firm / pf), Daily Flow, Daily Flow, Obligated Available
Number) MGD MGD MGD MGD Flow Capacity***
Broadstone 0.660 0.264 0.023 0 0.023 0.241
* The Firm Capacity 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.
*** A PIanning 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): Broadstone Station
Downstream Permit Number: WQ0032543
Page 1 of 6
rrrnr n A 1 f

III, Certification Statement:
I Michael Deaton, 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 I and II plus all
attached planning assessment addendums for which I am the responsible party. Signature of this
form indicates acceptance of this wastewater flow.
I le/26-
Signing Official Signature Date
NC Dept of Environmental Quality
NOV 2 2 2021
Raleigh Regional Office
Page 2 of 6
rTC'r AA 1 L

Kimley»>Horn
Broadstone Walk
NC Dept of Environmental. Quality
Nov 22 2021
Raleigh Regional Office
FAST TRACK PRIVATE SEWER SYSTEM EXTENSION APPLICATION COVER LETTER
Description:
Attachments:
The proposed development consists of 8 Multifamily Buildings,
including a clubhouse. A total sanitary sewer flow discharge of 17,280
GPD (see section VI.7 of FTA 04-16) has been calculated. To service
the development, 605 linear feet of 8" PVC sanitary sewer main is
being proposed. The applicant, Broadstone Walk, LLC, will own and
maintain the proposed sanitary sewer extension.
1. Fast Track (Form FTA 04-16) Application
2. Copy of Fast Track (Form FTA 04-16) Application
3. USGS topographic Map
4. Street Level Map
5. Flow Tracking Form
kimley-horn.com
421 Fayetteville Street, Suite 600. Raleigh, NC 27601
919 677 2000

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Sosid: 2161407
Status: Current -Active 0
Citizenship: Domestic
Annual Report Due Date: April 15th
CurrentAnnual Report Status:
Registered Agent: DHIC, Inc.
Addresses
Principal Office
113 S Wilmington St.
113 S Wilmington St.
113 S Wilmington St.
Raleigh, NC 27601
Raleigh, NC 27601
Raleigh, NC 27601
All LLCs are managed by their managers pursuant to N.C.G.S. 57D-3-20.
https://sosnc.gov/online_.services/Search/Business. Registrationprofile?Id-17434835

-NC Dept of Envicot►mG"`—
Kimley»>Horn
Transmittal
Date:
To:
Vizi
Raleigh Regional Office
421 Fayetteville St. Suite 600
Raleigh, North Carolina 27601
TEL [phone]
FAX [phone]
November 19, 2021 Job Number: 012141011
Broadstone Walk
Raleisth Regional Office — Water Quality Section
3800 Barrett Drive
Ralelh, NC 27609
We are sending these by
❑ U.S. Mail
❑ Other
Telephone No. 919-791-4200
• FedEx ❑ Hand Delivery
We are sending you
® Attached 0 Under separate cover via
the following items:
O Shop drawings ❑ Prints/P,ans ❑ Samples 0 Specifications ❑ Change Orders
O Other
Conies
Date
No. Descrrofian
2
11/19/2021
1
Fast Track Sewer Application Package
1
10/19/2021
2
$480 Submittal Fee— Check No. 1005
These are transmitted as checked below:
® For your use ❑ Approved as submitted 0 Resubmit ❑ Copies for approval
❑ As requested 0 Approved as noted 0 Submit 0 Copies for distr.bution
❑ For review and comment ❑ Returned for corrections 0 Return ❑ Corrected prints
Copy to: file
Signed: Chr14-Bofc4 P.E.