WQ0043354_Application (FTSE)_20220412

VMJ1111 1 11+1 IM41 JV11
NCDEQ-DWR
450 West Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
We are sending you attached the following items:
II
Shop Drawings
❑ Prints
❑ Plans
Samples
❑ Specifications
U Disk
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1 Ile L411UI11yb UI rldL ROCK
Henderson County, NC
Sanitary Sewer Extension
Sea Job No. E-6443
❑ Copy of Letter
Other
# Copies
Drawing #
Description
Disposition
1
$480.00 Application Fee
NC Department of
Environmental Quality
1
Cover Letter
Received
2
Fast Track Sewer Application
APR 0 5 2022
2
Flow Tracking Acceptance Form
Winston-Salem
1
USGS Topo Map
Regional Office
1
Aerial Photo
2
Construction Drawings
Remarks: l Justin,
I

APR 1 i 2022
Joi
Water Quality Regional Operations
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independent living facility with an adequate sewage disposal source and to meet the
future needs of these residents. The new assisted and independent living facilities are
located on S. Allen Road in Hendersonville, NC.
There will be one 8" sanitary sewer extension connected to an existing manhole with an
8" Sanitary Sewer outfall line running along S. Allen Rd towards Upward Road. There
will be a total of 1,196 LF of 8" sewer main extension with this project. The City of
Hendersonville waste -water treatment system has the capacity to serve this new
development and many other residences. There are no available sewer services to this
facility without the proposed sewer main extension.
Prepared By:
Address:
Phone:
Project:
H. Mack Summey, Jr., P.E.
P.O. Box 968 Asheboro, NC 27204
(336)-328-0902
The Landings of Flat Rock

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calculations, and project specifications referenced in 15A NCAC 02T .0305 and the applicable minimum design criteria. These
documents shall be immediately available upon request by the Division.
Projects that are deemed permitted (do not require a permit from the Division) are explained in 15A NCAC 02T.0303.
Projects not eligible for review via the fast track process (must be submitted for full technical review):
➢ Projects that do not meet any part of the minimum design criteria (MDC) documents;
➢ Projects that involve more than one variance from the requirements of 15A NCAC 02T;
➢ Pressure sewer systems utilizing simplex septic tank -effluent pumps (STEPs) or simplex grinder pumps;
➢ Simplex STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mains);
➢ Vacuum sewer systems.
General — When submitting an application, please use the following instructions as a checklist in order to ensure all required items are
submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and reduce the
amount of requested additional information. Failure to submit all required items will necessitate additional processing and review
time, and may result in return of the application. Unless otherwise noted, the Applicant shall submit one original and one copy of
the application and supporting documentation.
A. One Original and One Copy (second copy may be digital) of Application and Supporting Documents
® Required unless otherwise noted. Signatures on original must be "wet ink" or secure digital signatures.
Please do not submit engineering design plans with the application unless specifically requested.
B. Cover Letter/Narrative Description (Required for All Application Packages):
® List all items included in the application package, as well as a brief description of the requested permitting action.
➢ Be specific as to the system type, number of homes served, flow allocation required, etc.
➢ Include the permit number/status of any other required sewer permits (downstream/upstream)
➢ If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Modification Application Packages):
® Submit a check or money order in the amount of $480.00, dated no more than 90 days priart4)a3(i
➢ Payable to North Carolina Department of Environmental Quality (NCDEQ)
•
- •
APR 9 9 11112

• Downstream connection points and permit number (if known) for the receiving sewer
❑ Include an aerial location map showing general project area (such as street names or latitude/longitude) so that Division staff
can easily locate it in the field.
G. Existing Permit (Application Packages for Modifications to an Existing Permit):
® Submit a copy of the most recently issued existing permit.
❑ Include a descriptive and clear narrative identifying the previously permitted items to remain in the permit, items to be
added, and/or items to be modified (the application form itself should include only include items to be added/modified). The
narrative should also include whether any previously permitted items have been certified.
❑ The narrative should clearly identify the requested permitting action and accurately describe the sewers to be listed in
the final permit.
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
D Per 15A NCAC 02T .0305(h)(1), submit documentation of power reliability for pumping stations.
This alternative is only available for average daily flows less than 15,000 gallons per day
• It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is compatible with
the station. The Division will accept a letter signed by the applicant (see 15A NCAC 02T .0106(b)) or proposed contractor,
stating that "the portable power generation unit or portable, independently -powered pumping units, associated appurtenances
and personnel are available for distribution and operation of this pump 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 in the case of a multiple station power outage. (Required at time of certification)
I. Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per I5A NCAC 02T .0115(a)(1) provide the Certificate of Public Convenience and Necessity from the North Carolina Utilities
Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by the sewer
extension, or
❑ Provide a letter from the North Carolina Utilities Commission's Water and Sewer Division Public Staff stating an application
for a franchise has been received and that the service area is contiguous to an existing franchised area or that franchise approval
is expected.

Water Quality Section
Fayetteville, North Carolina 28301-5095
[phone]
[phone] Fax
Montgomery, Moore, Robeson, Richmond,
Sampson, Scotland
Mooresville Regional Office
610 E. Center Avenue
Mooresville, North Carolina 28115
[phone]
[phone] Fax
Alexander, Cabarrus, Catawba, Cleveland,
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
Stanly, Union
Water Quality Section
Raleigh Regional Office
3800 Barrett Drive
Raleigh, North Carolina 27609
[phone]
[phone] Fax
Chatham, Durham, Edgecombe, Franklin,
Granville, Halifax, Johnston, Lee, Nash,
Northampton, Orange, Person, Vance, Wake,
Warren, Wilson
Water Quality Section
Washington Regional Office
943 Washington Square Mall
Washington, North Carolina 27889
[phone]
[phone] Fax
Beaufort, Bertie, Camden, Chowan, Craven,
Currituck, Dare, Gates, Greene, Hertford, Hyde,
Jones, Lenoir, Martin, Pamlico, Pasquotank,
Perquimans, Pitt, Tyrrell, Washington, Wayne
Water Quality Section
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
[phone]
[phone] Fax
Brunswick, Carteret, Columbus, Duplin, New
Hanover, Onslow, Pender
Water Quality Section
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, North Carolina 27105
[phone]
[phone] Fax
Alamance, Alleghany, Ashe, Caswell, Davidson,
Davie, Forsyth, Guilford, Rockingham, Randolph,
Stokes, Surry, Watauga, Wilkes, Yadkin
Water Quality Section

2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ['Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3. Signature authority's name: Lee Smith per 15A NCAC 02T .0106(b)
Title: Utilities Director
4. Applicant's mailing address: 305 Williams Street
City: Hendersonville State: NC Zip: 28792-
5. Applicant's contact information:
Phone number: [phone] Email Address: [e-mail]
I1. PROJECT INFORMATION:
1. Project name: The Landings of Flat Rock
2. Application/Project status: ® Proposed (New Permit)
❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ00 and issued date:
For modifications, also attach a detailed narrative description as described in Item G of the checklist.
If new construction, but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Henderson
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.302075° Longitude:-82.414459
5. Parcel ID (if applicable): 9588127382 (or Parcel ID to closest downstream sewer)
111. CONSULTANT INFORMATION:
1. Professional Engineer: H. Mack Summey Jr. PE
Firm: Summey Engineering Associates, PLLC
Mailing address: PO Box 968
City: Asheboro State: NC
Zip: 27204-1106
License Number: 26447
MJT 1'1[1
APR 1 , 71122

Kesiaential (lnaiviaually Uwnea)
❑ Residential (Leased)
❑ School / preschool / day care
❑ Food and drink facilities
❑ Businesses / offices / factories
11 Ketail (stores, centers, malls)
❑ Retail with food preparation/service
❑ Medical / dental / veterinary facilities
❑ Church
E Nursing Home
11 car Wash
❑ Hotel and/or Motels
❑ Swimming Pool/Clubhouse
❑ Swimming Pool/Filter Backwash
❑ 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 El No
6. Has a flow reduction been approved under 15A NCAC 02T .01 14(f)? ❑ Yes ❑ No
➢ lives, provide a copy of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(0)
Daily Design Flow a,b
No. of Units
Flow
Assisted/lndependent Living Studio
120 gal/day
70
8,400 GPD
Independent Living 1 Bedroom
120 gal/day
59
7,080 GPD
Independent Living 2 Bedroom
240 gal/day
12
2,880 GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
18,360 GPD
a See I5A NCAC 02T .01 14(b), (d), (e)(1) and (e)(2) for caveats to wastewater des'gn flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.01 141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
R. Wastewater generated by nroiect: 18.360 GPD lner 15A NCAC 02T .01141

➢ Section I1 & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section [II 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
VI II. PUMP STATION DESIGN CRITERIA (If Applicable)— 02T .0305 & MDC (Pump Stations/Force Mains):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: ° Longitude: - 0
3. Total number of pumps at the pump station:
3. Design flow of the pump station: millions gallons per day (firm capacity)
➢ This should reflect the total GPM for the pump station with the largest pump out of service.
4. Operational point(s) per pump(s): gallons per minute (GPM) at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
If any portion of the force main is less than 4-inches in diameter, please identify the method of solids reduction per
MDCPSFM Section 2.01 C.1.b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please-
,spec;
b. Power reliability in accordance with 15A NCAC 02T .0305(h)(1):
D Standby power source or ❑ Standby pump
`\

Class 11 impounded reservoirs used as a source of drinking water, and associated wetlands.
100 feet
**Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
high water (or tide elevation) and wetlands associated with these waters (see item IX.2)
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches, as well as wetlands associated with these waters or classified as WL.
10 feet
Any building foundation (horizontal)
5 feet
Any basement (horizontal)
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade (vertical)
36 inches
➢ If noncompliance with 02T.0305(f) or (g), see Section X.1 of this application
*15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(f) cannot be achieved. Please check "yes"
above if these alternatives are used and provide narrative information to explain.
**Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
2. Does this project comply with the minimum separation requirements for water mains? ® Yes ❑ No ❑ N/A
➢ If no, please refer to 15A NCAC 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 ❑ N/A
> Please provide supplementary information identifying the areas of non-conformance.
➢ See the Division's draft separation requirements for situations where separation cannot be met.
> No variance is required if the alternative design criteria specified is utilized in design and construction.
4. Is the project located in a river basin subject to any State buffer rules? ❑ Yes Basin name: ® No
If yes, does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑ Yes ❑ No
> This includes Trout Buffered Streams per 15A NCAC 2B.0202 I J) j i
5. Does the project require coverage/authorization under a 404 Nationwide/individual permits k.,� ❑ Yes ® No
l:ii
or 401 Water Quality Certifications?;; t� 1 ji
> Please provide the permit number/nermittine status in the cover letter if coverage/author ization is required.

I R• n'AAck- SUMMai jr, , attest that this application for -The t-0.r tI A€j5 04 nte_4ac- G
(Professional Engineer's name frr ApplAtation Item III. I.) (Project Name front Application Item 11.1)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans,
specifications, engineering calculations, and all other supporting documentation to the best of my knowledge. 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 fof 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 may 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. 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:
o%%%%%%%CAR%%%%%%
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26447 1
3.29-13-
NKSUMM;-0••
3. Applicants Certification per 15A NCAC 02T .0I06(b):
1, Lee Smith , attest that this application for The Landings of Flat Rock
(Signature Authority Name from Application Item 1.3.)
(Project Name from Application Item 11.1)
attest that this application has been reviewed by me and is accurate and complete to the best of my knowledge.
1 understand that if all rpnnirpd nartc of thic annliratinn arp not rmmmlptpd and that :F slI ran,„rad vi,nnnrtlna d.......,. o..t.a:....

"20220304FTA20137" History
n Document created by Deborah Sholl ([e-mail])
2022-03-31 - 8:18:50 PM GMT
Ley Document emailed to Lee Smith ([e-mail]) for signature
2022-03-31 - 8:20:51 PM GMT
'n Email viewed by Lee Smith ([e-mail])
2022-04-01 - 4:23:19 PM GMT
d© Document e-signed by Lee Smith ([e-mail])
Signature Date: 2022-04-01 - 4:25:05 PM GMT - Time Source: server
O Agreement completed.
2022-04-01 - 4:25:05 PM GMT

calculations, ana project specitications reterenced in I5A NCAC 02T .0305 and the applicable minimum design criteria. These
documents shall be immediately available upon request by the Division.
Projects that are deemed permitted (do not require a permit from the Division) are explained in I5A NCAC 02T.0303.
Projects not eligible for review via the fast track process (must be submitted for full technical review):
➢ Projects that do not meet any part of the minimum design criteria (MDC) documents;
➢ Projects that involve more than one variance from the requirements of 15A NCAC 02T;
➢ Pressure sewer systems utilizing simplex septic tank -effluent pumps (STEPs) or simplex grinder pumps;
➢ Simplex STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mains);
➢ Vacuum sewer systems.
General — When submitting an application, please use the following instructions as a checklist in order to ensure all required items are
submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and reduce the
amount of requested additional information. Failure to submit all required items will necessitate additional processing and review
time, and may result in return of the application. Unless otherwise noted, the Applicant shall submit one original and one copy of
the application and supporting documentation.
A. One Original and One Copy (second copy may be digital) of Application and Supporting Documents
• Required unless otherwise noted. Signatures on original must be "wet ink" or secure digital signatures.
Please do not submit engineering design plans with the application unless specifically requested.
B. Cover Letter/Narrative Description (Required for All Application Packages):
® List all items included in the application package, as well as a brief description of the requested permitting action.
➢ Be specific as to the system type, number of homes served, flow allocation required, etc.
> Include the permit number/status of any other required sewer permits (downstream/upstream)
➢ If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Modification Application Packages):
® Submit a check or money order in the amount of $480.00, dated no more than 90 days prior
➢ Payable to North Carolina Department of Environmental Quality (NCDEQ)
D. Fast Track Application (Required for All Application Packages. Form FTA 115-211•
TITationub�ttal.;
P>�
APR i 1 2Ue22

➢ Downstream connection points and permit number (if known) for the receiving sewer
® Include an aerial location map showing general project area (such as street names or latitude/longitude) so that Division staff
can easily locate it in the field.
G. Existing Permit (Application Packages for Modifications to an Existing Permit):
® Submit a copy of the most recently issued existing permit.
❑ Include a descriptive and clear narrative identifying the previously permitted items to remain in the permit, items to be
added, and/or items to be modified (the application form itself should include only include items to be added/modified). The
narrative should also include whether any previously permitted items have been certified.
❑ The narrative should clearly identify the requested permitting action and accurately describe the sewers to be listed in
the final permit.
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
O Per 15A NCAC 02T .0305(h)(1), submit documentation of power reliability for pumping stations.
➢ This alternative is only available for average daily flows less than 15,000 gallons per day
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is compatible with
the station. The Division will accept a letter signed by the applicant (see 15A NCAC 02T .0106(b)) or proposed contractor,
stating that "the portable power generation unit or portable, independently -powered pumping units, associated appurtenances
and personnel are available for distribution and operation of this pump 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 in the case of a multiple station power outage. (Required at time of certification)
I. Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per 15A NCAC 02T .01 15(a)(1) provide the Certificate of Public Convenience and Necessity from the North Carolina Utilities
Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by the sewer
extension, or
❑ Provide a letter from the North Carolina Utilities Commission's Water and Sewer Division Public Staff stating an application
for a franchise has been received and that the service area is contiguous to an existing franchised area or that franchise approval
is expected.

[phone]
[phone] Fax
Sampson, Scotland
Mooresville Regional Office
610 E. Center Avenue
Mooresville, North Carolina 28115
[phone]
[phone] Fax
Alexander, Cabarrus, Catawba, Cleveland,
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
Stanly, Union
Water Quality Section
Raleigh Regional Office
3800 Barrett Drive
Raleigh, North Carolina 27609
[phone]
[phone] Fax
Chatham, Durham, Edgecombe, Franklin,
Granville, Halifax, Johnston, Lee, Nash,
Northampton, Orange, Person, Vance, Wake,
Warren, Wilson
Water Quality Section
Washington Regional Office
943 Washington Square Mall
Washington, North Carolina 27889
[phone]
[phone] Fax
Beaufort, Bertie, Camden, Chowan, Craven,
Currituck, Dare, Gates, Greene, Hertford, Hyde,
Jones, Lenoir, Martin, Pamlico, Pasquotank,
Perquimans, Pitt, Tyrrell, Washington, Wayne
Water Quality Section
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
[phone]
[phone] Fax
Brunswick, Carteret, Columbus, Dublin, New
Hanover, Onslow, Pender
Water Quality Section
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Winston-Salem, North Carolina 27105
[phone]
[phone] Fax
Alamance, Alleghany, Ashe, Caswell, Davidson,
Davie, Forsyth, Guilford, Rockingham, Randolph,
Stokes, Surry, Watauga, Wilkes, Yadkin
Water Quality Section

2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3. Signature authority's name: Lee Smith per 15A NCAC 02T .0106(b)
Title: Utilities Director
4. Applicant's mailing address: 305 Williams Street
City: Hendersonville
State: NC Zip: 28792-
5. Applicant's contact information:
Phone number: [phone] Email Address: ([e-mail]
II. PROJECT INFORMATION:
1. Project name: The Landings of Flat Rock
2. Application/Project status: ® Proposed (New Permit)
['Existing Permit/Project
If a modification, provide the existing permit number: WQ00 and issued date:
For modifications, also attach a detailed narrative description as described in Item G of the checklist.
If new construction, but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Henderson
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.302075° Longitude: -82.414459
5. Parcel ID (if applicable): 9588127382 (or Parcel ID to closest downstream sewer)
I11. CONSULTANT INFORMATION:
1. Professional Engineer: H. Mack Summey Jr. PE
Firm: Summey Engineering Associates, PLLC
Mailing address: PO Box 968
City: Asheboro State: NC Zip: 27204-1106
License Number: 26447

LJ Residential (Leased)
❑ School / preschool / day care
❑ Food and drink facilities
❑ Businesses / offices / factories
❑ Retail with food preparation/service
❑ Medical / dental / veterinary facilities
❑ Church
N Nursing Home
❑ Hotel and/or Motels
❑ Swimming Pool/Clubhouse
❑ Swimming Pool/Filter Backwash
❑ 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? 0 Yes El 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(f))
Daily Design Flow 81°
No. of Units
Flow
Assisted/Independent Living Studio
120 gal/day
70
8,400 GPD
Independent Living 1 Bedroom
120 gal/day
59
7,080 GPD
Independent Living 2 Bedroom
240 gal/day
12
2,880 GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
18,360 GPD
a See I5A NCAC 02T .01 I4(b), (d), (e)(I) and (e)(2) for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.0I 14] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 18,360 GPD (per 15A NCAC 02T .0114)
';• net not innlnrla f 1fiirn ninlI1c, nr 1sra.,1n11oh, nor.,,aae.1 ,.11,.....1.:,.,...

> 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
VII1. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: 0Longitude: - . °
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
APR ' 2022
Water Quality Regional Ope:',_.
Asheville Regional Office
If any portion of the force main is less than 4-inches in diameter, please identify the method of solids reduction per
MDCPSFM Section 2.01C.1.b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1):
IT Standhv newer sniirce nr 17 Standhv nmmn

**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(f) cannot be achieved. Please check "yes"
above if these alternatives are used and provide narrative information to explain.
**Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
2. Does this project comply with the minimum separation requirements for water mains? ® Yes ❑ No ❑ N/A
> If no, please refer to 15A NCAC 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 ❑ N/A
> Please provide supplementary information identifying the areas of non-conformance.
➢ See the Division's draft separation requirements for situations where separation cannot be met.
> No variance is required if the alternative design criteria specified is utilized in design and construction.
4. Is the project located in a river basin subject to any State buffer rules? ❑ Yes Basin name: ® No
If yes, does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑ Yes ❑ No
➢ This includes Trout Buffered Streams per 15A NCAC 2B.0202
1041
5. Does the project require coverage/authorization under a 404 Nationwide/individual permits ❑ Yes E'No�
or 401 Water Quality Certifications? !
➢ Please provide the permit number/permitting status in the cover letter if coverage/authorization i k uike1l. Dia '-J

1, I• h:uk SUsMey r)p p attest that this application for lbt Lu-naiA'04 11a-4r-k
(Professional Engineer's nave: fn Applcation Item 111.1.) (Project Name frodfApplication Item 11.1)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans,
specifications, engineering calculations, and all other supporting documentation to the best of my knowledge. 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 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 may 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. 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: ``%([, RQ
Q F SSicf o
si
26447 r :l
1 r
•
�'o Ti FNOINE�Q.� Ya'�
' o aK SUst M?`; `'�.._..........'
3. Applicant's Certification per 15A NCAC 02T .0106(b):
1, Lee Smith , attest that this application for The Landings of Flat Rock
(Signature Authority Name from Application Item 1.3.)
(Project Name from Application Item 11.1)
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

"20220304FTA20137" History
n Document created by Deborah Sholl ([e-mail])
2022-03-31 - 8:18:50 PM GMT
E, Document emailed to Lee Smith ([e-mail]) for signature
2022-03-31 - 8:20:51 PM GMT
n Email viewed by Lee Smith ([e-mail])
2022-04-01 - 4:23:19 PM GMT
6e Document e-signed by Lee Smith ([e-mail])
Signature Date: 2022-04-01 - 4:25:05 PM GMT - Time Source: server
O Agreement completed.
2022-04-01 - 4:25:05 PM GMT

I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Hendersonville WWTF
b. WWTP Facility Permit #: NC0025534
All flows are in MGD
c. WWTP facility's permitted flow 4.800
d. Estimated obligated flow not yet tributary to the WWTP 0.298
e. WWTP facility's actual avg. flow 2.350
f. Total flow for this specific request 0.0184
g. Total actual and obligated flows to the facility 2.667
h. Percent of permitted flow used 55.6%
II. Complete this section for each pump station you are responsible for along the route of this proposed
wastewater flow.
List pump stations located between the project connection point and the WWTP:
(A) (B) (C) (D)=(B+C) (E)=(A-D)
Design Obligated,
Pump Pump Average Approx. Not Yet Total Current
Station Station Firm Daily Flow** Current Tributary Flow Plus
(Name or Permit Capacity, * (Firm / pf), Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow, MGD MGD Flow Capacity***

works has adequate capacity to transport and treat the proposed new wastewater.
Lee nit Apr 1, 2022 12:51 EDT)
Apr 1, 2022
Signing Official Signature Dale
Utilities Director
Title of Signing Official

wuu per year; ana tnat
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

construction projects not yet contributing tlow 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)* 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.=0.015MGD
g. = 3.215 MGD

uesign average uany r iow is tne firm capacity or tne pump station aiviaeo oy a peaking ractor tpr/ or not less tnan
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)
Design
Firm Average
Putnp Station Capacity Daily Flow
(Name or Number) MGD (Firm / pf)
Kaw Creek PS 0.800 0.320
Valley Road PS
Approx.
Current Avg.
Daily Flow,
MGD
(C) (D)=(B+C) (E)=(A-D)
Obligated,
Not Yet Total Current
Tributary Flow Plus
Daily Flow, Obligated Available
MGD Flow Capacity*
0.252 0.080 0.332 -0.012
1.895 0.758 0.472
0.135 0.607 0.151

i ne planning assessment may menmy a iunueu project currently in uesign or construction, or a piannea 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 vet tributary flows in amounts
that exceed the firm pump station capacities identified in Section 11 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.

"FTSE-10-18-Iandingsflatrock" History
n Document created by Deborah Sholl ([e-mail])
2022-04-01 - 3:44:46 PM GMT
-► Document emailed to Lee Smith ([e-mail]) for signature
2022-04-01 - 3:46:55 PM GMT
n Email viewed by Lee Smith ([e-mail])
2022-04-01 - 4:48:20 PM GMT
6© Document e-signed by Lee Smith ([e-mail])
Signature Date: 2022-04-01 - 4:51:09 PM GMT - Time Source: server
O Agreement completed.
2022-04-01 - 4:51:09 PM GMT

I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Hendersonville WWTF
b. WWTP Facility Permit #: NC0025534
All flows are in MGD
c. WWTP facility's permitted flow 4.800
d. Estimated obligated flow not yet tributary to the WWTP 0.298
e. WWTP facility's actual avg. flow 2.350
f. Total flow for this specific request 0.0184
g. Total actual and obligated flows to the facility 2.667
h. Percent of permitted flow used 55.6%
II. Complete this section for each pump station you are responsible for along the route of this proposed
wastewater flow.
List pump stations located between the project connection point and the WWTP:
(A) (B) (C) (D)=(B+C) (E)=(A-D)
Design Obligated,
Pump Pump Average Approx. Not Yet Total Current
Station Station Firm Daily Flow** Current Tributary Flow Plus
(Name or Permit Capacity, * (Firm / pfl, Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow, MGD MGD Flow Capacity***

WU11CS 11dS auegllale eapaelly LU L1a11SpUl L MILL LICa1 L11C piUpUSCU 11CW WdSLCWaLCI.
Lee-Smit Apr 1, 2022 12:51 EDT)
Apr 1, 2022
Signing Official Signature Date
Utilities Director
Title of Signing Official

1V14,1Ll 1/%4 allu u tal
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

construction projects not yet contriouting now to me collection system. riows allocated mrougn mteriocai
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)* 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.=0.015MGD
g. = 3.215 MGD

ucsigu nvelagc uauy r uw s i Mc 111111 capacity ui uic pump siauvu uivwvu uy a pcarcwg iacwr kin) VI ❑OL iess man
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)
Design
Firm Average
Pump Station Capacity Daily Flow
(Name or Number) MGD (Firm / pf)
Kaw Creek PS 0.800 0.320
Valley Road PS
Approx.
Current Avg.
Daily Flow,
MGD
(C) (D)=(B+C) (E)=(A-D)
Obligated,
Not Yet Total Current
Tributary Flow Plus
Daily Flow, Obligated Available
MGD Flow Capacity*
0.252 0.080 0.332 -0.012
1.895 0.758
0.472
0.135
0.607 0.151

Inc planning asscsswcui away iucnuiy a 'uuucu pwjcci',uncuuy w uesigu ur cuusuucuuu, ur a pianneu 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 proiect'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 1l 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.

"FTSE-10-18-Iandingsflatrock" History
n Document created by Deborah Sholl ([e-mail])
2022-04-01 - 3:44:46 PM GMT
E74 Document emailed to Lee Smith ([e-mail]) for signature
2022-04-01 - 3:46:55 PM GMT
n Email viewed by Lee Smith ([e-mail])
2022-04-01 - 4:48:20 PM GMT
6© Document e-signed by Lee Smith ([e-mail])
Signature Date: 2022-04-01 - 4:51:09 PM GMT - Time Source: server
O Agreement completed.
2022-04-01 - 4:51:09 PM GMT