WQ0043296_Application (FTSE)_20220310

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: uAd,co\V3Z.°\lo (to be completed by DWR)
Ail items must be completed or the application will be returned
I. APPLICANT INFORMATION:
I. Applicant's name: Hillsborough Dealership Property II, LLC (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: Tony Fisher per 15A NC AC 02T .0106(b)
Title.
4. Applicant's mailing address: 4900 Leigh Drive
City: Raleigh State: NC Zip: 27616-
5. Applicant's contact information:
Phone number (919) 215-69I8 Email Address: tony.ftsher(auniversityford.com
II. PROJECT INFORMATION:
I. Project name: Hi1lsborough CDJ+R
2. Application. Project status:
® Proposed (New Permit) ❑ 1-:xisting 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. ;
n
If new construction, but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Orange Coumy
4. Approximate Coordinates (Decimal Degrees): Latitude: 36.0563 Longitude: -79.0783 CIT x
tn
5. Parcel ID (if applicable): 9873698536 (or Parcel ID to closest downstream sewer) r. v<,
III. CONSULTANT INFORMATION: G'
1. Professional Engineer: Timothy A. Smith License Number: 30517 1.�
Firm: Summit Design & Engineering Services A
Mailing address: 320 Executive Court
zi
City: Hillsborough State: NC Zip: 27278-
Phone number: [phone] Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Hillsborough WWTP Permit Number: NC0026433
Owner Name: Town of Hillsborough
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
I. Permit Number(s): WQ 0037048
2. Downstream (Receiving) Sewer Information: 3 inch D Gravity ® Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS N/A
Owner Name(s): Paliouras Enterprises, LLC
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 peveloner's Operational Agreement (FORM; DEN.) been attached?
❑ Yes ❑ No ® NIA
3. If the Applicant is a Home/Property Owners' Association, has an ] 1OA POA Operational Agreement (FORM: 1-1421L4 and
supplementary documentation as required by 15A NCAC 02T.01 I5(c) been attached?
El Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply):
❑ Residential (Individually Owned)
❑ Residential (Leased)
❑ School / preschool 1 day care
O Food and drink facilities
❑ Businesses i offices 1 factories
® Retail (stores, centers, malls)
❑ Retail with food preparation/service
❑ Medical f dental / veterinary facilities
0 Church
❑ Nursing Home
❑ Car Wash
O Hotel and/or Motels
0 Swimming Pool/Clubhouse
❑ Swimming Pool/Filter Backwash
❑ Other (Explain in Attachment)
5. Nature of wastewater : % Domestic 100 °•o Commercial ° o Industrial (See 15A NCAC 02T .01031201)
If Industrial, is there a Pretreatment Program in effect? ❑ Yes❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .01 14(0? 0 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(t))
Daily Design Flow'.b
No. of Units
Flow
Grocery Store
???? gal/DAY
GPD
gall
GPD
gal
GPD
gal!
GPD
gall
GPD
gal.
GPD
Total
GPD
a See 15A NCAC fl2T .0114lb). fd). {e)f 11 and ; e)i21 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 .01 I4(c), design flow rates for establishments not identified [in table 15A 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: ?????? GPD (per 15A NCAC 02T .0114)
➢ 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:
O 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_(Cravity Sewers):
I. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
243
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
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pum Statians. Force
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 me hod of solids reduction per
MDCPSFM Section 2.01 C. I .b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with 15A NCAC 02T .O fi thK I I:
❑ Standby power source or ❑ Standby pump
➢ Must have automatic activation and telemetry - 15A NCAC 02T.0305(h)(l)(B)_
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility 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

IX. SETBACKS & SEPARATIONS = (02B .0200 & 15A NCAC 02T .0305(0):
1. Does the project comply with all separations/alternatives found in 15A NCAC 02T .030510 & '? ® Yes ❑ No
I5A NCAC 02T.0305(f) contains minimum separations that shall be provided 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-1 waters of Class I or
Class 1I 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.0305f ft or (0). see Section X,1 of this application
*15A NCAC 02T.0305(g) contains alternatives where separations in 1J2 03051 t? 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
2. Does this project comply with the minimum separation requirements for water mains? ® Yes ❑ No ❑ N A
➢ If no, please refer to I5A NCAC 18C.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? ❑ Yes ❑ No ® NIA
➢ 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: Neuse 0 No
If yes, does the project comply with setbacks found in the river basin rules per I5A NCAC 02B .*200? ® 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 I SA NCAC 0 _Q105(c)(r,) (additional permitsrcertifcations)? ® Yes ❑ No
Per 15A NCAC 02T,*I05(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?" 0 Yes ® No
Per 15A NCAC 02T,0402, "high -priority sewer" means any aenal 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:
1. Does the submitted system comply with I vA NCAC 02T. the Minimum Design Criteria for the Permitting of Pump `.Z"taUvnl
and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteria (latest 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. Approval of the request will be issued
concurrently with the approval of the permit, and proiects 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 protect, the full technical review is required.
2. Professional Engineer's Certification:
I, Timothy A. Smith , attest that this application for I-lillsborouah CDJ + R
(Professional Engineer's name from Application item 111.1.) (Project Name from Application Item 11. 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 hest 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 f?csittn Criteria fcf_tlie I-ast-Track Permitting
of Pump Stations and Force Mains ( latest version]. Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design
NOTE — In accordance with General Statutes 143-215.6A and 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 S 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 56.0701)
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
\\\�}lsitrtri„if/cARo,
30517
,
'' 3/7/2022
I, Tony Fisher , attest that this application for Hillsborough CDJ+R
(Signature Autlionty Name from Application Item 1.3.1 (Project Name from Application Item Ill)
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 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 S 10,000 as well as civil penalties up to S25,000 per violation.
Signature:
Date.
//342
FORM: FTA 06-2 l Page 5 of 5

r 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: Hillsborough Dealership Property II
Project Name for which flow is being requested: CDJR Dealership
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: Town of Hillsborough WWTP
b. WWTP Facility Permit #: NC0026433
All flows are in MGD
c. WWTP facility's permitted flow 3.0
d. Estimated obligated flow not yet tributary to the WWTP 0.458
e. WWTP facility's actual avg. flow 1.083
f. Total flow for this specific request .0025
g. Total actual and obligated flows to the facility 1.54
h. Percent of permitted flow used 51
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***
E. Brady WQ0035536 1.584 .6336 .340 .0908 .4318 .2018
* 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): WWTP
Downstream Permit Number: As Above
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I K. Marie Strandwitz, 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 certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
2/25/2022
Signing OIcial Signature Date
Utilities Director
Title of Signing Official
Page 2 of 6
FTSE 10-18

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Paliouras Enterprises, LLC
Project Name for which flow is being requested: Hillsborough CDJ+R
More than one FTSE may be tequired for a single project tf the owner of the WPM is not responsible for all punrp
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: Paliouras Property
b. WWTP Facility Permit #: WQ0037048
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
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
All flows are in MGD
il. 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,
Pump Average Daily Approx. Not Yet Total Current
Station Firm Flow** Current Avg. Tributary Flow Plus
(Name or Capacity, * (Firm r pt), Daily Flow, Daily Flow, Obligated Available
Number) MGD MGD MGD MGD Flow Capacity***
Paliouras 0.144 0.0576 0.0030 0.0030 0.0060 0.0516
* 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 (pi) not less than 2.5.
*** 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): Town of Hillsborough
Downstream Permit Number: UNK
Page 1 of 6
FTS E 04-1 {,

III. Certification Statement:
I Nick Paliouras 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.
9-2
Signing Official Signature
Page 2 of 6
?/7/,20a,
Dare
FTSE 04-16

SUMMIT
DESIGN AND ENGINEERING SERVICES
Project:
SDE Project #:
Information Provided by:
320 Executive Court, Hillsborough, NC 27278
Phone // 919.732.3883 Web 1/ www.summitde.net
Fast Track Sewer Application
Cover Letter
Hillsborough CDJR
19-0102.010
Timothy A. Smith, P.E.
March 7, 2022
Contents:
Cover Letter, wastewater flow calculations and project narrative, Division of Water Resources
Fast Track Sewer System Extension application and attachments.
Project Narrative:
Hillsborough CDJ+R consists of a 23,593 sq. ft. car dealership building, parking lots, private road,
and sidewalks on 5.98 acres of land. The building will be a one-story structure with office and
showroom space, service bays and other open areas. The site is located on NC HWY 86 S in
Hillsborough, North Carolina and identified with Orange County Parcel PIN #9873698536. The
development of this site will require a private sewer extension to connect to an existing private
pump station located on the parent development parcel. (Orange County Parcel PIN #873697321)
This private gravity extension is not required for the new dealership but is part of the approval
for the project by the Town of Hillsborough and will serve future development on the parent
parcel. For the new dealership, there will only be a new service line installed to connect to the
existing pump station. The private pump station has a private force main that discharges into the
Town of Hillsborough public sewer system. The gravity sewer extension will consist of 1 new
manhole and 243 If of 8" SDR-35 PVC pipe. The new sewer main will be stubbed out for future
further private expansion within the parent development parcel.
Wastewater Flows:
20 plumbing fixtures at 125 gpd/fixture (per 15A NCAC 027 .0114 Wastewater Flow Rates)
Total Wastewater Flow = 2,500 gpd
Items included with this submittal: (one original and one copy)
• Cover Letter
• Fast Track Form and $480 fee check
• Flow Tracking Forms (Two)
o One for private pump station
& One for Town of Hillsborough
• Site Maps (USGS and Google Street Map)
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1r
SUMMIT
DESIGN AND ENGINEERING SERVICES
LETTER OF TRANSMITTAL
TO: NCDEQ - Division of Water Resources
ATTN
3800 Barrett Drive, Suite 100
I Raleigh, NC 27609
r
Scott Vinson
919-791-4200
TRANSMITTED VIA: Fedex
WE ARE SENDING YOIJ:
320 Executive Court, Hillsborough, NC 27278
Phone /1 919.732.3883 Web /1 www.summitde.net
IDATE:3/8/2022 jPROJ. NO.. 19-0102
RE: Hillsborough CDJ+R Dealel:ship
Fast Track Sewer Extension Application
fQ
oco
COPIES I DRAWING DATE
DESCRIPTION r,
1
C-1 thru A5.0
N/A
2/22/2022
3/7/2022
Hillsborough CDJ+R Construction Drawings
Cover Letter
N/A
1/13/2022
N/A
Fast Track Sewer Application 1
3/7/2022 Flow Tracking From - Private Pump Station
N/A
2/25/2022 Flow Tracking Form - Town of Hillsborough
TRANSMITTED
For Approval
COMMENTS:
COPY TO:
N/A
N/A Google Maps Site Location Map
N/A
N/A NCGS Quad Map Site Location
N/A 1/13/2022
$480 Fee Check
_t N/A 3/8/2022
As Requested
CD Disk with Digital Files
For Your Use . For Review and Comment
SIGNATURE:
Timothy A. Smith»:d-..