WQ0043088_Application (FTSE)_20220124

December 22, 2021
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RECEIVE0/NC1)ENRlDWR
Mr. Dean Hunkele JAN 0 3 2022
NCDEQ Wilmington Regional Office
Water Quality Section water ouelny Raw"
opmoos Section
127 Cardinal Drive Extension AKVW P1 gIonal
hnm�.,�oa Ragloae� Office
Wilmington, North Carolina 28405
Subject: NCDOT Project R-5021
NC 211 Widening
Brunswick County
Southeast Brunswick Sanitary District Pump Station Relocation
Dear Sir:
Please find enclosed the completed Fast Track Sewer Application and supporting documentation for the
above -mentioned project. One original and one copy of the following are included for your review and
approval.
Fast Track Permit Application
Permit Application Fee of $480.00 (check #173974)
USGS & Street Level Maps
Proiect Narrative:
The enclosed documents are submitted for the relocation of the existing Southeast Brunswick Sanitary
District Pump Station #4 located along the south side of Southport Supply Road SE and across the road
from Sacred Heart Catholic Church. This project also includes the relocation of 8" gravity sanitary sewer
and 6" force main along the south side of Southport Supply Road SE. The relocation begins at the
intersection of Old Long Beach RD SE and Southport Supply Road SE and travels east towards Sacred
Heart Catholic Church ending at Pump Station #4. These sewer relocations are due to impacts from
construction associated with NCDOT project R-5021, widening of NC 211. The sewer relocations will not
add any additional flows.
Sincerely,
Rummel, Klepper & Kahl, LLP
Kevin Nash, PE
Manager
Enclosure
cc: Bryan Badey PE
Engineers I Construction Managers I Planners I Scientists

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Divlslon of Water Resources FTA 06-21 & SUPPORTING DOCUMENTATION
Application Number. U&GdU3 D b nob mnq,tvcdbyDa'Rt
All items must be completed or the application will be returned
1. APPLICANT INFORMATION:
I. Applicant's name: Southeast Brunswick Sanitary District (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3. Signature authority's name: Bryan McCabe per I SA NCAC 02T .0106(b)
Title: District Manager
4. Applicant's mailing address: 4240 Committee Drive SE
City: Southport State: NC Zip: 28461
5. Applicant's contact information:
Phone number. (9I0) 457-0006 Email Address: bmecabe't southeasibrnswick.com
11. PROJECT INFORMATION:
I. Project name: NCDOT R-5021: NC 211 Pump Station N4 Relocation
2. ApplicationfProject status: ® Proposed (New Permit) ❑ Existing Pennit/Project
If a modification, provide the existing permit number: %V000 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. W000_
3. County where project is located: Brunswick
4. Approxunate Coordinates (Decimal Degrees): Latitude: 33.94895' Longitude:-78.03729'
5. Parcel ID (if applicable): _ (or Parcel ID to closest downstream sewer)
Ill. CONSULTANT INFORMATION:
I. Professional Engineer: Kevin Nash License Number: 045517
Firm: RK&K
Mailing address: 8601 Six Forks Road. Form 1, Suite 700
City: Raleigh State: NC Zip: 27615-5276
Phone number [phone] Email Address: knash4?rkk.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
I. Facility Name: Permit Number: _ W &QQ 0 'a-0 O
Owner Name:
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
I. Permit Number(s): %V0
2. Downstreanm (Receiving) Sewer Information: _ inch ❑ Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s): _
FORM: FTA 06-21 Page I 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 ® N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEV) been attached?
❑ Yes ❑ No ® NIA
3. If the Applicant is a I Ionic/Property Owtmers' Association, has an HOA/POA Operational Agreement (FORM: HOA) 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 / veterinary facilities ❑ Swimming Pool/Clubhouse
❑ Food and drink facilities ® Church ❑ Swimming Pool/Filter Backwash
® Businesses / offices / factories ❑ Nursing I Ionic ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic %Commercial _ % Industrial (See 15A NCAC 02T .0103(20))
If Industrial, is there a Pretreatment Program in effect? ❑ Yes❑ No
6. Hasa Row reduction been approved under 15A NCAC 02T .0114(8? []Yes ®No
If Yes, provide a cony of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (sec 02T.0114(f))
Daily Design Flow '"
No. of Units
Flow
gal/
GPD
gal/
GPD
gaV
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
GPD
a See 15A NCAC 021.0114(b). (d). (e)(1) and (e)(2) for caveats to wastewater design Flow rates (i.e., minimum Bow 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.42 -4.
b Per 15A NCAC 02T .0114(c), design Flow rates for establishments not identified [in table 15A NCAC 02T.01141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 0 GPD (per 15A NCAC 02T .0114)
y Do not include future flows or previously permitted allocations
If permitter) 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

ViL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feel) Material
8 1,400 PVC C900DR18
➢ Section II & Ill 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) — 21.03 5 & MDC (Pump Stations/Force Mains):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
I. Pump station number or name: Southeast Brunswick Sanitary District Sewer IRunpstation d
2. Approximate Coordinates (Decimal Degrees): Latitude: 33.94895' Longitude:-78.03729'
3. Total number of pumps at the pump station: 2
3. Design flow of the pump station: 0.216 millions gallons per day (firm capacity)
➢ This should reflect the total GPM for the pump station with the largest pump out of service.
J. Operational point(s) per punp(s): 220 gallons per minute (GPM) at 71 feet total dynamic head (-I DID
5_ Summarize the force main to he permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
6
2.065
PVC C900 DR18
8
435
HDPE DR9
If any portion of the force main is less titan 4-inches in diameter, please identify the method of solids reduction per
MDCPSFM Section 2.01C. Lb. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify) _
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1):
® Standby power source or ❑ Standby pump
Must have automatic activation and telemetry - 15A NCAC 02T.0305 ft l )(B).
➢ Required for all pump stations with an average daily Flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility and may not be portable
Or if the pump station has an average daily Bow less than 15,000 gallons per day 15A NCACO2T.0305(hx I)(C):
❑ Portable power source with manual activation, quick -connection receptacle and telemetry
or
❑ Ponable pumping unit with plugged ennergency ptunp 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

IX. SETBACKS & SEPARATIONS - (02B.0200 & i5A NCAC 02T.0305(f)):
1. Does the project comply with all separations/alternatives found in 15A NCAC 02T .0305(D & (g)? ® Yes ❑ No
15A NCAC 02T.0305(0 contains minimum separations that shall he nrovided for sewer cvctemr
- -
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)
IO feet
Reclaimed water lines (vertical - reclaimed over sewer)
I8 inches
Reclaimed water lines (horizontal - reclaimed over sewer)
2 feet
#tAny private or public water supply source, including any wells, WS-1 waters of Class I 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 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(t) or (g). see Section X.1 of this application
*15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(fl cannot be achieved. Please check "yes"
above if these alternatives are used and provide narrative informtion to explain.
**Stream classifications can be identified using the Division's NC Surface Water Classifications webVgge
2. Does Otis project comply with the minimum separation requirements for water mains? ® Yes []No ❑ N/A
➢ If no, please refer to 15A NCAC ISC.0%6(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? ® Yes ❑ No ❑ N/A
➢ Please provide supplementary information identifying the areas of non-conformance.
➢ Seethe 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 15A NCAC 2B.0202
5. Does the project require coverage/authorization under a 404 Nationwide/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 15A NCAC 02T.0105(e)(61(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, stonowater management plans, etc.).
7. Does this project include any sewer collection lines that are deenmed "high -priority?" ❑ Yes ® No
Per 15A NCAC 02T.0402, "high -priority sewer" means any aerial sewer, server contacting surface waters,
siphon, or sewers positioned parallel to streanmhanks 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 permiltee or its representative at least once every six -months and
inspections documented per 15A NCAC 02T.0403(a)(5) or the permitlee's individual System -Wide Collection permit.
FORM: FTA 06-21 Page 4 of 5

X. CERTIFICATIONS:
I. Does the submitted system comply with 15A NCAC 02T, the Mininnun Design Criteria for the Permitting of Pump Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteria (latest version) as applicable?
® Yes ❑ No
If no, fir projects requiring a single variance, complete and submit the Variance/Alterative 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 mac be subject to longer
review times. For proiecls requiring two or more variances or where the variance is determined by llte Division to be a
significant portion of the proiecl, the full technical review is required.
2. Professional Engineers Certification:
1, KEVI N N ASIa , attest (bat this application for ,502 ( " Oak( P S,-*Li
(Professional Gngineer's name from Application Item 111.6 (Project Nam. fmm Application Item ILI)
-
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 my knowledge the proposed design has been prepared in accordance with the applicable regulations,
Minimum Design Criteria for Gravitv Sewers (latest version), and the Mininium Design Criteria for the Fast -Track Permiltine
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of (his
submittal package, inclusion of these materials under my signature and seal signifies that 1 have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes I43-215.6A and 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 S25,000 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,fi Q7,Q,)
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
attest that this application for )- i 1 _ NL all P. 5. 4 1 (Signal re Auaxnip Nance from Application Item 1.3) (Project Nancec from Applicaticm Item IL )
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 understated 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 %Vater 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 inforination and attachments are not included, this application
package will be returned to me as incomplete.
NOTE. -- hi 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 S25,000 per violation.
Signature:-^�
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Date:
------ --- ----
FORM: FIFA 06-21
Page 5 of 5

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NORTH CAROLINA DEPARTMENT OF
TRANSPORTATION
ENVIRONMENTAL ANALYSIS UNIT
STIP PROJECT: R-5021
NC 211 WIDENING
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T BRUNSWICK SANITARY DISTRICT