WQ0043747_Application (FTSE)_20220819

DWR
Division of Water Resources
NC Dept ofEnvironmental Quality
AUG 19 2022
State of North Carolina
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Raleigh Regional Office FTA 06-21 & SUPPORTING DOCUMENTATION
Application Number.WQ OD (3747 (to be completed by DWR)
All Items must be completed or the application will be returned
I. APPLICANT INFORMATION:
I, Applicant's name; Town of Selma (company, municipality, IIOA, utility, etc.)
2. Applicant type: 0 Individual D Corporation 0 General Partnership 0 Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal 0 Other
3. Signature authority's name: Brent Taylor per 15A NC AC 02T .0106(b).
Tide: Town Manager
4. Applicant's mailing address; 114 North Raiford Street
City: Selma State: I Zip: 27576
5. Applicant's contact information:
Phone number: [phone] Email Address: btaylor(n7sglma-nc.com
II. PROJECT INFORMATION:
1. Project name: Brack Wilson Pump Station Relocation and System Improvements
2. Application/Project status: ® Proposed (New Pennitl ❑ 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: Johnston County
4. Approximate Coordinates (Decimal Degrees): Latitude: N035°32'41.47° Longitude: W078°17'40.91°
5. Parcel ID (if applicable): 260516-94-7028 (or Parcel ID to closest downstream sewer)
III, CONSULTANT INFORMATION:
1. Professional Engineer: Christopher N. Huff License Number: Q444 Q
Finn: WithersRavenel
Mailing address: 115 MacKenan Dr.
City: Cary State: NC Zip: 2751 l-
Phone number: [phone] Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
I. Facility Name: Central Johnston County Regional W W)'P Permit Number: NC0030716
Owner Name: Johnston County
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Perttit Number(s): WQCS00294
2. Downstream (Receiving) Sewer Information: 21-inch
Z Gravity 0 Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00294
Owner Name(s): Town of Selma
FORM: FTA 06-2 t
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 ® N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operation! Arcement (FORM. DEV) been attached?
❑ Yes ❑ No ® N/A
3. If the Applicant is a Home/Property Owners' Association, has an HOA.•TOA Operational AgreetnenL j j ORM: HO j and
supplementary documentation as required by I5A NCAC 02T.0115(c) been attached?
❑ Yes ❑ No ® N/A
4. Origin of wastewater: (check ail that apply):
❑ Residential (Individually Owned) ❑ Retail (stores, centers, malls)
❑ Residential (Leased) 0 Retail with food preparation/service
❑ School J preschool / day care ❑ Medical / dental / veterinary facilities
❑ Food and drink facilities ❑ Church
❑ Businesses ? offices / factones ❑ Nursing Horne
❑ Car Wash
❑ Hotel and/or Motels
❑ Swimming Pool/Clubhouse
❑ Swimming Pool/Filter Backwash
❑ Other (Explain in Attachment)
Nature of wastewater : _% Domestic _% Commercial _ % Industrial (S 15A NCAC 02T .0103L20f
If Industrial, is there a Pretreatment Program in effect? ❑ Yes ® No
5. Has a flow reduction been approved under 1 S_1k MCAC Et& u 4 ? ❑ Yes ® No
> If yes, provide a copy of flow reduction approval letter with this application
6. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(t))
Daily Design Flow
No. of Units
Flow
gal/
GPI)
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
0 GPD
a See 15A NCAC 021..0114 02), L),_(e)(I) and te)I2) 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 (Q.S, 42A-4).
h Per 15A NCAC 02T .01 4(c), design flow rates for establishments not identified [in table 15A NCAC 02-1 _U 11_C shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
7. Wastewater generated by project: 0 GPD (per 1 r A NC_ AC 02T .0114)
> Do not include future flows or previously permitted allocations
If permitted flow is zero, please indicate why:
D Pump Station/Force Main or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line.
Please provide supplementary infonnation 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

VIl. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
12
197
PVC
15
50
PVC
➢ Section [I & II] of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section El 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 (Prim r tations/Force Mains
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
I. Pump station number or name: Brack Wilson Park Pump Station (16)
6. Approximate Coordinates (Decimal Degrees); Latitude: N035°32'41,47° Longitude: W078° 17'40.9I°
2. Total number of pumps at the pump station: 2
3. Design flow of the pump station: 0.648 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): go gallons per minute (GPM) at {¢ feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
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 Ncaic 02T d1305(h)(1 t:
® Standby power source or ❑ Standby pump
➢ Must have automatic activation and telemetry - 15A NCAC 02T.0305(h)(1)(I3):
D. Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility and may not be portable
Or if the pump station has an average daily flow less than 15,000 gallons per day I5A NCACO2T.0305(h)(1)(C):
❑ Portable power source with manual activation, quick -connection receptacle and telemetry -
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry:
➢ Include documentation that the portable source is owned or contracted by the applicant and is compatible with the station.
➢ If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided
as part of this permit application in the case of a multiple station power outage.
FORM: FTA 06-21 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(1));
1. Does the project comply with all separations/alternatives found in 15A NCAC 02T .03051f1 & 121? ® Yes ❑ No
15A NCAC 02T_0305(1) contains minimum separations that shall be provided for sewer systems:
Setback Parameter* Separation Required
Storm sewers and other utilities not listed below (vertical) 18 inches
'Water mains (vertical - water over sewer preferred, including in benched trenches)
-Water mains (horizontal)
Reclaimed water lines (vertical - reclaimed over sewer)
18 inches
10 feet
18 inches
Reclaimed water lines (horizontal - reclaimed over sewer)
**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.
**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)
**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.
Any building foundation (horizontal)
Any basement (horizontal)
Top slope of embankment or cuts of 2 feet or more vertical height
2 feet
100 feet
50 feet
10 feet
5 feet
Drainage systems and interceptor drains
Any swimming pools
Final earth grade (vertical)
10 feet
10 feet
5 feet
10 feet
36 inches
➢ If noncompliance with 021'4305in or Ia . see Section X.1 of this application
*15A NCAC 02T.0305(g) contains alternatives where separations in 0/11f f1 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 webltagc
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? tEl Yes ❑ No ❑ N/A
A Please provide supplementary information identifying the areas of non-conformance.
➢ See the Division's draft separation reyu rements for situations where separation cannot be met.
➢ No variance is required lithe 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: Nouse River Basin ❑ No
If yes, does the project comply with setbacks found in the river basin rules per 15A KAC 0_2B_.02007 ® Yes ❑ No
➢ This includes Trout Buffered Streams per 15A NCAC 213.0202
5. Does the project require coverage/authorization under a 404 Nationwide/individual permits ❑ Yes ® No
or 401 Water Quality Certifications?
➢ Please provide the permit number/permitting status in the cover letter if coverage/authorization is required.
6. Does project comply with I SA NCAC 02T.0105te ) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T_0105(c1(6), directly related environmental permits or certification applications must be being prepared,
have been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion
and sedimentation control plans, stormwater management plans, etc.).
7. Does this project include any sewer collection lines that are deemed "high -priority?" 0 Yes ® No
Per I5A 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.
➢ [f 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:
I . Does the submitted system comply with }SA KACII2T, the lvitnimurn ucCriteria f4F 5 l'cnti�ittii,g of` Puunp Stgl'orts
mai Comm MajasnagAlzaistal and the;iravtty Sewer Minimum Design Criteria {fates v m as applicable?
® Yes ❑ No
If no, for projects requiring a single variance, complete and submit the Variance/Altemative Design Request application
(VADC 10-14) and supporting documents for review to the Central Office. Approval of the reauest will be Issued
concurrently with the aDproval of the Permit. and Protects reauiring a variance approval may be sublect to longer
review times,For uroJects requiring two or more variances or where the variance is determined by the Division to be a
significant portion of the protect. the full technical review is required.
2. Professional Engineer's Certification:
Brack Wilson Pump Station Relocation
i, Christopher N. Huff , attest that this application for and System Improvements
(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. 1 further
attest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable regulations,
jjinirum Desi(ii Critetia Ter araviiN Scwcr; i EatcsL'_czkie ), and the Minimum Design Critcri$ to rke.FasialatUlrfnit
trfrun p itationi and Fttiree Maim. ii�iysI:6:3.io+I . 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)
�Ne►rnrrliy,i
Nortb Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per I5A NCAC 02T .0106(b):
1 Brent- Taylor , attest that this application for
(Signature Authority Name from Application item T.3.)
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Brack Wilson Pump Station
Relocation and Sewer improvements
(Project Name from Application Item I1.1)
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 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. 1 will make no claim against the Division
of Water Resources should a condition of this permit be violated. 1 also understand that if all required parts of this application
package are not completed and that if all required supporting information and attachments are not included, this application
package will be returned to me as incomplete.
NOTE - In accordance with General Statutes 143-215.6A and .I. 2l,�,ttit, 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,
Signature:
Date:
vz-
FORM: FTA 06-21 Page 5 of 5

NC Dept of Enviromnental Qualir
1 WithersRavenei
Our People. Your Success.
August 18, 2022
Department of Environmental Quality
Raleigh Regional Office— Water Quality Section
3800 Barrett Drive
Raleigh, North Carolina 27609
Attn: Fast Track Permit Reviewer
RE: Brack Wilson Pump Station Relocation and System Improvements
AUG 19 2022
Raleigh Regional Office
To Whom it May Concern:
Enclosed you will find the Fast Track Application for the Brack Wilson Pump Station Relocation and System
Improvements project. There will be no additional flow requested with this application. This project will
abandon the current Brack Wilson Pump Station and relocate Brack Wilson Pump Station to a location on
the same parcel. The relocation of the pump station will include the replacement of pump station
equipment. The permit for the existing Brack Wilson Pump Station was not able to be located by the
Owner or the Engineer. This application is being submitted as if Brack Wilson Purnp Station is a new pump
station only because the current pump station permit is unavailable.
Brack Wilson Pump Station Relocation and System Improvements project consists of the relocation of
Brack Wilson Pump Station approximately 100 feet southeast of the current Brack Wilson Pump Station
location and approximately 150 feet northeast of the intersection of North Forest Street and West Oak
Street. In addition, the project includes installation approximately 197 LF of 12-inch and 50 LF of 15-inch
gravity sewer of gravity sewer mains to convey flow from existing gravity sewer to the new Brack Wilson
Pump Station and approximately 186 LF of 6-inch new force main to convey flow from the new Brack
Wilson Pump Station to the existing force main. Approximately 100 LF of 10-inch PVC gravity sewer, 210
LF of 12-inch PVC gravity sewer and 100 LF of 6-inch force main will be abandoned or removed. These
lines connect Brack Wilson Pump Station to the existing gravity sewer and force main at the pump station's
current location and will be abandoned or removed after the installation of the new gravity sewer and
force main segments (described above).
Items included in submittal:
Two paper prints of the Cover Letter/Narrative
► Two paper prints of FTA 04-16 Form signed and sealed
► Two paper print of USGS Topographic
► Two paper prints of Aerial Site Map
► $480 Check for Application Fee
219 Station Road, Suite 101 I Wilmington, NC 28405
t: 910.256.9277 I f: 910.256.2584 I www.withersravenel.com I License No. F-1749
Asheville I Cary I Charlotte [Greensboro I Pittsboro 'Raleigh I Wilmington

:WithersRavenel
Our People. Your Success
Please contact me if you have any questions or need any additional information.
Thank you,
Leonard McBryde III, PE
Utility Director, Wilmington
WithersRavenel
919-238-0424 direct
984-365-0528 cell
219 Station Road, Suite 101 I Wilmington, NC 28405
t: 910.256.9277 I f: 910.256.2584 I www.withersravenel.com I License No. F-1749
Asheville I Cary Charlotte (Greensboro I Pittsboro I Raleigh I Wilmington

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PUMP STATION USGS LOCATION MAP
SCALE:1' d 1000'
PROPOSED PUMP STATION
E MCA ON
USGS LOCATION MAP
Wit ersRavenei
II,. Engineers I Planners I Surveyors
11S Macllaran NMI Can. MC 27511
• 11,4693340 Irma a. F•14T91 www' wnhnvwenrl wn

1
PUMP STATION AERIAL LOCATION MAP
SCALE 1' - 250'
SELMA SRF BRACK
PROPOSED PUMP STATION
RELOCATION
AERIAL LOCATION MAP
-4•WithersRavenel
1.&einem1 Wanness I Suneyon
11.4 Machcaen Dn. I Gay. NC 77511
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