WQ0036188_Application (FTSE)_20121004

To: NCDENR — DWQ
Washington Regional Office
943 Washington Square Mall
Washington, North Carolina 27889
ATrENT'' Permit Review
CEGROUF
301 GLENWOOD AVENUE, SUITE 220
RALEIGH, NC 27603
Phone: [phone]
E-Mail: [e-mail]
Transmittal
DATE: 10/04/12
PROJECT NO: 1 90-03
RE: SECU — Goldsboro, NC
Sanitary Sewer Fast -Track Submittal
Quantity
Drawing No.
Description
1
original,
1 copy
Form FTA
12/07 ver5
Fast -Track application (gravity sewer) for the Goldsboro Office of the
State Employees' Credit Union
1 check
Dated 9/27/12
Application fee of $480 payable to NCDENR
1
Dated 10/2/12
Downstream Sewer, VW TP Capacity and Flow Tracking/Acceptance
1
Color USGS map of site location
1
Sealed 9/26/12
Form WSCAS-12/07 Watershed Classification Attachment
RECEIVED
OCT - 8 2012
1
DWQ-WARO
REMARKS
Please contact me if you have any questions. Thank you

CE GROUP
301 GLENWOOD AVENUE, SUITE 220
RALEIGH, NC 27603
Phone: [phone]
E-Mail: mike®cegroupinc.com
Memorandum
To: Washington Regional Office, NCDENR - DWQ
From: Mike Zaccardo, PE, CE Group, Inc. G
Date: September 26, 2012
Cc: David Kaiser, OBA
Rama Chittilla, City of Goldsboro
Re: State Employees' Credit Union — Goldsboro Office
Goldsboro, NC
The proposed State Employees' Credit Union — Goldsboro Office project will be
located at 2811 Wayne Memorial Drive across from Wayne Community College.
The purpose of this submittal is to gain approval to install new 8" gravity sanitary
sewer collection lines to accommodate the construction of this new 7,760 SF office
building.
The proposed 77 LF of 8" SDR 35 PVC, 1,487 LF of 8" Class 50 DIP, If1Je 1"�-- 6 '` /14-e5
SDR 35 PVC, and in l (1 L lass 50 DIP piping will handle the domestic arm
sewage flows from this facility. This new sewer extension will discharge into an 4
existing sanitary sewer manhole located at the end of North Hospital Drive.
ot in �c�e
In order to alleviate any wetland disturbance, we have designed the proposed � ep+"h''II
gravity sanitary sewer to be jack and bored beneath the existing wetlands. We have 4eti2 tobolln
specified the use of 8" restrained joint ductile iron pipe which will be placed within a
16" steel encasement pipe as shown on Sheet C1101.
The total proposed average daily flow from the SECU — Goldsboro Office project is
calculated as: 550 gpd (total of 22 personnel x 25 gpd/person).
These new gravity sanitary sewers will be owned, operated and maintained by the
applicant, the City of Goldsboro once it is installed, tested, and certified.
Please let me know if you need any additional information.

RECEIVED
OCT - 8 2012
DW
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
FAST -'TRACK APPLICATION
(F1'A 12/07 ver5)
WERS, PUMP STATIONS, AND FORCE MAINS
sewer systems are not to be included as part of this application package)
INSTRUCTIONS: Indicate that you have included/addressed the following list of required application package items by
checking the space provided next to each applicable item. Failure to submit all required items will lead to your application
being retumed as incomplete. Forms are available from the web site or by calling the Regional Office serving your county:
http://h2o. enr. state. nc. us/percs/Collection%20Systems/CollectionSystemApplications.html
® A. Application Form - Submit one original and one copy of the completed and appropriately executed application
form. The application should include a project narrative describing the final build -out design (i.e. system and/or
pump station to ultimately serve 500 homes, but flow for only 100 homes being requested now). For modifications,
clearly explain the reason for the modification (La adding another phase, changing line size/length, etc.). Only
include the modified information in this permit application - do not duplicate project information that has already
been included in the original permit
Any changes to this form will result in the application being retumed. The Division of Water Quality (Division) will
only accept application packages that have been fully completed with all applicable items addressed. You do not
need to submit detailed plans and specifications unless you respond NO to Item B(13).
Separate applications should be made for non-contiguous sewer systems.
® B. Application Fee - Submit a check in the amount of $480 made payable to: North Carolina Department of
Environment and Natural Resources (NCDENR). Checks shall be dated within 90 days of application submittal.
❑ C. Certificates of Public Convenience and Necessity - If the application is being submitted in the name of a
privately -owned public utility, submit two copies of the Certificate of Public Convenience and Necessity (CPCN)
which demonstrates that the public utility is authorized to hold the utility franchise for the area to be served by the
sewer extension. If a CPCN has not been issued, provide two copies of a letter from the North Carolina Utilities
Commission's Public Staff that states that an application for a franchise has been received, that the service area
is contiguous to an existing franchised area, and/or that franchise approval is expected. The project name in the
CPCN or letter must match that provided in Item A(2)a of this application.
® D. Operational Agreements — Submit one original and two copies of a properly executed operational agreement, as
per 15A NCAC 02T .0115, if the application is submitted by a private applicant and will be serving residential or
commercial lots (e.g., houses, condominiums, townhomes, outparcels, etc.) that will be sold to another entity. If
the applicant is a home or property owner's association, use Foram HOA 02/03. If the applicant is a developer,
use Form DEV 02/03. EVEN IF THE PROJECT MAY BE TURNED OVER TO A MUNICIPALITY UPON
COMPLETION, FORM DEV 02/03 IS REQUIRED.
® E. Downstream Sewer, WWTF Capacity and Flow Tracking/Acceptance — FORM FTSE 10/07 (Flow
Tracking/Acceptance for Sewer Extension Permit Applications) is required with every application. The applicant
(and owners of downstream sewers, pump stations and/or treatment facilities submitting FORM FTSE-10/07)
certifies that the addition of the volume of wastewater to be permitted in this project has been evaluated along the
route to the receiving treatment plant, and that the flow from this project will not cause capacity related sanitary
sewer overflows or overburden any downstream pump station en route to the receiving wastewater treatment
plant. Where the applicant is not the owner of the downstream sewer, submit two copies of FORM FTSE 10/07
from the owner of the downstream sewer and owner of the WWTF, if different. The flow acceptance indicated in
FORM FTSE-10/07 must not expire prior to permit issuance and must be dated less than one year prior to the
application date. Submittal of this application and FORM FTSE-10/07 Indicates that owner has adequate
capacity and will not violate G.S. 143-215.67(a). Intergovernmental agreements or other contracts will not be
accepted in lieu of project -specific FTSE 10/07.
® F Map — Submit an 8.5-inch by 11-inch COLOR copy of a USGS Topographic Map of sufficient scale to identify the
entire project area and the closest surface waters. Each map or maps must show the location of the sewer line
and pump stations and be of reproducible quality. Include a street level map showing the downstream connection
point, and the permit number for the downstream sewer, if known.
FTA12/07

® G. Stream Classifications — Watershed Classification Attachment (Form WSCAS-12/07) If any portion of the
sewer system project is within 100 feet of any surface water or wetlands, the Watershed Classification Attachment
may need to be completed. A variance must be requested for encroachment within required setbacks or buffers
pursuant to 2T .0305 (f) and be indicated in Item B-13 with supporting documentation/justification provided.
❑ H Environmental Assessments — If this project Is subject to an Environmental Assessment (EA) [15A NCAC
01C], this application cannot be used. Send the project application on the most current version of Form
PSFMGSA to the Design Management Unit, 1633 Mail Service Center, Raleigh, NC 27699-1633. Applications
cannot be accepted until a Finding of No Significant Impact (FONSI) or Environmental Impact Statement (EIS)
has been issued. A copy is to be submitted with that permit application.
❑ I. Flow Direction — Many wastewater treatment systems are entering into agreements for regionalization efforts
and emergency treatment capacity. Parts of the system are installed so that the wastewater flow can be directed
to more than one treatment facility. If this is the case with this project, please indicate in B(12) and give the permit
number of the second treatment facility.
® J. Certifications — Section C
The application must be certified by both the applicant and the design engineer who is a North Carolina
Registered Professional Engineer (PE). The applicant signature must match the signing official listed in Item
A(1b). The PE should NOT certify the application if he/she is unfamiliar with 15A NCAC Chapter 2T, the Gravity
Sewer Minimum Design Criteria (most recent version) and the Minimum Design Criteria for the Fast -Track
Permitting of Pump Stations and Force Mains (most recent version), as applicable to the project
THE COMPLETED FTA 12/07 APPLICATION PACKAGE, INCLUDING ALL SUPPORTING
DOCUMENTS AND $480 FEE, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
2090 US Highway 70
Swannanoa, North Carolina 28778
[phone]
[phone] Fax
Avery, Buncombe, Burke, Caldwell, Cherokee,
Clay, Graham, Haywood, Henderson, Jackson,
Macon, Madison, McDowell, Mitchell, Polk,
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Fayetteville, North Carolina 28301-5094
[phone]
[phone] Fax
Anson, Bladen, Cumberland, Hamett, Hoke,
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
Raleigh Regional Office
1628 Mail Service Center
Raleigh, North Carolina 27699-1628
[phone]
[phone] Fax
Chatham, Durham, Edgecombe, Franklin,
Granville, Halifax, Johnston, Lee, Nash,
Northampton, Orange, Person, Vance, Wake,
Warren, Wilson
Washington Regional Office
943 Washington Square Mall
Washington, North Carolina 27889
[phone]
[phone] Fax
Beaufort, Bertie, Camden, Chowan, Craven,
Currituck, Dare, Gates, Grccne, Hertford, Hyde,
Jones, Lenoir, Martin, Pamlico, Pasquotank,
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wilmington Regional Office
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
[phone]
[phone] Fax
Brunswick, Carteret, Columbus, Duplin, New
Hanover, Onsiow, Pender
Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, North Carolina 27107
[phone]
[phone] Fax
Aiamance, Allegheny, Ashe, Caswell, Davidson,
Davie, Forsyth, Guilford, Rockingham, Randolph,
Stokes, Surry, Watauga, Wilkes, Yadkin
For more Information, please visit our web site at
http://h2o. enr.state.nc.us/peres/Collection%20Systems/CollectionSystemsHome.html
or contact the Regional Office serving your county.
FTA12/07

USE THE TAB KEY TO MOVE FROM FIELD TO FIELD!
(to be cation Number.
(to be completed by DWQ) led 000 3 to
• 8. PERMIT INFORMATION ' ' A. APPLICATION INFORMATION
1. Owner/Permittee:
la. City of Goldsboro
Full Legal Name (company, municipality, HOA, utility, etc.)
lb. Mr. Scott Stevens, City Manager
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials!)
lc. The legal entity who will own
this system
Municipality
is:
Private Partnership
• Individual • Federal
■ State/County ■
• Corporation ■ Other (specify):
1 d. P.O. Drawer A
1 e.
1g.
Goldsboro
Mailing Address
City RECEIVED
27533
1f. North Carolina
State
Zip Code
1 h. 919-580-4330
1 i.
919-580-4344
1j.
OCT — 2012
Telephone
Facsimile
E-mail
2. Project (Facility) Information: /t! /� /AR®
Office
2a. State Employees' Credit Union — Goldsboro Oce
2b.
D -
Wayne �/ y �/
Brief Project Name (permit will refer to this name)
County Where Project is Located
3. Contact Person:
3a. Michael V Zaccardo, PE
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b. 919-367-8790 ext 103
3c.
[e-mail]
Phone Number
E-mail
1. Project is r New • Modification
(of
an existing permit)
If Modification, Permit No.:
Item B(3))
(go to Item 2(a)) .
2. Owner is r Public (skip to
• Private
2a. If private, applicant will be:
store, church, single office, etc.) or
etc. - skip to Item B(3))
etc. - go to Item B(2b))
2b.
If sold, facilities owned by a (must choose one)
(Instruction C)
Assoc./Developer (Instruction D)
■ Retaining Ownership (i.e.
■ Public Utility
• Leasing units (lots, townhomes,
• Homeowner
IN Selling units (lots, townhomes,
3. City of Goldsboro
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
4a. Goldsboro Wastewater Treatment Plant
4b. NC0023949
Name of WWTF
WWTF Permit No.
5a. City of Goldsboro
5b. 8"
@ Gravity
• Force
Main
5c. WQ0031218
Owner of Downstream Sewer
Receiving Sewer Size
Permit # of Downstream Sewer (Instruction E)
6. The origin of this wastewater is (check all that apply):
• Residential Subdivision
• Retail (Stores, shopping centers)
• Institution
■ Hospital
■ Church
• Nursing Home
■ Other (specify):
100 ok
Domestic/Commercial
% Industrial (attach
• Apartments/Condominiums
• Mobile Home Park
description.)
(RO: contact your Regional Office
Pretreatment staff)
% Other (specify):
• School
• Restaurant
►Zi Office
7. Volume of wastewater to be allocated or permitted for
this particular
allocations
project: 550 gallons
per day
*Do not include future flows or previously permitted
8. If the permitted flow is zero,
indicate why:
Interceptor
in
of existing
Line where flow will be permitted
Permit No.
in subsequent permits that connect to this line
expected (see 15A NCAC 02T .0303 to determine if a
• Pump Station, Outfall or
■ Flow has already been allocated
• Rehabilitation or replacement
sewer with no new flow
permit is required)
FTA12/07

B. PERMIT INFORMATION (CONTINUED)
9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2T .0114 for
the value in Item B(7) AND/OR the design flow for line or pump station sizing if a reduced or zero flow is being requested in
Item B(7). Values other than that in 15A NCAC 2T .0114 (b) and (c) muSt be supported with actual water or wastewater use
data in accordance with 15A NCAC 2T .0114 (f).
22 people x 25 gal/person/day = 550 gallons
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches)
Length (feet)
New Gravity or Additional
Force Main
8" SDR 35 PVC
77' (S64-'>eAP
M,, New Gravity
8"Class 50 DIP
1,487'
New Gravity
SDR 35 PVC w.Gr.c
nor ;, he, d '"
New Garrity
t,_�-,,is
Class 50 DIP .".; {i-.
li. i" i,
* Orbrvtty
11. Summary of Pump Stations w/ associated Force Mains to be Permitted (attach additional sheets as necessary)
Pump Station Location ID (self chosen - as shown on plans/map for reference)
Design Flow
(MGD)
Operational Point
GPM @TDH
Power Reliability Option
1 - permanent generator w/ATS;
2 - portable generator w/MTS
Force Main Size
Force Maln Length
Pump Station Location ID
(self chosen -
as shown on plans/map
for reference)
Design Flow
(MGD)
Operational Point
GPM RTDH
Power Reliability Option
1 - permanent generator w/ATS;
2 - portable generator w/MTS
Force Main Size
Force Main Length
Pump Station Location ID (self chosen - as shown on plans/map for reference)
Design Flow
{MGD)
Operational Point
GPM �TDH
Power Reliability Option
1 - permanent generator w/ATS;
2 - portable generator w/MTS
Force Main Size
Force Main Length
12. Will
El Yes
the wastewater flow in the proposed sewer lines or pump stations be able to be directed to another treatment facility?
0 No If Yes, permit number of 2"d treatment facility
TO — if 'yes' to 6,12 please contact the Central Office PERCS Unit)
13.
Does
Mains
applicable?
0
the
(latest
Yes
sewer
•
system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force
version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC Chapter 2T as
No If No, please reference the pertinent minimum design criteria or regulation and indicate why a variance is
requested. SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS PERTINENT TO THE
VARIANCE WITH YOUR APPLICATION
FTA 12/07

.
'Check
14. Have the following permits/certifications been submitted for approval for the system or project to be served?
Wetland/Stream Crossings - General Permit or 401 Certification? • Yes ■ No ►Zl N/A Boring beneath wetlands
Sedimentation and Erosion Control Plan? ►Zi Yes • No • N/A
Stormwater? 0 Yes Q No IN N/A
15. Does this project include any high priority lines, [see 15A NCAC 02T .0402
manholes)?
NO
(2)1 involve aerial lines, siphons, or interference
if Yes: ■ and provide details
r,
C.. CERTIFICATIONS
1. Owner/Permittee's Certification: (Signature of Signing Official
I, Scott A.Stevens , attest that
and Protect Name)
this application for
and complete to the
and that if all required
to being returned
any person who
shall be guilty of a Class
000 per violation.
State Employees's Credit Union -
Goldsboro Office has been reviewed by me
and is accurate
not completed
package is subject
and 143-215.6B,
any application
penalties up to
best of my knowledge. I understand
supporting documentation and
as incomplete. Note: In accordance
knowingly makes any false
2 misdemeanor, which may include
that if all required parts of this application are
attachments am not included, this application
with North Carolina General Statutes 143-215.6A
statement, representation, or certification in
a fine not exceed 10,000 ivil
'$25,
la. C "J M51' losZ1 Z-
Sign' dal Signature Date
ENGINEERING DESIGN DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL OF THIS
APPLICATION. THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR PROXIMITY
TO OTHER UTILITIES, DESIGN CALCULATIONS. ETC. REFER TO 15A NCAC 02T .0305
2. Professional Engineer's Certification: (Signature of Design Engineer and Protect Name)
I, Michael V Zaccardo , attest that this application for State Employees' Credit Union - Goldsboro Office has
been reviewed by me and is accurate, complete and consistent with the information in the engineering plans, 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, Gravity Sewer Minimum Design Criteria
for Gravity Sewers adopted February 12, 1996, and the Minimum Design Criteria for the Fast -Track Permitting of Pump
Stations and Force Mains adopted June 1, 2000 and the watershed classification in accordance with Division guidance.
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 NC General Statutes 143-215.6A and 143-215.68, any person who knowingly
makes any false statement, representation, or certification in any application 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.
2a. Michael V Zaccardo, PE
•`••0auu a
.••..'(H 1
. e 0.04,
ol .'/;
r•,
..� ,�
- - , +pig
• j�;f±
1,1;: w!:•C{Q`
' it
iV �
��ep
'NC PE Seal, Signature
.4 of c
lit i•
4,..
y •9
.
O o
S"�S`
1W 1 ^ ,t��)
& Date
Professional Engineer Name
2b. CE Group, Inc.
Engineering Firm
2c. 301 Glenwood Avenue, Suite 220
Mailing Address
2d. Raleigh
2e. NC
2f. 27603
City
State
Zip
2g. 919-367-8790 ext
103
2h. 919-322-0032
2i. [e-mail]
Telephone
Facsimile
E-mail
FTA12/07

iV: a corn
Coll
USGS TOPOGRAPHIC MAP
August 22, 2012
STATE EMPLOYEES' CREDIT UNION
GOLDSBORO OFFICE

FORM WSCAS-12/07
WATERSHED CLASSIFICATION ATTACHMENT
FOR SEWER SYSTEMS
Applicant Name
Project Name
State Employees' Credit Union
1000 Wade Avenue, Raleigh, NC 27605
State Employees' Credit Union — Goldsboro Office
Professional Engineer Name
Engineering Firm Name
Michael V. Zaccardo, PE
CE Group, Inc.
301 Glenwood Avenue, Suite 220
Raleigh, NC 27603
Location
ID
Name of Waterbody'
County
River
Basin
Waterbody Stream
Index No.
Waterbody
Classification
F27NW
Stoney Creek
Wayne
Neuse
27-62
C:NSW
RECEIVE'
OCT - 8 2012
DWQ-WAR
1
If unnamed, Indicate "unnamed tributary to X", where X Is the named waterbody to which the unnamed tributary joins.
1 certify that as a Registered Professional Engineer in the State of
North Carolina that I have diligently followed the Division's instructions
for classifying waterbodies and that the above classifications are
inclusive of the stated project, complete and correct to the best of my
knowledge and belief.
PE Seal, Signature and Date ►
*** END OF FORM WSCAS-12/07 ***
FORM: WSCAS-12/07
Page 1 of 1

W ATFR State of North Carolina
O Department of Environment and Natural Resources
7 Division of Water Quality
-< Flow Tracking/Acceptance for Sewer Extension Permit Applications
(1-'I'SE —10/07)
Project Applicant Name: City of Goldsboro
Project Name for which flow is being requested: SECU, 2811 Wayne Memorial Drive
More than one FTSE-10/07 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: City of Goldsboro Water Reclamation Facility
b. WWTP Facility Permit #: NC 0023949
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
14.2
0.48141
8.35
0.00055
8.83196
62.20%
II. Complete this section for each pump station you are responsible for along the route of this
proposed wastewater flow.
List pump stations located between the project connection point and the WWTP
Pump Station Name Approx. Capacity, MGD
(Firm/Design)
Westbrook Pump Station 18 mgd/firm
Approx. Current Avg.
Daily Flow, MGD
6.79
RECEIVED
OCT - 8 2012
III. Certification Statement:
I, Scott A. Stevens , certify that, to the best of my knowledge, 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. 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 Section I and II for h I am the responsible party. Signature of this form indicates
acceptance of this w
Signing Offic'al ignature
DWQ-!AWARD
Jo-ZlZ
City Manager Date