WQ0038104_Application (FTSE)_20151026

CO COX-EDWARDS COMPANY, INC.
CONSTRUCTION AND ENGINEERING
Established 1966
License No. 5046
October 23, 2015
NCDENR, Division of Water Resources
Washington Regional Office
Water Quality Section
943 Washington Square Mall
Washington, NC 27889
1205 Parkway Drive
Goldsboro, NC 27534
Email: [e-mail]
Re: Fast -Track Application (FTA 10-14)
Gravity Sewers, Pump Stations, and Force Mains
Point Five Development
Goldsboro, NC
Dear Ladies/Gentlemen
Tel. No.919-751-5100
Fax No. 919-751-1744
www.cox-edwards.com
RECEIVED/NCDENR/D1NR
OCT 262015
Water Quality Regional
Operations Section
Washington Regional Office
Enclosed for your review are one (1) original and (1) one copy of the following items:
1) Overview of the project provide a brief narrative of the design
2) Fast -Track Application (FTA 10-14)
3) Application fee in the amount of $480.00 made out to NCDENR, Division of Water Resources (only
original check is enclosed)
4) Flow Tracking/Acceptance for Sewer Extension Permit Applications Form FTSE-10/07 (provided by the
City of Goldsboro in lieu of FTSE 08-13 form)
5) 8.5"x 11" color copy of USGS Topographic Map identifying the project area
Please contact us if you have any questions during your review.
Sincerely,
COX-EDWARDS COMPANY, INC.
By 2-CQ '
_LAP-Ar
E. Scott Edwards, PE
Enclosures

WR),)
DWR
Division of Water Resources
--e) \ 1-\--
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
FAST -TRACK APPLICATION (FTA 10-14)
for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS
General - When submitting this 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.
For more information, visit the Water Quality Permitting Section's website or;
contact the Regional Office serving your county
Unless otherwise noted. the Applicant shall submit one original and one copy of the application and supporting
documentation to the appropriate Regional Office (see page 3).
A. Cover Letter:
❑ Include a brief project narrative describing the final 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 (i.e. adding another phase, changing line size, length, etc).
B. Application Form (FTA 10-14):
❑ Submit the completed and appropriately executed Fast -Track (FTA 10-14) Application. Any
unauthorized content changes to this form shall result in the application being returned. If necessary
for clarity or due to space restrictions, attachment to the application may be made, as long as the
attachments are numbered to correspond to the section and item to which they refer. You do not need
to submit detailed plans and specifications unless you respond NO to item B(13).
❑ The Professional Engineer's Certification of the application shall be signed, sealed and dated by a
North Carolina licensed Professional Engineer.
❑ The Applicant's Certification of the application shall be signed in accordance with 15A NCAC 02T
.0106(b). Per 15A NCAC 02T .0106(c), an alternate person may be designated as the signing official if
a delegation letter is provided from a person who meets the criteria in 15A NCAC 02T .0106(b).
C. Application Fee:
❑ Submit a check in the amount of $480 to: North Carolina Department of Environment and Natural
Resources (NCDENR).
Checks shall be dated within 90 days of application submittal.
D. Certificate of Public Convenience and Necessity (For Privately -Owned Public Utilities Only):
❑ Per 15A NCAC 02T .0115(a)(1), provide two copies of 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 two copies of 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.
❑ The project name in the CPCN or letter must match that provided in Item A(2)a of this application.
E. Operational Agreements (For Home/Property Owners' Associations and Developers of lots to be sold):
▪ Home/Property Owners' Associations
❑ Per 15A NCAC 02T .0115(c), submit the properly executed Operational Agreement (HOA 08-13).
❑ Per 15A NCAC 02T .0115(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
• Developers of lots to be sold
❑ Per 15A NCAC 02T .0115(b), submit the properly executed Operational Agreement (DEV 08-13).
Even if the project may be turned over to a municipality upon completion, Form DEV 08-13 is required.
INSTRUCTIONS FOR APPLICATION FTA 10-14 & SUPPORTING DOCUMENTATION Page 1 of 6

F. Downstream Sewer, WWTF Capacity and Flow Tracking/Acceptance Form (I- I SE 08-13)
❑ Submit the completed and appropriately executed Flow Tracking/Acceptance for Sewer Extension Permit
(FTSE 08-13) Form for all applications.
The applicant (and owners of downstream sewers, pump stations and/or treatment facilities submitting
form FTSE 08-13 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 08-13
from the owner of the downstream sewer and owner of the WWTF, if different.
❑ The flow acceptance indicated in form FTSE 08-13 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 08-13 indicates that owner has adequate capacity
and will not violate V.S. 143-215.67(a).
• Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific
FTSE 08-13.
G. Site Map (All Application Packages)
❑ Submit an 8.5-inch x 11-inch color copy of a USGS Topographic Map of sufficient scale to identify the
entire project area and closest surface waters. Each map must include at a minimum:
Y The location of the sewer line and pump stations and be of reproducible quality.
Y Downstream connection points and the permit number for the receiving sewer (if known)
Y Pump Station Locations and the longitude and latitude for each pump station (if applicable)
❑ Include a street level map showing all relevant project areas.
H. Stream Classification (WSCAS 01-1;
❑ Submit the completed and appropriately executed Watershed Classification Attachment form
(WSCAS 01-15) if any portion of the sewer system project is within 100 feet of any surface water or
wetlands.
▪ A variance must be requested for encroachment within required setbacks or buffers pursuant to
NCAC 02T .0305(f)
I. Environmental Assessments (Projects subject to an Environmental Assessment (EA)):
Projects involving an Environmental Assessment per 15A NCAC 0 1 C..0408, must be submitted for a full
technical review and must be submitted to the PERCS Unit on application forms provided by the Division.
Alternative Sewer Systems
Projects involving low pressure sewer systems, vacuum sewer systems and other alternative sewer
systems must be submitted for a full technical review and must be submitted to the PERCS Unit on
application forms provided by the Division.
K. 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 the project, please indicate in B(12)
and give the permit number of the second facility.
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(1 b). The PE should NOT certify the application if he/she is unfamiliar with 5A NCAC Chapter
, The Gravity Sewer Minimum Design Criteria (most recent version) and the Minimum Design Criteria
for the Permitting of Pump Stations and Force Mains (most recent version), as applicable to the project.
INSTRUCTIONS FOR APPLICATION EI'A 10-14 & SUPPORTING DOCUMEN"I ATION Page 2 of 6

THE COMPLETED APPLICATION PACKAGE INCLI)IN(; ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
Asheville Regional Office
Water Quality Section
Fayetteville Regional Office
Water Quality Section
Mooresville Regional Office
Water Quality Section
Raleigh Regional Office
Water Quality Section
2090 US Highway 70
Swannanoa, North Carolina 28778
[phone]
[phone] Fax
COUNTIES SERVED
Avery, Buncombe, Burke, Caldwell, Cherokee,
Clay, Graham, Haywood, Henderson, Jackson.
Macon, Madison, McDowell, Mitchell, Polk,
Rutherford, Swain, Transylvania, Yancey
225 Green Street Suite 714
Fayetteville, North Carolina 28301-5094
[phone]
[phone] Fax
Anson, Bladen, Cumberland, Harnett, Hoke,
Montgomery, Moore, Robeson, Richmond,
Sampson, Scotland
610 E. Center Avenue
Mooresville, North Carolina 28115
[phone]
[phone] Fax
1628 Mail Service Center
Raleigh, North Carolina 27699-1628
[phone]
[phone] Fax
Alexander, Cabarrus, Catawba, Cleveland,
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
Stanly, Union
Washington Regional Office
Water Quality Section
943 Washington Square Mall
Washington, North Carolina 27889
[phone]
[phone] Fax
Wilmington Regional Office
Water Quality Section
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
[phone]
[phone] Fax
Winston-Salem Regional Office
Water Quality Section
Chatham, Durham, Edgecombe, Franklin,
Granville, Halifax, Johnston, Lee, Nash.
Northampton, Orange, Person, Vance, Wake,
Warren, Wilson
Beaufort, Bertie, Camden, Chowan, Craven,
Currituck, Dare, Gates, Greene, Hertford, Hyde,
Jones, Lenoir, Martin, Pamlico, Pasquotank,
Perquimans, Pitt, Tyrrell, Washington, Wayne
Brunswick, Carteret, Columbus, Dublin, New
Hanover, Onslow, Pender
450 W. Hanes Mill Road
Suite 300
Winston-Salem, North Carolina 27105
[phone]
Alamance, Allegheny, Ashe, Caswell, Davidson,
Davie, Forsyth, Guilford, Rockingham, Randolph,
Stokes, Surry, Watauga, Wilkes, Yadkin
INSTRUCTIONS FOR APPLICATION FTA 10-14 & SUPPORTING DOCUMENTATION
Page 3 of 6

A. APPLICATION INFORMATION
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD
1. Owner/Permittee:
1a. Point Five Goldsboro LLC
1 b.
1 c.
Application Number: k(� O
(to be completed by DWR) i 1 �i j4.
Full Legal Name (company, municipality, HOA, utility, etc.)
Susan Poissant, Director of Development
Signing Official Name and Title (Please review 1 SA NCAC 2T .0106 (b) for authorized signing officials)
The legal entity who will own this system is:
El Individual ❑ Federal ❑ Municipality ❑ State/County ❑ Private Partnership ® Corporation ❑ Other (specify):
1d. 7075 Manlius Center Road le. East Syracuse
Mailing Address City
1f. New York 1g_ 13057
State Zip Code
1 h. 315-671-1500 1 i. 315-671-1500 Ij. [e-mail]
Telephone Facsimile E-mail
2. Project (Facility) Information:
2a. Point Five
Brief Project Name (permit will refer to this name)
3. Contact Person:
3a. Scott Edwards
B. PERMIT INFORMATION
2b. Wayne
County Where Project is Located
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b. 919-751-5100 3c. [e-mail]
Phone Number E-mail
1. Project is ® New 0 Modification (of an existing permit) If Modification, Permit No.:
2. Owner is ❑ Public (skip to Item B(3))
2a. If private, applicant will be:
Retaining Ownership (i.e. store, church, single office, etc.) or
® Leasing units (lots, townhomes, etc. - skip to Item B(3))
❑ Selling units (lots, townhomes, etc. - go to Item B(2b))
3. City of Goldsboro
® Private (go to Item 2(a))
2b. If sold, facilities owned by a (must choose one)
❑ Public Utility (Instruction D)
❑ Homeowner Assoc./Developer (Instruction E)
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
4a. City of Goldsboro Water Reclamation Facility 4b. 0023949
Name of WWTF
5a. City of Goldsboro
Owner of Downstream Sewer
8" ® Gravity
Receiving Sewer Size I❑ Force Main
6. The origin of this wastewater is (check all that apply):
❑ Residential Subdivision
❑ Apartments/Condominiums
❑ Mobile Home Park
❑ School
® Restaurant
® Office
5c.
WWTF Permit No.
Permit # of Downstream Sewer (Instruction F)
® Retail (Stores, shopping centers)
❑ Institution
❑ Hospital
❑ Church
❑ Nursing Home
❑ Other (specify):
100 % Domestic/Commercial
% Industrial
(Attach Description)
% Other
(Attach Description)
7. Volume of wastewater to be allocated or permitted for this particular project: 7900 gallons per day
*Do not include future flows or previously permitted allocations
8. If the permitted flow is zero, indicate why:
❑ Pump Station, Outfall or Interceptor Line where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit No.
❑ Rehabilitation or replacement of existing sewer with no new flow expected
(see 15A NCAC 02T .0303 to determine if a permit is required)
FTA 10-14 APPLICATION Page 4 of 6

9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 5A 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).
7 stores & shopping center areas without foot service 2500 SF, 1925 SF, 1701 SF, 1789 SF, 5000 SF, 1381 SF, and
15,904 SF each @100 gal/1000 SF plus 2 full service restaurants @ 40 gal/seats with 50 and 72 seats respectively
for 7900 gallons/day total_
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches) Length (feet)
8"
New Gravity or Additional
Force Main
203' gravity
Cl
w
H11. Summary of Pump Stations w/ associated Force Mains to be Permitted (attach additional sheets as necessary)
Q Pump Station Location ID: (self chosen - as shown on plans/map for reference)
0 Longitude: Latitude:
Z
0
Design Flow Operational Point Power Reliability Option
Q (MGD) GPM @TDH 1 - permanent generator w/ATS; Force Main Size
2 2 - portable generator w/MTS
0
LL
Pump Stati
1-
E Longitude:
LLl Design Flow
d (MGD)
Force Main Length
on Location ID: (self chosen - as shown on plans/map for reference)
Latitude:
m
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 the wastewater flow in the proposed sewer lines or pump stations be able to be directed to another treatment facility?
❑ Yes ® No If Yes, permit number of 2nd treatment facility :
(RO — if "yes" to B,12 please contact the Central Office PERCS Unit)
13. Does the sewer system comply with the Minimum Design Criteria for the Permitting of Pump Stations and Force Mains
(latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC Chapter 2T as applicable?
El Yes ❑No
If No, complete and submit the Variance/Alternative Design Request (VADC 10-14) application and supporting
documents for review. Approval of the request is required prior to submittal of the Fast Track Application and
supporting documents.
FTA 10-14 APPLICATION Page 5 of 6

C. CERTIFICATIONS
14 Have the following permits/certifications been submitted for approval for the system or project to be served?
Wetland/Stream Crossings - General Permit or 401Certification"
Sedimentation and Erosion Control Plan?
Trout Buffer Waiver?
Stormwater?
❑ Yes ❑ No
© Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
© N/A
❑ N/A
® N/A
® N/A
15. Does this project include any high priority lines (15A. NCAC 02T .0402 12 ) involve aerial lines, siphons, or interference
manholes)? These lines will be considered high priority and must be checked once every six months
Check if Yes ❑ and provide details:
1. Ownn/Perm' 's Certification (Signature of Signing Official and Project Name) v I �-bort�c-
1
, attest that this application for Point Five has ben reviewed by me and is accurate
�U complete to the best of my knowledge. I understand that if all required parts of this application are not completed and
hat if all required supporting documentation and attachments are not included. this application package is .subject to being
returned as incomplete. Note: In accordance with North Carolina General Statutes 143-215.6A and 143-215.6b, 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.
igning Official 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 :AC 02T .03.
2 Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
1, Edwin S,. Edwards.attest that this application for Point Five 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 1 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 143-215.6E, 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. Edwin S. Edwards
Professional Engineer Name
2b. Cox -Edwards Company, Inc.
Engineering Firm
2c. 1205 Parkway Drive
Mailing Address
2d. Goldsboro 2e. NC
City State
2g. 919-751-5100 2h. 919-751-1744
2f. 27534
Zip
2i. [e-mail]
Telephone Facsimile E-mail
FTA 10- I4 APPLICATION Page 6 of 6
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OFi\N ATFR State of North Carolina
LPG Department of Environment and Natural Resources
Division of Water Quality
Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE —10/07)
Project Applicant Name: Point Five Goldsboro LLC
Project Name for which flow is being requested: Point Five (Berkeley Blvd. and Cashwell Dr
intersection)
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
1.605175
9.67
0.0079
11.283075
79.46
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 Approx. Current Avg.
(Firm/Design) Daily Flow, MGD
Westbrook Pump Station
18 mgd/firm 9.12 MGD
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 Sections I and 11 for which I am the re nsible party. Signature of this form indicates
acceptance of this wastewater flow.
L12��1
Signing Official Signature City Manager Date

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OVERVIEW
The site for the proposed Point Five Development is situated on 2.62 acres of land on
the North side of the Cashwell Drive and Berkeley Blvd. (NCSR # 1579) intersection.
The property is located in Wayne County inside the City of Goldsboro municipal
limits. The existing site is made up of 3 properties — 501 N. Berkeley Blvd., owned
by NORFAM LCC and currently used as a gas station/convenience store, 503 N.
Berkeley Blvd., owned by NORFAM LLC and currently vacant with mostly
impervious surfaces, and 2901 Cashwell Drive, owned by Charles Norwood and
currently vacant with an existing building. The properties at 501 and 503 N. Berkeley
Blvd. are in ownership transition from NORFAM LLC to Point Five Goldsboro LLC.
Point Five plans to construct a single 18,496 SF commercial building with multiple
lease tenants. The wastewater flow rate is based on the following:
Unit Flow Extended
# Type of Establishment Rate Unit Quantity Total Flow
170 Vitamin Shoppe - 2500 SF 0.1 gal/SF 2500 250
160 Retail - 1925 SF 0.1 gal/SF 1925 193
150 Retail - 1701 SF 0.1 gal/SF 1701 170
140 Retail - 1789 SF 0.1 gal/SF 1789 179
130 Sleepy's - 5000 SF 0.1 gal/SF 5000 500
120 Retail - 1381 SF 0.1 gal/SF 1381 138
110 Restaurant - Fire House Subs 40 gal/seat 50 2000
100 Restaurant - Chipotle 40 gal/seat 72 2880
2910 Vacant 15,904 SF bld. - Cashwell Dr. 0.1 gal/SF 15904 1590
7900
gallons
Notes:
1. All establishments, except for restaurants, are treated as retail (stores and shopping
centers without food service, 100 ga1/1000 SF, per GS 15A NCAC 02T.0114, Part C).
2. The restaurants, considered full service, are 40 gallons per seat per GS.
1