WQ0043505_Application (FTSE)_20220516

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: kA) Q DO 13 SO 5 (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
I. Applicant's name: City of Rocky Mount (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
D Federal ❑ State/County ® Municipal
3. Signature authority's name: Peter Varney per 15A NC AC 021 .0 106(tr)
Title: Interim City Manager
4. Applicant's mailing address: 331 S. Franklin Street
City: Rocky Mount State: NC Zip: 27802-
5. Applicant's contact information:
Phone number: 2( 52) 972-1325 Email Address: peter.varney®rockymounmc.gov
❑ Other
II. PROJECT INFORMATION:
1. Project name: City of Rocky Mount Dirt Street Paving Proiect: Emerald. Coral. Topaz
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: Edgecombe
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.963553 Longitude: -77.747138
5. Parcel ID (if applicable): 387008702700 (or Parcel ID to closest downstream sewer) ra
a,
III. CONSULTANT INFORMATION:
a
1. Professional Engineer: David Revoir License Number: 26959
Firm: Appian Consulting Engineers. P.A.
Mailing address: 154 Roundabout Ct./P.O. Box 7966
4
City: Rocky Mount State: NC Zip: 27804-
Phone number: (252) 972 - 7703 Email Address: drevoir cr,appianengineers.com ,
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Rocky Mount Wastewater Treatment Plant Permit Number: NC0030317
Owner Name: City of Rocky Mount
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ Unknown
2. Downstream (Receiving) Sewer Information: 8 inch
® Gravity E Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS0002I
Owner Name(s): City of Rocky Mount
FORM: FTA 06-21
Page 1 of 5

VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑ No ®NrA
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agtggment LFORM DEVI been attached?
❑ Yes ❑ No ® NIA
3. If the Applicant is a Home/Property Owners' Association, has an HOA/POA Operational Agreement (FORM: HOA] and
supplementary documentation as required by 15A NCAC 02T.0 115(c) been attached?
❑ Yes El No ®N/A
4. Origin of wastewater: (check all that apply):
® Residential (Individually Owned) ❑ Retail (stores, centers, malls)
O Residential (Leased) ❑ Retail with food preparation/service
O School 1 preschool / day care 0 Medical.1 dental.. veterinary facilities
❑ Food and drink facilities ❑ Church
O Businesses r offices / factories 0 Nursing Home
O Car Wash
O Hotel and/or Motels
O Swimming Pool/Clubhouse
❑ Swimming Pool/Filter Backwash
❑ Other (Explain in Attachment)
5. Nature of wastewater : 100 % Domestic % Commercial •o Industrial (See 15A NCAC 02T .0103{20))
If Industrial, is there a Pretreatment Program in effect? ❑ Yes❑ No
6. Has a flow reduction been approved under 15A NCAC. 02T . 114tf)? ❑ 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(0)
Daily Design Flow Lb
No. of Units
Flow
Residential
120 gal/Bedroom
15
5400 GPD
gal;
GPD
gala
GPD
gal/
GPD
gal/
GPD
gaff
GPD
Total
5400 GPD
a See 15A NCAC 02T .i 114(h), (d (c)(l) and (RV) 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 l5A NCAC 02T .0114(c), design flow rates for establishments not identified [in table I5A NCAC 02T_0114] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 5400 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:
❑ Rehabilitation or replacement of existing sewers with no new flow expected
❑ Other (Explain):
FORM: FTA 06-21
Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8"
1400
DIP
8"
I400
PVC
D 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 (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: N/A
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)
D 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 2.01C.1.b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with I5A NCAC 02T .0305(h)(I):
❑ Standby power source or ❑ Standby pump
➢ Must have automatic activation and telemetry - 15A NCAC 02T.0305(h)(1)(B):
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
D 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)(I)(C):
❑ Portable power source with manual activation, quick -connection receptacle and telemetry -
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry:
D 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(t)):
I. Does the project comply with all separations/alternatives found in 15A NCAC 02T .0305(f) & (g)? ® Yes ❑ No
15A NCAC 02T.0305(f1 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
2Water mains (vertical - water over sewer preferred, including in benched trenches)
18 inches
2Water mains (horizontal)
10 feet
Reclaimed water lines (vertical - reclaimed over sewer)
18 inches
Reclaimed water lines (horizontal - reclaimed over sewer)
2 feet
**Any private or public water supply source, including any wells, WS-I waters of Class I or
Class II impounded reservoirs used as a source of drinking water, and associated wetlands.
100 feet
**Waters classified WS (except WS-I or WS-V), B, SA, ORW, HOW, 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.
I0 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(fl or (g), see Section X.1 of this application
*I5A 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 webpa.e
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(t) 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: Tar River ❑ No
If yes, does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .02t)1. (0 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 ISA NCAC 02T.010.54 6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0105LcK6), directly related environmental permits or certification applications must be being prepared,
have been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion
and sedimentation control plans, stormwater management plans, etc.).
7. Does this project include any sewer collection lines that are deemed "high -priority?" ❑ Yes ® No
Per 15A NCAC 02T.0402, "high -priority sewer" means any aerial sewer, sewer contacting surface waters,
siphon, or sewers positioned parallel to streambanks that are subject to erosion that undermines or deteriorates the sewer.
Siphons and sewers suspended through interference/conflict boxes require a variance approval.
> If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and
inspections documented per 15A 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. Dorn the submitted system comply with I5A NCA[=1, the Minimtun Design Criteria for the Permitting of Pump Station*
and Force Mains (latest version), and the Gravity SCwtr Minimum Dcsiwi Criteria (latest version) as applicable?
®Yes ❑No
if no, for projects requiring a single variance, complete and submit thc Variance/Alternative Design Request application
(VADC 10-14) and supporting documents for review to thc Central Office. Approval4f the request will be issued
concurrently with the approval of the permit. and protects requiritte a variance approval may be subject to loner
review times. For nroiects reauirine hro or more variances or where the variance h determined by the Division to be a
jlanif cant portion of the protect, the full technical review is required.
2. Professional Engineer's Certification:
I, J)avid Revoir, attest that this application for City of Rocky Mount l)irt Street Pavinn Prgjct: Emerald. Coral. Tgpaz
(Professional Engineer's name from Application Item 111.1.) (Project Name from 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. I further
attest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable regulations,
Minimum l Criteria far Gravity Novas #fateyt vixaiotiE, and the Minimum Design Criteria for the Fag -Track PLm iIti ru:
of Pimp Slatigits rind Fvrcc Mains f west +rcrsio). Although other professionals may have developed certain portions of this
submittal package. inclusion of these materials under my signature and scal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes I43-215.6A and 143-215,6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed S I0,000, as well as civil penalties up to S25,000 per violation. Misrepresentation oldie application
information, including failure to disclose any design non-compliance with the applicable Rules an ' ign criteria, may subject
the North Carolina -licensed Professional Engineer to referral to the licensing board. (21 NCAC .. t . i 1)
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, Peter Varney , attest that this application for City of Rocky Mount Dirt Street Paving Pmiccl: Emerald. Coral Totta4
(Signature Authority Name liom Application Item 1.3.) (Pmjccl Name from Application Item II.I )
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 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 Wall required parts of this application
package are not completed and that if all required supporting information and attachments arc not included, this application
package will be returned to me as incomplete.
NOTE — In accordance with General Statures 143-215.6A and J43-215.513, 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 S10,000 as well as civil penalties up to S25,000 per violation.
Signature:
FORM: FrA 06-21
flat 1i
Page 5 of 5

May 11, 2022
NCDEQ DWR
3800 Barrett Drive
Raleigh, NC 27609
RE: City of Rocky Mount Dirt Street Paving Project:
Emerald Lane, Coral Drive, Topaz Avenue
Rocky Mount, NC
Proposed New Sewer Line
To whom it may concern:
NC Dept of Environmental Q»atit
tviAY1 6 V22
Raleigh Regional Office
The following fast track sewer system extension application is being submitted on behalf of the City of
Rocky Mount for the City of Rocky Mount Dirt Street Paving Project. The sewer lines are proposed to be
located on Emerald Lane, Coral Drive, and Topaz Avenue in Rocky Mount, NC (Edgecombe County). Site
design proposes 1400 linear feet of 8" PVC and 1400 linear feet of 8" DIP. The proposed sewer lines will
supply 15 residential units with the estimated flow of 5400 gallons per day; all tributary to the Rocky
Mount Wastewater Treatment Plant. The project is located in Tar River basin and is subject to State Buffer
rules.
Please find attached:
• Fast Track Sewer Permit Application
• Sewer Permit Application Permit Fee
• Aerial Map of Project
• USGS Map of Area with Proposed General Vicinity of Sewer
Please let us know if you have any questions regarding the project.
Sincerely,
Appian Consulting Engineers, PA
Ryan Joyner
[e-mail]
P.O. Box 7966 • Rocky Mount, NC 27804 • [phone]
www.appianengineers.com • [e-mail]

•
sri
*Red lines indicate ` 5
general vicinity of,
proposed sewer
USGS QUAD MAP for
CRM STREETS
ROCKY MOUNT, NC
At
DATE: 1-14-22
REV.
SHEET
OF
SCALE: 1'-800'
J.N. 21-136
APPC VIIL, CONSULTING& STUCTURAL ENGINEERS P.A.
COMPREHENSIVE ENVIRONMENTAL SERVICES
P.O. Box 7966 / Rocky Mount, N.C. 27804
Phone: [phone]
Fox. [phone]
www. applanenglneere.com
E-Mail: adminOapp'anengineers.com
BOUNDARY DESCRIPTION SHOWN I5 NOT FOR RECORDATION
iininunir
Afiz00
0

-wit
CONSULTING ENGINEERS, PA
CIVIL, MUNICIPAL & STRUCTURAL ENGINEERS
COMPREHENSIVE ENVIRONMENTAL SERVICES
P.O. Box 7966
Rocky Mount, North Carolina 27804
252.972.7703 Phone
252.972.7638 Fax
[e-mail]
www.appianengineers.com
LETTER OF TRANSMITTAL
DATE: May 11, 2022
APPIAN JOB NO.: 21-136
TO:
NCDEQ Water Quality Section
3800 Barrett Drive
Raleigh, NC 27609
919-791-4200
PROJECT:
City of Rocky Mount Dirt Street Paving Project:
Emerald, Coral, Topaz
GENTLEMEN: We are sending you ❑ herewith ❑ under separate cover:
SUBMITTAL FOR:
CODE
FOR APPROVAL
1
FOR YOUR USE
2
D
AS REQUESTED
3
MI
BID TAB DISTRIBUTION
4
❑
APPROVED PERMITS
5
111
ACTION
CODE
APPROVED
A
APPROVED AS NOTED
B
a
III
NOT APPROVED
C
.
REVISE AND RESUBMIT
D
.
PLEASE SIGN AND RETURN
E
ll
PRINT
COPIES
DRAWING NUMBER
(REVISION NO. OR DATE)
DESCRIPTION
CODE
2
DWR Sewer Permit Application
1
#28471
$480 Check for Sewer Permit Application Fee
1
USGS Map of Dirt Streets
1
Aerial Map of Project Vicinity
1
Project Cover Letter
REMARKS:
Here are the Items in regard to the review of the Sewer Permit Application for CRM Dirt Streets Project.
Thank you, Ryan
Sent by: First Class Mail
UPS Next Day l AM
UPS Next 2nd Day
Federal Express
Faxed
Hand Delivered
Pick Up
cc: File
❑❑❑❑❑❑®
If enclosures received are not as listed above, kindly notify at once.
Thank you.
By Ryan Joyner
[e-mail]
5-11-zZ
Date -
Received By
Date