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HomeMy WebLinkAboutWQ0043108_Application (FTSE)_202202010 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: no Ix, completed by DWR) All items must be completed or the application will be returned I. APPLICANT INFORMATION: I. Applicant's name: Hoke County Public Works (company, municipality, HOA, utility, etc.) 2. Applicant type: ❑ Individual ❑ Corporation Cl General Partnership ❑ Privately -Owned Public Utility ❑ Federal ❑ State/County Municipal ❑ Other 3. Signature authority's name: Hilton Vannes per 15A NCAC 02T 0106(b) Title: Utilities Director 4. Applicant's mailing address: PO Box 240 City: Raeford State: NC Zip: 28376- 5. Applicant's contact information: Phone number: (910) 848-0385 Email Address: hvillines@hokecounty.org II. PROJECT INFORMATION: 1. Project name: B&B Loop Subdivision Application/Project status: tEl Proposed (New Permit) RECEIVED, DEQ/E?VVR JAN 1 8 Z WQROS FAYEl TZv(l_E REGIGNALOFFICE ❑ Existing Permit/Project Ifa 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: Hoke 4. Approximate Coordinates (Decimal Degrees): Latitude: 34.99004' Longitude:-79.14035' 5. Parcel ID (if applicable): 494550001048 (or Parcel ID to closest downstream sewer) III. CONSULTANT INFORMATION: I . Professional Engineer: C. Scott Brown License Number: 027452 Ah_C:... ..:....,. t... 4D SITE SOLUTIONS,? IN 409 CHICAGO DRIVE SUITE 112 FAYETTEVILLE, NC 28306 PAY TO THE ORDER OF NCDEQ Four Hundred Eighty and 00/100AAAAAAAA NCDEQ MEMO 0 0 0 o 0 o 0 0 0 0 00 BB&T FAYETTEVILLE, NORTH CAROLINA 66-112/531 1/17/22 $ **480.00 *****AAA A AA A A*****irk* A*A A A AAAA AA A *AARAAA A********** **** Al. A A A A*A A A A AA A THORIZED SIGNATURE. 71178 nm n m DOLLARSco :a January 17, 2022 ;CDE Q Fayetteville Reior al ?e ttn: Trent 4Dsite solutions civil engineering I land surveying RECEIVED" 225 Green Street, Suite 714 JAN 18 2022 12�t3 DEQ-FAYETTEVILLE REGIONAL OFFICE RE: Sewer Application, B&B Loop Subdivision, Hoke County, North Carolina e is e3 NC 2830_ Trent; Attached the ppl packa is sanitarysewera,..4 icatior check for the $480 review fee is also enclosed. This information as required in Part B of the application. B Loop Subdivision. A ter provides the additional B&BLoop Subdivision 1s a 25 lot residential sub- v inn located in Hoke County, AC. The requested flow 12,000 gpd (480 gpd/lot). The extension proposed is a gravity sewer extension that will connect to an existing gravity sewer owned and maintained by Hoke County Public Works. The requested extension will be owned and maintained by Hoke County Public Works after construction and certification are completed. I look forward to working with you on this project. If you have any questions or concerns, please feel free to contact us. Sincerely, 4D Site Solutions, Inc. Scott Brown, PE sbrown@4dsitesolutions.com Enclosure 409 Chicago Drive, Suite 112, Fayetteville, NC 28306 office 910-426-6777 fax 910-426-5777 On time, every time. ;: 4Dsitesotuti©ns.c.c�t Division of Water Resources State of North (:arolimi Department of Environmental Quality Division of Water Resources 15A NCAC 02T .0300 — FAST TRACK SEVER SYSTEM EXTENSION APPLICATION FTA 04-16 & SUPPORTING DOCUMENTATION \pplication Number: (to be completed by DWR) All items must be completed or the application 1011 he roomed APPLICANT INFORMATION: Applicant's name: Hoke County Public Works (company, municipality, FIOA, utility, etc.) 2. Applicant type: Individual J Corporation J General Partnership fl Privately -Owned Public Utility 0 Federal 0 State/County E Municipal 0 Other Signature authority's name: Hilton Villines per 1 5A NCAC 02T 0106a9 Title: Utilities Director 4. Applicant's mailing address: PO Box 240 City: Raeford State: NC Zip: 28376- 5. Applicant's contact information: Phone number; (910) 848-0385 Email Address: lwillines@hokecounty.orz II. PROJECT INFORMATION: 1. Project name: B&B Loop Subdivision 2. Application/Project status: Proposed (New Permit) RECEIVED DECVDWR JAN I 8 2A-/-7— INOROS FAYETTEVILI przpoNAL OFFICE 0 Existing Permit/Project lfa 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: Hoke 4. Approximate Coordinates (Decimal Degrees): Latitude: 34.99004' Longitude: -79,14035' 5. Parcel ID (if applicable): 494550001048 (or Parcel ID to closest downstream sewer) Ill. CONSULTANT INFORMATION: 1. Professional .Enaineer: C. Scott Brown License Number: 027452 Firm: 4D Site Solutions, Inc Mailing address: 409 Chicago Drive Suite 112 City: Fayetteville State: NC Zip: 28306- Phone number: (910) 426-6777 Email Address: sbrown@Adsitesolutions.com IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORIVIATION: 1. Facility Name: Hoke County WWTF Permit Number: NC0089176 Owner Name: Hoke County Public Works V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF): 1. Permit Number(s): WQ Downstream (Receiving) Sewer Size: 24 inch SystmWide Collection System Permit N filber(WA' applicablg.): WQCS00352 Owner Name(s): Hoke County FORM: FTA 04-16 Page 1 of 5 VI. GENERAL REQUIREMENTS If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached? El Yes No EN/A 2. It -the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEN been attached? r-th T., MNT/ A L j 1 L j 3. If the Applicant is a flotpcfProperty_Ownerst Associationjas an Operational Agreement HO.A..) been attached? El Yes 0No EN/A 4. Origin of wastewater: (check all that apply): El Residential Owned Residential Leased El School / preschool / day care 0 Food and drink facilities 0 Businesses / offices / factories El Retail (stores, centers, malls) 0 Retail with food preparation/service E Medical / dental / veterinary facilities E Church Nursing Horne 0 Car Wash El Hotel and/or Motels 0 Swimming Pool /Clubhouse 0 Swimming Pool/Filter Backwash 0 Other (Explain in Attachment) 5. Nature of wastewater : 100 % Domestic/Commercial % Commercial °//0 Industrial (See 15A NC.A(T 02T .0101(20j) >ls there a Pretreatment Program in effect? 0 Yes 6, Has a flow reduction been approved under I5A. NC.AC 02T .0-1 14(1)? E Yes 0 No r If yes, provide a copy of How reduction approval letter 7. Summarize wastewater generated by project: 0 No Establishment Type (see 021%01140') Daily Design Flow 'I' No. of Units 25 Flow 12,000 GPD Residential 480 gal/day/lot gal/ GPD gaU GPI) gal/ GPD gal/ GPD gal/ GPD . .,... , 717;;;/ 1 12,000 GPD a See 15A NC AU 02-1 I 14114 tcf). aralle)(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 (.70,....42A7.4.). b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified lin table 15A_N(_LVT 021J)I 141 shall be determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data. 8. Wastewater generated by project: 12,000 GPD (per 1 5A fAC 02T .0114) Do not include future flows or previously permitted allocations If permitted flow is zero, indicate why: 0 Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line 0 Flow has already been allocated in Permit Number: Ei Rehabilitation or replacement of existing sewer with no new flow expected 0 Other (Explain): FORM: FTA 04-16 Page 2 of 5 VI1. GRAVITY SEWER R DESIGN CRITERIA (if ,:p 02' ' .0305 • Sewer I. Summarize gravity sewer to be permitted: Size (inches) Length (feet) Material 8 778 PVC & DI Section 11 & Ill of the MDC for Permitting of Gravity Sewers contains information related to design criteria Section I11 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 VIII. M1MP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains): COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT 1. 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 (T.Dl-1) 5. Summarize the force main to be permitted (for this Pump Station): Size (inches) Length (feet) Material 6. Power reliability in accordance with 15A Ni'AC. 02T .(. 305(h)(1): O Standby power source or pump with automatic activation and telemetry - 15.A NCAC 02T .0305(h)(1)(13) 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: El Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T .0305(h)(I)(C) or ❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(1)(C): 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 tirneframes, shall be provided in the case ofa multiple station power outage. FORM: FTA 04-16 Page 3 of 5 LX. SETBACKS & SEPARATIONS — (02B .0200 8,s 15A NCAC 02T .0305(1)): 1. Does the project comply with all separations found in 15 NCAC [I) kw contains inin e arations that shall be Drovided for sewer systems: E Yes El No _,.... . Setback Parameter* Separation Required 24 inches Storm sewers and other utilities not listed below fvertical) 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 1 or Class 11 impounded reservoirs used as a source of drinking water 100 feet **Waters classified WS (except WS-1 or WS-V), B, SA, ORW, HQW, or SE3 from normal high water for 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 An buildin foundation 5 feet Any basement 10 feet jp 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 _ ✓ 15A NCAC 02T 0305() contains alternatives where separations in 02 0:;05(0 cannot be achieved. **Stream classifications can be identified using the Division's NC Surface Water Classifications IN Ovatzp_ ✓ fr noncompliance with 02T,095(flor(,g), see Section X of this application Does the project comply with separation requirements for wetlands? (50 feet of separation) Z Yes 0 No 0 N/A • Sec 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 15ANCAC 02B ,0200? El Yes 0 No Z N/A This would include Trout Buffered Streams per 15A. NCAC 28.0202 4. Does the project require coverage/authorization under a 404 Nationwide or individual permits or 401 Water Quality Certifications? s>6. Information can be obtained from the 401 8; ,Buffer_Petrnitting,Branch 0 Yes Z No 5. Does project comply with 15A NcAC 02'T.0105(c)(6) (additional permits/certifications)? Z Yes No Per 15A NCAC 02T.0105fp)(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, storm management plans, etc.), 6. Does this project include any sewer collection lines that are deemed Thigh -priority?" Per 15A NCAC 021.0402, "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. 0 Yes 0 NoZ N/A ▪ lf 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)(S) or the permitee's individual System -Wide Collection permit. FORM: FTA 04-16 Page 4 or 5 X. CERTIFICATIONS: Does the submitted system comply with 1 4NCAC 02T,, the Minima„ , 1)4si. nCriteria for.. the 1'er�rfittirtg of Pump alb Stations and, Force Mains.,(la,iest 3ersion), and the Gravity: Sewer Minimum Design Criteria Clatest version) as applicable? El Yes ❑ No If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for review. Approval of the request is required prior to submittal of the Fast Track Application and supporting documents. Professional Engineer's Certification: 1, S.i)A-12_rt,No (Professional Engineer's name from Application Item 111.1.) 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. 1 further attest that to the best of nay 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 ma_y 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 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. attest that this application for North Carolina Professional Engineer's seal, signature, and date: Applicant's Certification per 15A NCAC 02T 0106(b): r l � ` attest that this application for (Signature Authority's name LAC title from Application item 1.3.) 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 if all required supporting documentation and attachments are not included, this application package is subject to being returned as incomplete. 1 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 niay 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 14 _2 i 5 6 l and 1-1 . ? l !,b B, 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. ` 0, � r 111 t ,.1.1,r, ` _ "\ SEAL7. 7. 027452 • ' • VGINE.4At'' • O ''',,,„„wo ot,,1 g Signature: Date: I�O1ZM.: FTA 04-16 Page 5 of 5 Resources ��7( t YF } ?t[ (S( State oflNorthy1elCarolina Oepartmctut 0 EnvironmenFal Quality Division of Water ResonrkTN 15.\ NCAC o2'T .o300 — FAST TRACK SEWER SYSTEM t NTF' SION :APPL.ICA t 1r3 04-16 S: SUPPORTING DOC1' of ',''1'_'.1.10 Application timber: All item arlust he comp eted or the ap ilicatiof ‘vill he returned APPLICANT INFORMATION: t to be completed by i MIN.': I . ,\pplicant's name: Hoke County Public Works (company, municipality, 11OA, utility, etc.) .Applicant type: 1 _i Individual Federal ►`�] Corporation 0 General Partnership �] State/County g§ Municipal S nature authority's name: Hilton 1iilines per , ( ` c' ` Title: Utilities Director Applicant's mailing address: PO Box 240 City: ,Raeford State: NC rip: 28376- Applicant's contact information: Phone number. (9iQ) 4&8-0385 Email Address: hv'illines l hokecountv.org II. PROJECT INFORMATION: I_ Project name: B&B Loop Subdivision ?. Application/Project status: 0 Proposed (New Permit) ❑ Existing Permit 'Project 11'a modification, provide the existing permit number: WQOQ_ and issued date: 11 new construction but part of piaster plan, provide the existing permit number: WQOO_._-.___ 3. County where project is located: lioke Fl. Approximate Coordinates (Decimal Degrees): Latitude: 34.99004 Longitude: -79..14 35' Parcel ID (if applicable): 494550001048 (or Parcel ID to closest downstream sewer) ❑ Privately -Owned Public Utility Other DEQ/IJ R J,AN 1 8 oLt III. CONSULTANT iNFORMATION: I. Professional Enaineer: C Scott Brown License Number: 027452 Firm:4DD Site Solutions, Inc Mailim address: 409 Chicago Drive, Suite 112 City: Fayetteville State: NC Zip: 28306-_ Phone number: (91 Q) 426-6777 Email Address: sbrov']i 11. dsitesolutit)11s.Coi11 1V. WS'l'KW TER TREATMENT A TMENT FAi. 11,FI`V (Wi ,.FF) INFORMATION: Facility Name: Hoke County WWII' l' I'e rtnit Number: NCOOS9176 Owner Name: Hoke County Public Works RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF): i . Permit Nuinber(s): WQ Owner Name(.): Hoke._Cpurity Downstream (Receiving) Seaver Size: '?Al inch `VQCSOQ S r,10N1tL OFFICE FORM: FTA O4-16 Page i of 5 3. lithe Applicant is a 1,•;;,:' 4. Origin ot vastewater (check all that apply); F.] Residential Owned r1 Residential Ltmsed 1 1 School / preschool / dav i:are Food and drink !licit ities j 1JUS1110S-SeS les GENERAL REOFIRENIENTS It*the .\pplicant is a Privately -Owned Public Utility.. has a Certificate ol"Public Convenience and Nec.essity heen attached? Irthe AtTlicara is a Develimcr of. lois to be sold. has a • „ 1 Yes FiNc, [7-,,]N/A El Retail (stores. centers. titans) Rta• RIO(' preparationlservice 1 1 'Medical / dental ,/ veteriflaT\ la Lil ChLII.C11 ri 'Nursing I ',pine Nature o1 wastewater lt.to DomestaciCommercial (1/0 Commercial 1)CL11 at /1Cile(t.' been attached'," Li car Wash I 1 Hotel andfor Nylotels Switrimin,, Pool /Clubhouse Po-diFilter Backwash Othca- (Fs:plain in Attachment) Industrial : • : 1 >Is there a Pretreatment Program in etIek..fl El Yes 61 I ,aS a 110 reduction becn appro\ed under . F. If vesprovide a copy of nOANred iletinn approval letter Summarize wastevi'ater Ltenerate,d by project: Esiablisitkoetil Type see 1)esigri Flow 'li . . . -480 .4altdav/Icit aal nt gal,/ i ; Nc). of Units' Flow 1; l2„Ct)0 (di) (i1)1.) CiliD CiPD it (.iPD ; (WI) I 1(iial I 2,0()() (PI) (its to \,,:tste,:;.,ateimilesiL2...n Cli•-)Y,., rates (i.e.„ mitunium Cloy, per prov)oseci trigua(o.vn ni,•)n-resid;•.:attial di..,..i.,.topment uses, laciiities4 ntr..ar high public use 1.,-;;•,:i7itecl, south or :;:a 1;k:, as defined in ' • b Per ISA 14(c)tkien1r (:!.P.11.4klitnerits not itientilled lin1ttE4C••- sitar! be detenin ned i neni to tio\v datln water w,=ing tivi•tires. (..)ecuparev of paiftrns, aild other measured &dia. Wastewater ,Yencrated h project: 1,000 CiPD Do not include future. flows or previously permitted allocations IT permitted 110v;,is zero_ indicate why - ramp Station or Graviv,, Se\-,,er vdieredu ill be permitted Flow has already been allocated in Permit Number: 1 kehabilltati011 or replaeenient or existing sewer with no new flow expected 111 Other (Explain): . - SUL)Sei.ilaelit panlitS that COiliteCt tO thiS FoRm 04_16 Pai&e2 of 5 se,,ver to ht: 1;e1 milted Si-ze Material C& DI p- Section 1 Ill or the \ ID(for Perillitlin!..10 Gra'ity Sewer,, contain. information related to des(dn criteria Section 111 contains mibrination related to 16111111LIM Slopes lot- usavik ev-, Cr{ S') Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MD(' VIII. PUMP STAT1()N 1)ESIGN CRITERIA (If — 1:011PLVIT FOR EACH PUNIP STATION INCLUDED IN THIS PROJECT 1, Pump station number or name: Approximate Coordinates (Decirmil Degrees): 1 at tudL 1,orq.0tude: 3 Design now oldie bump station millions ',_tallons per day (firm capacity) 4. Operational point(s) of the pump( s). gallons per minute at feet total dynamic head ( 5. Summarize the force main to be perrnitted (Cor this Pump Station): Size (inches) - Length (feet) Alaterial in accordance with s•;t.dndhs.,, powo- .:ottrc.. or pump v,111 i0ufliaHCacIi\ ilE1011 - fr':\ F Required for all pump stations v\ith an average_ daily Clow greater than or equal to 15.000 uallons per day Must be permanent to rilCilitV Ur 11 the pump station has au average daily llo\\ less than I 5.000 ,..zallons per day: El Portable po,Aer source with manual activation, quick -connection receptacle and telemetry - 15A. NC.,\C 02.T .0305(h)( 1 )((f) Portable pumping unit v, it h plugged emergency pump connection and ielemeuv 15A NCAC 02'1' .0305(h)( 111 C.'): shall be demonstrated to the Division thin the portable source is ov,,ned or contracted by the .ipplit.iant, Oran agreement) and is compatible, with the station. IC the portdble power source or pump is dedicated to multiple pump stations. an evaluation or ait the pump stations' storage capacities and the rotation schedule or the Portable Pov,c.:r source or pump. includin12. o. iimorrame,-; sh:111 provided in 11W ea>e 015 multiple suitdon powei FORM. FT1 ir)--1- fs') Page 3 of .5 E. SETE V-KS (0213 .0200 & 15A ‘4(-.AC 02T .0305(1)); Ik 177 , • the project comply Jih all 15A NCAC 02-I.0305(1-) cont anis minimum separationsthat shtilLheprovideci for seWer systems: Setback 11 eterSeparation Required Storm sewers tint' other utilities riot listed below (vertical) 24 inches Water mains tvertical-water over seWer including in benched trenches) 18' inches Water mains (horizontal) 10 feet , Rechtimed water lines (vertical - recliaimed over sewer) ; 18 inches 1 I Reclaimed water lines (horizontal - reclaimed over se \Aer) 2 feet -; -- I Any private or public i\ ater supply source, including any wells.. WS-I waters of -('lass 1 or Class 11 impounded reservoirs used as a source of drinking water 100 feet **Waters classified WS (except WS-1 or WS-V), B. S:. ORW, 1 IQW, or Sli front normal il.t,41t1 w::ltcr (or ticitc clicvat;,011) and i;;',-:.t.1ands (see iIt•tr, 1:\;...71 .: . -- **Any other Sifelill, lake. impoundment, 0 I ground water lowering and surface drainaue 10 leet ditches Any buildirT foundation 5 feet Any basement _ 111)feet ...._. Top slope of embankment or cuts ol- 2 feet or more vertical hei.uht 10 feet__ Drainaue systems and interceptor drains Any s,A imming pools Final earth v-ade (vertical) contains alternati\ eS xvhere serdrations in Cicm ions 01 n IL 1 1ir1 the Di% ision's IT noncompliance \Nith see Section X oi this application 5 feet II/ feet 3O inches cannot be achieved. Does the project comply Nat ith separaTion requirements for vs etlands? (50 feet orsepaitaion) .cc 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 design and construction As built documents should reference the location of areas effected 3 Does the project comply yid] setbacks found in the river basin rules per El Yes Li No [1] N/A • Thk ,:vottid in(•lude Trout Bulftled Stri-';k111S per ' -1 Does the project require coyerauelauthorization under a 404 Nationwide or individual permits or -101 \Valet: Quality Certifications? -• Intbrmation can be obtained from the Li] yes [] No 5. Does project comply with .'; '',..; 21 , ':,':;;.....;,), (additional permits/certifications)? Li Yes Lj No Per ;'' ' '' : t.,. directly related environmental permits or cu tilicat ion applications are being prepared, have been applied for. or have been obtained. Issuance (--,Ithis permit is contingent on issuance 1 02 (xpencieni permits (erosion Jnci Seciiiiieniation control plans. SIOITIMaier manauement plans, etc.) Does tins project include any se\=, er collection lines that are deemed Per ,; -high-priority sewer means -any aerial sewer, sewer contactinu, surface waters, siphon, Or SCAVer positioned parle to streambanks that is subject to erosion that undermines or deteriorates the sewer. LI Ves Li NO ED N/A • yes. include an attachment with details for each line, including type (aerial line, size.. material., and location). High priority lines shall he inspected by the perm it tee or its rep resell In 1 ive a t least once every six -months and inspections documented per 15A NCAC 021..0403(o)(5) or the perntitee's System -Wide Collection permit. FORM: ETA 04-16 Pau,e of 5 1)u1‘...-; llie s!.ahi-Pitted tip, Stt'ili an.i}aiij i l_.-1 _� .`to If i\o, complete and titihlllii the eti. for review. Approval alt'S( iS retruiri'(1 ,kri0r to 4E hntitta ; of the Fast Track : 1.E }lki;aiirm and . 5ilF?liorti5 �@ cl0e11l114'i31s. ''1o1,essional Ell..yineeI s riance llternaati\c [ sivl.n Request application (V:1DC 10-11' and supporting documents c t11i a tit%il. sional Engineer's name from `application Item 111. i ..l has been reviewed by me and is accurate. complete and consistent \:yith the iinformation supplied in ihe plans, specifications. engineering calculations. and all other stipportino documentation to the best of ni knowledge I further attest that to the fist of my knows -ledge the proposed design has been prepared in accordance with the applicable regulations. Gravity Sewer Minimum Design C'riteriaa for (iravity Sewers (latest version)_ and the ;Minimum Desig.n Criteria _ for the Fast- !lack Permitting of Pump Stations and Force Mains (latest version). Although other processionals may have developed certain portions ot'this submittal package, inclusion of these materials under my signature and seal sit lilies that 1 have re-Vier4:ct1 this material and have judged it to be consistent v'ith the pFOposed dcsiun. N%j I F In accordance :with General Statutes 143-2 1 OA and I-1 3-215.eB, any person who knna'1%ingly makes any lake statement, representation, or certicicaation in any application package shall be e.uilty of a Class 2 misdemeanor. which may t:ftitieie tt €Iiie not ut: exeeeu S it),t.' u, as well as civil t_7eutiiile tip to ., 00i. attest that this ai)1!Itt attc!i North Carolina Professional Engineer's seal, signature, and agate: Applicant's Certification per I:5A .. CA(' (2i 010(1)(i terr, 1 t- rf �, f_l �� .....:.af 't S _ �. .�'yC�'_-t"�`g.._. � ... `� r' .�i.-ate C1(Signature Authority':; name .: title ii�a,ra � plillcatit�n Item l.i. j has been reviewed by Inc and is accurate and complete to the best ofInv knowvleds.,'e, i understand that if all required parts of this application are not completed and that ii all required supp'rting documentation and attachments are not iil0it;aied, this application package is subject to being returned as incoiliplete. 1 understand that any discharge of wastewater ti-oni tliis non - discharge system to surface waters or the land trill I.CSIIIt 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 ol'this permit he violated. I also understand that if all required parts of this application package .are not completed and that if all required supportina3 inlorniaation and attachments are not included. this application package will he returned to me as incomplete. tI. '1 . --- in accordance with Gen€eri'l tatotes and al t erion who knowingly makes an farce '. a slncmeni, ;epre e'iltatti0n.. or certification an any application pacLi.m,e .;hall be !`tnit' of a Class 2 misdei'.1etinor, -wl ich may include_ a line not to exceed S 10.00O as well as civil penalties up to `a25.000 per violation. Signature` �_ 2 attes that this application for Date:ram- 1 A f )-t- let Page 5 or 5 State of North Carolina Department of Environmental Quality Division of Water Resources (?i\ kion of Viatt Rt ,� �, Flow Tracking for Sewer Extension Applications S��°'�'rr���r�i �'r-"icE (FTSE 10-18) DECVOVVR JAN 1 /at WQ O S Entity Requesting Allocation: County of Hoke Project Name for which flow is being requested: B&B Loop More than one FTSE may be required for a single project if the owner of the W` /7P 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: Hoke County Waste Water Treatment Facility b. WWTP Facility Permit #: NC0089176 All flows are in MGD c. WWTP facility's permitted flow 1.500 MGD d. Estimated obligated flow not yet tributary to the WWTP 0.286 MGD e. WWTP facility's actual avg. flow 0.595 MGD f. Total flow for this specific request 0.0053 MGD g. Total actual and obligated flows to the facility 0.911 MGD h. Percent of permitted flow used 60.7% 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 Average Approx. Obligated, Pump Pump Daily Current Not Yet Total Current Station Station Firm Flow** Avg. Daily Tributary Flow Plus (Name or Permit Capacity, * (Firm / pf), Flow, Daily Flow, Obligated Available Number) No. MGD MGD MGD MGD Flow Capacity*** Regional WQ0036140 3.750 1.500 0.590 0.298 0.888 0.612 * 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 (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): Hoke County Collection System Downstream Permit Number: WQCS00352 Page 1 of 6 FTSE 10-18 III. Certification Statement: I Hilton Villines, Utilities Director 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 addendurns 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 Signature Date 41 A fin .A A Tit e o igning OfTcial Page 2 of 6 FTSE 10-18 PLANNING ASSESSMENT ADDENDUM (PAA) Submit a planning assessment addendum for each pump station listed in Section II where Available Capacity is < 0. Pump Station (Name or Number): Given that: a. The proportion and amount of Obligated, Not Yet Tributary Daily Flow (C) accounts for % and MGD of the Available Capacity (E) in Pump Station ; and that b. The rate of activation of this obligated, not yet tributary capacity is currently approximately MGD per year; and that c. A funded Capital Project that will provide the required planned capacity, namely is in design or under construction with planned completion in ; and/or d. The following applies: Therefore: Given reasonably expected conditions and planning information, there is sufficient justification to allow this flow to be permitted, without a significant likelihood of over -allocating capacity in the system infrastructure. I understand that this does not relieve the collection system owner from complying with G.S. 143- 215.67(a) which prohibits the introduction of any waste in excess of the capacity of the waste disposal system. Signing Official Signature Date Page 3 of 6 FTSE 10-18 Instructions for Flow Tracking form (FTSE) and Planning Assessment Addendum (PAA) Section I a. WWTP Facility Name: Enter the name of the WWTP that will receive the wastewater flow. b. WWTP Facility Permit #: Enter the NPDES or Non -Discharge number for the WWTP receiving the wastewater flow. c. WWTP facility's permitted flow, MGD: From WWTP owner's NPDES or Non -Discharge permit. d. Estimated obligated flow not yet tributary to the WWTP, MGD: This includes flows allocated to other construction projects not yet contributing flow to the collection system. Flows allocated through interlocal agreements or other contracts not yet contributing flow to the collection system are also included. For POTWs that implement a pretreatment program, include flows allocated to industrial users who may not be using all of their flow allocation. Please contact your Pretreatment Coordinator for information on industrial flow tributary to your WWTP. As of January 15, 2008 the POTW should have reviewed flow allocations made over the last two years and reconciled their flow records, to the best of their ability, so it is known how much flow has been obligated and is not yet been made tributary to the WWTP, in accordance with local policies and procedures employed by the reporting entity. e. WWTP facility's actual avg. flow, MGD: Previous 12 month average. f. Total flow for this specific request, MGD: Enter the requested flow volume. g. Total actual and obligated flows to the facility, MGD Equals [d + e + f] h. Percent of permitted flow used: Equals [(g / c)* 100j For example: On January 15 a POTW with a permitted flow of 6.0 MGD, reported to the Regional Office that there is 0.5 MGD of flow that is obligated but not yet tributary. The annual average flow for 2007 is 2.7 MGD. There is a proposed flow expansion of 0.015 MGD. The first Form FTSE submitted after January 15, 2008 may have numbers like this: c. = 6.0 MGD d. = 0.5 MGD e. = 2.7 MGD f.=0.0I5MGD g.=3.215MGD h. = 53.6 The next Form FTSE may be updated like this with a proposed flow expansion of 0.102 MGD: c. = 6.0 MGD d. = 0.515 MGD e. = 2.73 MGD f. = 0.102 MGD g. = 3.349 MGD h. = 55.8% Each subsequent FTSE form will be updated in the same manner. Page 4 of 6 FTSE 10-18 Section 11 List the pump station name or number and approximate pump station firm capacity, approximate design average daily flow (A) approximate current average daily flow (B), and the obligated, not yet tributary flow through the pump station (C) for each pump station that will be impacted by the proposed sewer extension project. Calculate the total current flow plus obligated flow (D=B+C) and the available capacity (E=A-D). Include the proposed flow for this project with other obligated flows that have been approved for the pump station but are not yet tributary (C). Firm capacity is the maximum pumped flow that can be achieved with the largest pump out of service as per the Minimum Design Criteria. Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor (pf) of not less than 2.5. If the available capacity (E) for any pump station is < 0, then prepare a planning assessment for that pump station if the system has future specific plans related to capacity that should be considered in the permitting process. (A) (B) (C) (D)=(B+C) (E)=(A-D) Obligated, Design Approx. Not Yet Total Current Firm Average Current Avg. Tributary Flow Plus Pump Station Capacity Daily Flow Daily Flow, Daily Flow, Obligated Available (Name or Number) MGD (Firm / pf) MGD MGD Flow Capacity* Kaw Creek PS 0.800 0.320 0.252 0.080 0.332 -0.012 Valley Road PS 1.895 0.758 0.472 0.135 0.607 0.151 Page 5 of 6 FTSE 10-18 Planning Assessment Addendum Instructions Submit a planning assessment addendum for each pump station listed in Section II where available capacity is < 0. A planning assessment for Kaw Creek PS (see example data above) may be performed to evaluate whether there is significant likelihood that needed improvements or reductions in obligated flows will be in place prior to activating the flows from the proposed sewer extension project. If the system decides to accept the flow based on a planning assessment addendum, it is responsible to manage the flow without capacity related sanitary overflows and must take all steps necessary to complete the project or control the rate of flow to prevent sanitary sewer overflows. The planning assessment may identify a funded project currently in design or construction, or a planned project in the future not yet funded but in a formal plan adopted by the system. The system should carefully weigh the certainty of successful timely project completion for any expansion, flow management diversion or infiltration and inflow elimination projects that are the foundation of a planned solution to capacity tracking and acceptance compliance. For example: Given that: a. The proportion and amount of obligated, not yet tributary flow accounts for 24 % and 0.080 MGD of the committed flow in Pump Station Kaw Creek; and that b. The rate of activation of this obligated, not yet tributary capacity is currently approximately 0.01 MGD per year; and that c. A funded capital project that will provide the required planned capacity, namely is in design or under construction with planned completion in ; and/or d. The following applies: The master plan and ten year capital plan contain recommended scope and funding for a capital project entitled Kaw Creek Pump Station upgrade with funding planned in July 2014. This project is planned to add 0.100 MGD to the firm capacity of the pump station by October 2015. Inclusion of this proposed capital project as a condition of this Flow Tracking/Acceptance for Sewer Extension Permit Application elevates this project's priority for funding and construction to be implemented ahead of the activation of obligated, not yet tributary flows in amounts that exceed the firm pump station capacities identified in Section II above. Therefore: Given reasonably expected conditions and planning information, there is sufficient justification to allow this flow to be permitted, without a significant likelihood of over -allocating capacity in the system infrastructure. Page 6 of 6 FTSE 10-18 DEQ/DVIR i 1 8 to2ti State of North Carolina Department of Environmental Quality Division of Water Resources Div Rion of Witter Reaorrrre s WO ` S7AYEFlow Tracking for Sewer Extension Applications ,t �M ,r- f �i,� C�=F�G (FTSE 10-18) Entity Requesting Allocation: County of Hoke Project Name for which flow is being requested: B&B Loop 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: Hoke County Waste Water Treatment Facility b. WWTP Facility Permit #: NC0089176 Wows are in MGD c. WWTP facility's permitted flow 1.500 MGD d. Estimated obligated flow not yet tributary to the WWTP 0.286 MGD 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 0.595 MGD 0.0053 MGD 0.911 MGD 60.7% 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: Pump Station (Name or Number) Pump Station Permit No. Firm Capacity, * MGD (A) Design Average Daily Flow** (Firm / pf), MGD (B) Approx. Current Avg. Daily Flow, MGD (C) (D)=(B+C) Obligated, Not Yet Tributary Daily Flow, MGD Total Current Flow Plus Obligated Flow (E)=(A-D) Available Capacity*** Regional WQ0036140 3.750 1.500 0.590 0.298 0.888 0.612 * 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 (pi) not less than 2,5per Section 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): Hoke County Collection System Downstream Permit Number: WQCS00352 Page 1 of 6 FTSE 10-18 III. Certification Statement: I Hilton Villines, Utilities Director 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 relatrelated sanitary sewer overflows or overburden any downstream pimp station en route to the receiving ed sanitary Jv j--- r' treatment plantlunder 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 certifies that the receiving collection system or treatment works has adequate capacity to transport and treat the proposed new wastewater. Signing Official Signature l Tit e o igning Of vial A n /I Page 2 of 6 FTSE 10-18 PLANNING ASSESSMENT ADDENDUM (PAA) Submit a planning assessment addendum for each pump station listed in Section II where Available Capacity is < 4. Pump Station (Name or Number): Given that: a. The proportion and amount of Obligated, Not Yet Tributary Daily Flow (C) accounts for % and MGD of the Available Capacity (E) in Pump Station ; and that b. The rate of activation of this obligated, not yet tributary capacity is currently approximately MGD per year; and that c. A funded Capital Project that will provide the required planned capacity, namely is in design or under construction with planned completion in ; and/or d. The following applies: Therefore: Given reasonably expected conditions and planning information, there is sufficient justification to allow this flow to be permitted, without a significant likelihood of over -allocating capacity in the system infrastructure. I understand that this does not relieve the collection system owner from complying with G.S. 143- 215.67(a) which prohibits the introduction of any waste in excess of the capacity of the waste disposal system. Signing Official Signature Date Page 3 of 6 FTSE 10-18 Instructions for Flow Tracking form (FTSE) and Planning Assessment Addendum (PAA) Section I a. WWTP Facility Name: Enter the name of the WWTP that will receive the wastewater flow. b. WWTP Facility Permit #: Enter the NPDES or Non -Discharge number for the WWTP receiving the wastewater flow. c. WWTP facility's permitted flow, MGD: From WWTP owner's NPDES or Non -Discharge permit. d. Estimated obligated flow not yet tributary to the WWTP, MGD: This includes flows allocated to other construction projects not yet contributing flow to the collection system. Flows allocated through interlocal agreements or other contracts not yet contributing flow to the collection system are also included. For POTWs that implement a pretreatment program, include flows allocated to industrial users who may not be using all of their flow allocation. Please contact your Pretreatment Coordinator for information on industrial flow tributary to your WWTP. As of January 15, 2008 the POTW should have reviewed flow allocations made over the last two years and reconciled their flow records, to the best of their ability, so it is known how much flow has been obligated and is not yet been made tributary to the WWTP, in accordance with local policies and procedures employed by the reporting entity. e. WWTP facility's actual avg. flow, MGD: Previous 12 month average. f. Total flow for this specific request, MGD: Enter the requested flow volume. g. Total actual and obligated flows to the facility, MGD Equals [d + e + fi h. Percent of permitted flow used: Equals [(g i c)* 100] For example: On January 15 a POTW with a permitted flow of 6.0 MGD, reported to the Regional Office that there is 0.5 MGD of flow that is obligated but not yet tributary. The annual average flow for 2007 is 2.7 MGD. There is a proposed flow expansion of 0.015 MGD. The first Form FTSE submitted after January 15, 2008 may have numbers like this: c. = 6.0 MGD d. 0.5 MGD e. = 2.7 MGD f = 0.015 MGD g.=3.215MGD h.=53.6% The next Form FTSE may be updated like this with a proposed flow expansion of 0.102 MGD: c. = 6.0 MGD d. = 0.515 MGD e. = 2.73 M G D f. = 0.102 MGD g. = 3.349 MGD h.=55.8% Each subsequent FTSE form will be updated in the same manner. Page 4 of FTSE 10-18 Section II List the pump station name or number and approximate pump station firm capacity, approximate design average daily flow (A) approximate current average daily flow (B), and the obligated, not yet tributary flow through the pump station (C) for each pump station that will be impacted by the proposed sewer extension project. Calculate the total current flow plus obligated flow (D=B+C) and the available capacity (E=A-D). Include the proposed flow for this project with other obligated flows that have been approved for the pump station but are not yet tributary (C). Firm capacity is the maximum pumped flow that can be achieved with the largest pump out of service as per the Minimum Design Criteria. Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor (pf) of not less than 2.5. If the available capacity (E) for any pump station is < 0, then prepare a planning assessment for that pump station if the system has future specific plans related to capacity that should be considered in the permitting process. (A) (B) (C) (D)=(B+C) (E)=(A-D) Obligated, Design Approx. Not Yet Total Current Firm Average Current Avg. Tributary Flow Plus Pump Station Capacity Daily Flow Daily Flow, Daily Flow, Obligated Available (Name or Number) MGD (Firm / pf) MGD MGD Flow Capacity* Kaw Creek PS 0.800 0.320 0.252 0.080 0.332 -0.012 Valley Road PS 1.895 0.758 0.472 0.135 0.607 0.151 Page 5 of 6 FTSE 10-18 Planning Assessment Addendum Instructions Submit a planning assessment addendum for each pump station listed in Section II where available capacity is < 0. A planning assessment for Kaw Creek PS (see example data above) may be performed to evaluate whether there is significant likelihood that needed improvements or reductions in obligated flows will be in place prior to activating the flows from the proposed sewer extension project. If the system decides to accept the flow based on a planning assessment addendum, it is responsible to manage the flow without capacity related sanitary overflows and must take all steps necessary to complete the project or control the rate of flow to prevent sanitary sewer overflows. The planning assessment may identify a funded project currently in design or construction, or a planned project in the future not yet funded but in a formal plan adopted by the system. The system should carefully weigh the certainty of successful timely project completion for any expansion, flow management diversion or infiltration and inflow elimination projects that are the foundation of a planned solution to capacity tracking and acceptance comp! iance. For example: Given that: a. The proportion and amount of obligated, not yet tributary flow accounts for 24 % and 0.080 MGD of the committed flow in Pump Station Kaw Creek: and that b. The rate of activation of this obligated, not yet tributary capacity is currently approximately 0.01 MGD per year; and that c. A funded capital project that will provide the required planned capacity, namely is in design or under construction with planned completion in ; and/or d. The following applies: The master plan and ten year capital plan contain recommended scope and funding for a capital project entitled Kaw Creek Pump Station upgrade with funding planned in July 2014. This project is planned to add 0.100 MGD to the firm capacity of the pump station by October 2015. Inclusion of this proposed capital project as a condition of this Flow Tracking/Acceptance for Sewer Extension Permit Application elevates this proiect's priority for funding and construction to be implemented ahead of the activation of obligated, not vet tributary flows in amounts that exceed the firm pump station capacities identified in Section II above. Therefore: Given reasonably expected conditions and planning information, there is sufficient justification to allow this flow to be permitted, without a significant likelihood of over -allocating capacity in the system infrastructure. Page 6 of 6 FTSE 10-18 r tutiv . DECUOV/R Lvo