WQ0034122_Application (FTSE)_20090608

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NCDENR
lardi
Laserfiched
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
Sprunt Hill, Assistant Superintendent
Wayne County Schools Board of Education
Wayne County Public Schools
2001 East Royall Avenue
Goldsboro. NC 27533
Dear Mr. Hill
June 8, 2009
Subject Permit No. WQ0034122
Wayne County Schools Board of Education
Brogden Primary School Sewer
Wastewater Collection System Extension
VVayne County
In accordance with your application received June 1, 2009, we are forwarding herewith Permit No.
W00034122, dated June 8, 2009, to Wayne County Schools Board of Education for the construction and
operation of the subject wastewater collection system extension. This permit shall be effective from the date of
issuance until rescinded and shall be subject to the conditions and limitations as specified therein. This cover
letter shall be considered a part of this permit and is therefore incorporated therein by reference.
Please pay particular attention to Permit Condition 3, which requires that the wastewater collection
facilities be properly operated and maintained in accordance with 15A NCAC 2T .0403 or any individual system-
wide collection system permit issued to the Permittee.
Permitting of this project does not constitute an acceptance of any part of the project that does not meet
15A NCAC 2T; the Division of Water Quality's (Division) Gravity Sewer Minimum Design Criteria adopted
February 12. 1996 as applicable: and the Division's Minimum Design Criteria for the Fast -Track Permitting of
Pump Stations and Force Mains adopted June 1, 2000 as applicable, unless specifically mentioned herein.
Division approval is based on acceptance of the certification provided by a North Carolina -licensed Professional
Engineer in the application. It shall be the Permittee's responsibility to ensure that the as -constructed project
meets the appropriate design criteria and rules. Failure to comply may result in penalties in accordance with
North Carolina General Statute §143-215.6A through §143-215.6C, construction of additional or replacement
wastewater collection facilities, and/or referral of the North Carolina -licensed Professional Engineer to the
licensing board.
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended. and other applicable Laws, Rules, and Regulations, permission is hereby granted to Wayne County
Schools Board of Education for the construction and operation of approximately 386 linear feet of 6-inch gravity
sewer to serve 701 students as part of the Brogden Primary School Sewer project, and the discharge of 1,402
gallons per day of collected wastewater into the City of Goldsboro's existing sewerage system, pursuant to the
application received June 1, 2009. and in conformity with 15A NCAC 2T; the Division's Gravity Sewer Minimum
Design Criteria adopted February 12. 1996 as applicable; the Division's Minimum Design Criteria for the Fast -
North Carolina Division of Water Quality
943 Washington Square Mall
Washington, NC 27889
Internet' www.ncwaterquality.oro
Phone: [phone]
FAX' [phone]
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper
NorthCarolina
Naturally

Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and other supporting
data subsequently filed and approved by the Department of Environment and Natural Resources and considered
a part of this permit.
The sewage and wastewater collected by this system shall be treated in the City of Goldsboro
Wastewater Treatment Facility (NPDES Permit No. NC0023949) prior to being discharged into the receiving
stream.
This permit shall become voidable unless the agreement between Wayne County Schools Board of
Education and the City of Goldsboro for the collection and final treatment of wastewater is in full force and effect.
If any parts, requirements, or limitations contained in this permit are unacceptable. you have the right to
request an adjudicatory hearing upon written request within 30 days following receipt of this permit. This request
must be in the form of a written petition, conforming to Chapter 150B of North Carolina General Statutes, and filed
with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC 27699-6714. Unless such
demands are made, this permit shall be final and binding.
If you need additional information concerning this matter, please contact Thom Edgerton at (252) 948-
3955 or via E-mail at thom.edgerton(a�ncdenr.goV.
incerely,
it- Cali CCU r--
Fo Coleen H. Sullins
cc: Wayne County Health Department
Washington Regional Office, Surface Water Protection Section (City of Goldsboro Collection System)
Steven J. Miller, PE (CLH Design, PA, 400 Regency Forest Drive, Suite 120, Cary, NC 27518)
City of Goldsboro (214 N. Center St., PO Drawer A, Goldsboro, NC 27533-9701
Water Quality Central Files
PERCS (formerly NDPU) Files

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
This permit shall be effective from the date of issuance until rescinded and shall be subject to the following specified
conditions and limitations:
This permit shall become voidable unless the wastewater collection facilities are constructed in accordance with the
conditions of this permit: 15A NCAC 27; the Division of Water Quality's (Division) Gravity Sewer Minimum Design
Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast -Track
Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and other supporting materials
unless specifically mentioned herein.
This permit shall be effective only with respect to the nature and volume of wastes described in the application and
other supporting data.
The wastewater collection facilities shall be properly maintained and operated at all times. The Permittee shall
maintain compliance with an individual system -wide collection system permit for the operation and maintenance of
these facilities as required by 15A NCAC 2T .0403. If an individual permit is not required, the following performance
criteria shall be met as provided in 15A NCAC 2T .0403:
a. The sewer system shall be effectively maintained and operated at all times to prevent discharge to land or
surface waters, and any contravention of the groundwater standards in 15A NCAC 2L .0200 or the surface
water standards in 15A NCAC 2B .0200.
b. A map of the sewer system shall be developed and shall be actively maintained.
c. An operation and maintenance plan shall be developed and implemented.
d. Pump stations that are not connected to a telemetry system shall be inspected every day (i.e. 365 days per
year). Pump stations that are connected to a telemetry system shall be inspected at least once per week.
e. High -priority sewer lines shall be inspected at least once per every six-month period of time.
f. A general observation of the entire sewer system shall be conducted at least once per year.
g. Inspection and maintenance records shall be maintained for a period of at least three years.
h. Overflows and bypasses shall be reported to the appropriate Division regional office in accordance with 15A
NCAC 2B .0506(a), and public notice shall be provided as required by North Carolina General Statute §143-
215 1C.
This permit shall not be transferable. In the event there is a desire for the wastewater collection facilities to change
ownership, or there is a name change of the Permittee, a formal permit request shall be submitted to the Division
accompanied by documentation from the parties involved, and other supporting materials as may be appropriate.
The approval of this request shall be considered on its merits and may or may not be approved.
Construction of the gravity sewers, pump stations, and force mains shall be scheduled so as not to interrupt service
by the existing utilities nor result in an overflow or bypass discharge of wastewater to the surface waters of the State.

Per 15A NCAC 2T.0116, upon completion of construction and prior to operation of these permitted facilities, the
completed Engineering Certification form attached to this permit shall be submitted with the required supporting
documents to the address provided on the form. A complete certification is one where the form is fully executed and
the supporting documents are provided as applicable.
A copy of the construction record drawings shall be maintained on file by the Permittee for the life of the wastewater
collection facilities.
Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 2T, the Division's Gravity
Sewer Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast -
Track Permitting of Pump Station and Force Mains adopted June 1, 2000 as applicable; and other supporting
materials may subject the Permittee to an enforcement action by the Division, in accordance with North Carolina
General Statutes §143-215.6A through §143-215.6C.
In the event that the wastewater collection facilities fail to perform satisfactorily, including the creation of nuisance
conditions, the Permittee shall take immediate corrective action, including those as may be required by this Division,
such as the construction of additional or replacement facilities.
10. The issuance of this permit shall not exempt the Permittee from complying with any and all statutes, rules.
regulations, or ordinances that may be imposed by other government agencies (local, state and federal) which have
jurisdiction, including but not limited to applicable river buffer rules in 15A NCAC 2B .0200, erosion and
sedimentation control requirements in 15A NCAC Ch. 4 and under the Division's General Permit NCG010000, and
any requirements pertaining to wetlands under 15A NCAC 2B .0200 and 15A NCAC 2H .0500.
11. Noncompliance Notification:
The Permittee shall report by telephone to a water quality staff member at the Washington Regional Office.
telephone number 252-946-6481, as soon as possible, but in no case more than 24 hours or on the next working
day, following the occurrence or first knowledge of the occurrence of either of the following.
a. Any process unit failure, due to known or unknown reasons, that renders the facility incapable of adequate
wastewater transport, such as mechanical or electrical failures of pumps, line blockage or breakage, etc.: or
Any failure of a pumping station or sewer line resulting in a by-pass directly to receiving waters without treatment
of all or any portion of the influent to such station or facility.
Overflows and spills occurring outside normal business hours may also be reported to the Division of Emergency
Management at telephone number [phone] or [phone]. Voice mail messages or faxed information
shall not be considered as the initial verbal report. Persons reporting any of the above occurrences shall file a spill
report by completing and submitting Part I of Form CS-SSO (or the most current Division approved form) within five
days following first knowledge of the occurrence. This report must outline the actions taken or proposed to be taken
to ensure that the problem does not recur. Part II of Form CS-SSO (or the most current Division approved form) can
also be completed to show that the SSO was beyond control.

12. Gravity sewers installed below the minimum required slope per the Division's Gravity Sewer Minimum Design Criteria
shall not be acceptable and shall not be certified until corrected. If there is an unforeseen obstacle in the field where
all viable solutions have been examined, a slope variance can be requested from the Division with firm supporting
documentation. This shall be done through a permit modification with fee. Such variance requests will be evaluated
on a case -by -case basis. Resolution of such request shall be evident prior to completing and submitting the
construction certification.
Permit issued this the eighth day of June, 2009
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
i .
1 "-t
For Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number WQ0034122

Permit No. WQ0034122
June 8, 2009
ENGINEER'S CERTIFICATION
Complete and submit this form to the permit issuing office (address below) with the following:
• One copy of the project record drawings (plan/profile views and detail drawings of sewer lines) of the wastewater collection system
extension. Final record drawings should be clear on the plans. Record drawings should indicate the design and the marked up
changes during construction.
• Supporting design calculations (selected pumps, system curve, operating point, available storage if portable generator(s) or
storage greater than longest past three year outage reliability option selected) for any pump stations permitted as part of this
project
• Changes to the project should be clearly identified on the record drawings or in written summary form. Permit modifications are
required for any changes resulting in non-compliance with this permit, regulations or minimum design criteria. Modifications should
be submitted prior to certification.
This project shall not be considered complete nor allowed to operate until this Engineer's Certification and all required supporting
documentation have been received by the Division. Therefore, it is highly recommended that this certification be sent in a
manner that provides proof of receipt by the Division.
ENGINEER'S CERTIFICATION
❑ Partial ❑ Final
, as a duly registered Professional Engineer in the State of North Carolina, having been authorized to
observe (❑ periodically, ❑ weekly, ❑ full time) the construction of the Brogden Primary School Sewer. Wayne County project,
consisting of 386 linear feet of 6-inch gravity sewer to serve 701 students for the Permittee hereby state that, to the best of my abilities,
due care and diligence was used in the observation of the construction such that the construction was observed to be built within
substantial compliance of this permit; 15A NCAC 2T; the Division of Water Quality's (Division) Gravity Sewer Minimum Design Criteria
adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and
Force Mains adopted June 1, 2000 as applicable; and other supporting materials.
North Carolina Professional Engineer's
seal, signature, and date:
SEND THIS FORM & SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS
NORTH CAROLINA DIVISION OF WATER QUALITY
WASHINGTON REGIONAL OFFICE — SURFACE WATER PROTECTION SECTION
ATTN: REGIONAL SUPERVISOR
943 WASHINGTON SQUARE MALL
WASHINGTON, NC 27889
The Permittee is responsible for tracking all partial certifications up until a final certification is received. Any wastewater flow made tributary to the
wastewater collection system extension prior to completion of this Engineer's Certification shall be considered a violation of the permit and shall subject
the Permittee to appropriate enforcement actions.

CLH design, p.a.
MacGregor Park, 125 Edinburgh South, Suite 310
Cary, North Carolina 27511
Phone: [phone] Fax: [phone]
Email [e-mail]
LETTER OF TRANSMITTAL
To: Al Hodge
0
9
29-May-09
Company:
Address:
NC-DENR Washington Regional Office -Department of Water Quality
943 Washington Square Mali
City, State Zip:
Washington, NC 27889
Phone:
Fax:
Method:
Subject:
❑ Prints
❑ Reports
UPS Ground
Brodgen Primary School
❑ Originals
❑ Copy of Letter
CLH Project Number: 08-148
❑ Specifications ® Applications
❑ Submittals ® Other: Fee
We are sending you the following items:
No. of Copies Date
• 1
29-May-09
Description
FTA Form
• 1
Check
•
•
•
FTSE Brogden Pump Station
FTSE Genoa Pump Station
FTSE City of Goldsboro Water Reclamation Facility
•
•
•
Additional Remarks:
Enclosed is all of the information to review our application Gravity Sewer. Please feel free to contact me
with questions or clarifications at919-319-6716 x 4007
Best Regards,
Terry Naranjo --'7
Signed 1 L
cc: File
08-148 permit

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
FAST -TRACK APPLICATION
(FTA 12/07 ver5)
for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS
(Pressure & Vacuum 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 returned 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 (i.e. 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 returned. 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 Form 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, VWVTF 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-10107 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.
FTA l 2/07

❑ 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.
El 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.
® J.
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.
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, Harnett, 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, Greene, 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, Onslow, Pender
Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, North Carolina 27107
[phone]
[phone] Fax
Alamance, Alleghany, 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.
FTA 12/07

USE THE TAB KEY TO MOVE FROM FIELD TO FIELD!
Application Number:
(to be completed by DWQ) V-
(1
-u �j Z7i
1. Owner/Permittee:
1a_ Wayne County Schools Board of Educations
Full Legal Name (company, municipality, HOA, utility, etc.) kUtt a 1 2009
Z lb. Sprunt Hill, Assistant Superintendent
Q 1 c.
Z
re
0 1 d.
Signing
The
■
Wayne
Official Name and
legal entiN. who will
Individual 0 Federal
County Public Schools
Title (Please review
own this system
■ Municipality
2001 East
is:
0
15A NCAC
State/County
Royal! Avenue
2T
•
.0106 (b) for authorized
Private Partnership
1 e. Goldsboro
signing officials!)
■ Corporation
0 Other (specify):
LL.
Z 1 f.
Mailing
North
Address City
Carolina 1 g. 27533
Z
0 1h.
State
919-7315900
Zip Code
1i. 1j. shi!!(c�wcps.orc
QTelephone
V 2.
Project
Facsimile E-mail
(Facility) information:
J 2a.
Brogden
Primary School 2b. Wayne
G.
O. Q 3.
Brief
Contact
Project Name (permit will refer to this name) County Where Project is Located
Person:
Terry
Naranjo
Q3a.
Name
and Affiliation of Someone Who Can Answer Questions About this
Application
3b.
919-319-6716
3c. [e-mail]
Phone
Number E-mail
1.
Project
is
0 New
■ Modification (of an existing permit) If Modification, Permit No.:
2.
Owner
is
■ Public (skip to Item B(3)) 0 Private (go to Item 2(a))
2a.
If
applicant will be: 2b. If sold, facilities owned by a (must choose one)
0
•
■
private,
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))
■
•
Public Utility (Instruction C)
Homeowner Assoc./Developer (Instruction D)
3. City
of Goldsboro Z t A- r-i • Cm \--c-✓ S + - POD r `-`-' {-✓ 8 !o b a S 1 o y c Z7,`
Z Owner
/
of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project 9 7 0
0 4a. Goldsboro
Municipal WWTP 4b. t71-"00 2-3`14c
QName
of WWTF
WWTF Permit No.
M 5a. WCBOE,
County of Wayne
5b. 8"
0
Gravity
5c. Unknown
re Owner
0 6. The
of Downstream Sewer
origin of this wastewater is
Receiving Sewer Size
(check all that apply):
■
Force Main
Permit # of Downstream Sewer (Instruction E)
Z
100 % Domestic/Commercial
F,
■
■
Residential Subdivision
Apartments/Condominiums
•
•
Retail (Stores, shopping centers)
Institution
% Industrial (attach
2
W0School
a
■ Mobile Home Park
• Restaurant
• Office
■
■
■
■
Hospital
Church
Nursing Home
Other (specify): sP eci
description.)
(RO: contact your Regional Office
Pretreatment staff)
CO
% Other (specify):
7.
Volume of wastewater to be allocated or permitted for this particular project: 1402 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 12/07

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).
School addition with cafeteria and gym (already has a cafeteria onsite that will be converted to offices)
=12 GPD/Student — 10 GPD/Student = 2 GPD/Student * 701 Students = 1,402 GPD
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches) Length (feet) New Gravity or Additional
Force Main
6 210 Gravity
6
176.22 Gravity
psi3 VP
W11. Summary of Pump Stations w/ associated Force Mains to be Permitted (attach additional sheets as necessary)
z Pump Station Location ID
H
Z
0
U
Z
0
Design Flow
(MGD)
Operational Point
GPM @TDH
(self chosen - as shown on plans/map for reference)
Power Reliability Option
1 - permanent generator w/ATS;
2 - portable generator w/MTS
Force Main Size
Force Main Length
QPump Station Location ID (self chosen - as shown on plans/map for reference)
etet Design Flow Power Reliability Option
(MGD) Operational Point 1 - permanent generator w/ATS; Force Main Size Force Main Length
Q GPM @TDH LL 2 - portable generator w/MTS
Z
H
2
W Pump Station Location ID (self chosen - as shown on plans/map for reference)
d Design Flow Operational Point Power Reliability Option
(MGD) GPM @TDH 1 - permanent generator w/ATS; Force Main Size Force Main Length
2 - portable generator w/MTS
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 Fast Track Permitting of Pump Stations and Force
Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC Chapter 2T as
applicable?
® Yes ❑ 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

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? ❑ Yes ❑ No ® N/A
Sedimentation and Erosion Control Plan? ❑ Yes ❑ No ❑ N/A
❑ Yes ❑ No [I] N/A
Stormwater?
15. Does this project include any high priority lines, [see 15A NCAC 02T .0402 (2)] 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
C. CERTIFICATIONS
1. Owner/Permittee's Certification: (Signature of Signing Official and Project Name)
. attest that this application for Brogden Primary Schoo 1 has been reviewed by me
and i4 accurate and 'con'plete to the best of my knowledge. t understand that if all required its of this application are
not completed and that (k 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 143-215.6E any person who knowingly makes any false statement. representation, or certification in any
appli '.n shall be ; ty of a Class 2 misdemeanor. which may include a fine not to exceed $10,000 as well as civil
penal up . $25 00 p - olation.
Official Signatur
5-13--0 r
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 Project Name)
1, Steven J, Miller , attest that this application for Brogden Primary School 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 143-215.6B, 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.
2a. Steven J. Miller
Professional Engineer Name
2b. CLH Design, PA
Engineering Firm
2c. 400 Regency Forest Drive, Suite 120
Mailing Address
2d. Cary
City
2g. 919-319-6716 2h. 919-319-7516 2i. [e-mail]
Telephone Facsimile E-mail NC PE Seal, Signature & Date
.
2e. NC 2f. 27518 F ..Gi .•S •
State Zip '�,`4 j. M\\-',29
l
FTA 12/07

W A TF State of North Carolina
—190 Department of Environment and Natural Resources
7 Division of Water Quality
Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE —10/07)
Project Applicant Name: Wayne County Schools, Board of Education
Project Name for which flow is being requested: Brogden Primary School Addition
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
All flows are in MGD
c. WWTP facility's permitted flow 14.2
d. Estimated obligated flow not yet tributary to the WWTP 0.041
e. WWTP facility's actual avg. flow 6.79
f. Total flow for this specific request .001402
g. Total actual and obligated flows to the facility 6.8324
h. Percent of permitted flow used 48.1%
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
Brogden Primary School Pump
Station
Genoa Pump Station
0.432 MGD 0.030 MGD
0.400 MGD 0.180 MGD
III. Certification Statement:
I, Joseph Huffman , 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 II for which I am the responsible party. Signature of this form
indicates acc .tance of this wastewater flow.
r-2?--z:D
SOficialSg�t� Date

BROGDEN ELEMENTARY SCHOOL
DATE 2-3-09
PROJECT NO: 08-148
DRAWN BY RBT
USGS SGS TOUAPD MAP: SOUTHWEST GIX DSBORO, 1974
MAP
CLH DESIGN, PA
Regency Park
400 Regency Forest Drive
Suite 120
Cary, North Carolina 27518
Phone: [phone]
Fax: [phone]

City of Goldsboro
P.O. Drawer ..A.
North Carolina
27533 -9701
[phone]
May 28, 2009
MAY 2 9 2009
NC Dept. of Environment & Natural Resources
Division of Water Quality
943 Washington Square Mall
Washington, NC 27889
RE: City of Goldsboro Water Reclamation Facility
WWTP Facility Permit No.: NC0023949
Brogden Primary School Addition Sewer Extension
Permit Application
Dear Sir/Madam:
Please find enclosed the above -referenced Flow Tracking/Acceptance for Sewer
Extension Permit Application for Brogden Primary School Addition in Goldsboro, NC.
If additional information is required, please feel free to contact me at [phone].
erely,
Guy M. Anderson, P. E.
City Engineer
/jdm
Enclosure

DF�=F,4 State of North Carolina
PG Department of Environment and Natural Resources
Division of Water Quality
- t vw~� - Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE —10/07)
Project Applicant Name: Wayne County Schools, Board of Education
Project Name for which flow is being requested: Brogden Primary School Addition
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:
b. WWTP Facility Permit #:
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
.001402
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
rnqttr,,,ec,,,,g1Q415�,1;� .�32 , 030 ,k.G-fl
III. •:fication Stat=�.• -:
k - I, ' { e , , certify that, to the best of my knowledge, the addition of the
volum : , f wastewater to • - SI itted 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
establ. policies rocedures using the best available data. This certification applies to those items
listed ve in Sectir which I am the responsible party. Signature of this form indicates
ac
Sin Official Signature
w.
Vt.( 6 5
Date
2009

OF W A TFR State of North Carolina
O\ PG Department of Environment and Natural Resources
"'^ r Division of Water Quality
Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE —10/07)
Project Applicant Name: Wayne County Schools, Board of Education
Project Name for which flow is being requested: Brogden Primary School Addition
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:
b. WWTP Facility Permit #:
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
.001402
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
Genoa Pump Station
Approx. Capacity, MGD Approx. Current Avg.
(Firm/Design) Daily Flow, MGD
goo goo 4,40 /t qe y /op,
III. Certification Statement:
I, aliE A MANOZ , 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 II for which I am the responsible party. Signature of this form indicates
acceptance of its s a tewater flow.
vi wt. F ury sowiees ointty e'
gnature Date

i1E State of North Carolina
OG Department of Environment and Natural Resources
yr Division of Water Quality
-c Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE —10/07)
Project Applicant Name: Wayne County Schools, Board of Education
Project Name for which flow is being requested: Brogden Primary School Addition
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
All flows are in MGD
c. WWTP facility's permitted flow 14.2
d. Estimated obligated flow not yet tributary to the WWTP 0.041
e. WWTP facility's actual avg. flow 6.79
f. Total flow for this specific request .001402
g. Total actual and obligated flows to the facility 6.8324
h. Percent of permitted flow used 48.1%
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
Brogden Primary School Pump
Station
Genoa Pump Station
0.432 MGD 0.030 MGD
0.400 MGD 0.180 MGD
III. Certification Statement:
I, Joseph Huffman , 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 II for which I am the responsible party. Signature of this form
indicates acc- .tance of this wastewater flow.
Si{y%-g0'tcialSignature
J 2 L---eD�
Date