WQ0032533_Application (FTSE)_20090918

City of coCdsboro
P.O. Drawer _A
North Carolina
27533-9701
September 18, 2009
[phone]
SEP 2 1 2009
NCDENR
Washington Regional. Office
943 Washington Square Mall
Washington, NC 27889
RE: Wayne Memorial Drive Water & Sewer Extension Project
Fast -Track. Application Modification for Permit # WQ0032533
Dear Sir/Madam
I am enclosing the following items concerning the referenced project:
• One original and one copy of the completed Fast -Track Application for Gravity
Sewers, Pump Stations, and Force Mains (1,1 A 12/07 ver5);
• One original and one copy of the Flow Tracking/Acceptance for Sewer Extension
Permit Application (FTSE-10/07);
• One original of the USGS Topographic Map identifying the entire project area and
closest surface waters. Map also shows the location of the • downstream connection
point;
City of Goldsboro Check No. 91334 in the amount of $480.00 for the application
fee.
Your review and approval of this project is respectfully requested. If you have any
questions, please contact me at [phone].
Sincerely,
Guy M. Anderson, P. E.
City Engineer.
/jdm
Enclosures

o014 rFq 1=, — 7 . ; ..� • 4
State of North Carolina
Q - ` Department of Environment and Natural Resources
�i r Division of Water Quality
- SEP 2 1 2009 FAST -TRACK APPLICATION
(F1 A 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 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/peres✓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-contiquous 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.
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.
® E.
FT'A 12J07

❑ 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(1 b). 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, Alieghany, 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/Colleciion%20Systems/CollectionSystemsHome.html
or contact the Regional Office serving your county.
FTA12/07

USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number:
(to be completed by DWQ)
1. Owner/Permittee:
la. City of Goldsboro
Full Legal Name (company, municipality, HOA, utility, etc.)
Z lb. Joseph R. Huffman, City Manager
Signing Official Name and
Q lc. The legal entity who will
Z • Individual ■ Federal
0 1 d. P.O. Drawer A
Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials!)
own this system is:
it Municipality ■ State/County ■ Private Partnership ■ Corporation
le. Goldsboro
■
Other (specify):
L.L. Mailing Address City
Z '1f. NC 1g. 27533-9701
Z State Zip Code
0 1 h. [phone] 1 i. [phone] 1j. [e-mail]
Q• Telephone Facsimile E-mail
U '2. Project (Facility) Information:
J 2a. Wayne Memorial Drive Water & Sewer Extension 2b. Wayne
0- Brief Project Name (permit will refer to this name) County Where Project is Located
0' 3. Contact Person:
Guy M. Anderson, P.E., City Engineer
Q'3a.
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b. [phone] ,3c. [e-mail]
Phone Number E-mail
1. Project is
■ New
►5 Modification (of an existing permit) If Modification, Permit No.: WQ0032533 (Length Increased)
2. Owner is ►i1 Public (skip to Item B(3)) ■ Private (go to Item 2(a))
be: 2b. If sold, facilities owned by a (must choose one)
2a.
If private, applicant will
■ 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(26))
• Public Utility (Instruction C)
• Homeowner Assoc./Developer (Instruction D)
3. City of Goldsboro
Z Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
0 4a. Goldsboro Wastewater Treatment Plant 4b. NC0023949
Name of WTF WTF Permit No.
Q WW
2 :5a. City of Goldsboro
5b. 18°
►5
Gravity
5c. WQ0031218
Ce ' Owner of Downstream Sewer
Receiving Sewer Size
•
Force Main
Permit # of Downstream Sewer (Instruction E)
° 6. The origin of this wastewater is (check alfthat apply):
Z ,
100 % Domestic/Commercial
F—
►�1 Residential Subdivision
►aa Apartments/Condominiums
■
■
Retail (Stores, shopping centers)
Institution
% Industrial (attach
E ,
fx ,
lJ.l '
a
• Mobile Home Park
• School
• Restaurant
►�� Office
•
■
■
•
Hospital
Church
Nursing Home
Other (specify):
description.)
(RO: contact your Regional Office
Pretreatment staff)
% Other (specify):
m
7.
Volume of wastewater to be allocated
or permitted for this particular project:
0 gallons per day
8.
*Do not include future flows or previously permitted allocations
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
a Flow has already been allocated in Permit No. WQ0032041
• 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

W
Z
Z
0
Z
0
H
ce
0
LL
Z
H
2
ce
0
m
;9. Provide the wastewater flow calculations used
the value in Item B(7) AND/OR the design flow
in determining the permitted flow in accordance with 15A NCAC 2T .0114 for
for line or pump station sizing if a reduced or zero flow is being requested in
2T .0114 (b) and (c) must be supported with actual water or wastewater use
(f).
Design Flow = 917,706 GPD
Where 15' Pipe Flowing Half Full
S = 0.20%
N = 0.013
(attach additional sheets if necessary)
Length (feet) New Gravity or Additional
Force Main
, •
i 2,078 '--7 . � i Gravity
Item B(7). Values other than that in 15A NCAC
data in accordance with 15A NCAC 2T .0114
10. Summary of Sewer Lines to be Permitted
Size (inches)
15
-- - --- ---- --
Force Mains to be Permitted (attach additional sheets as necessary)
(self chosen - as shown on plans/map for reference)
'11. Summary of Pump Stations
!Pump Station Location ID
Design Flow
(MGD) i
w/ associated
Power Reliability Option
Operational Point
1 - permanent generator w/ATS; Force Main Size Force Main Length
GPM © TDH
2 - portable generator w/MTS
T
(self chosen - as shown on plans/map for reference)
PPump Station Location ID
Design Flow Power Reliability Option
Operational Point;
(MGD) GPM ©TDH , 1 - permanent generator w/ATS; Force Main Size Force Main Length
; 2 - portable generator w/MTS
— —
(Pump Station Location ID (self chosen - as shown on plans/map for reference)
Design Flow
(MGD)
Operational Points
GPM @TDH
Power Reliability Option
1 - permanent generator w/ATS; Force Main Size Force Main Length
2 - portable generator w/MTS '
in the proposed sewer
number of 2nd treatment
contact the Central
lines or pump stations be able to be directed to another treatment facility?
facility
12. Will the wastewater flow
■ Yes No If Yes, permit
(RO — if "yes" to B,12 please
Office PERCS Unit)
13. Does the sewer system
Mains (latest version), the
applicable?
comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force
Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC Chapter 2T as
please reference the pertinent minimum design criteria or regulation and indicate why a
is requested. SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS
TO THE VARIANCE WITH YOUR APPLICATION
►i1 Yes ■ No If No,
variance
PERTINENT
FTA12.107

'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 ® N/A
Sedimentation and Erosion Control Plan? ® Yes ❑ No ❑ N/A
Stormwater? ❑ Yes ❑ No ® N/A
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
'1a.
Owner/Permittee's Certification: (Signature of Signing Official and Project Name)
I Joseph R. Huffman , attest that this application for Wayne Memorial Drive Water & Sewer Extension
has been reviewed by me and is accurate and complete to the best of my knowledge. I 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 retumed 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.
o9'
Date
!ENGINEERING DESIGN DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL OF THIS
APPLICATION. THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR PROXIMITY
co TO OTHER UTILITIES, DESIGN CALCULATIONS. ETC, REFER TO 15A NCAC 02T .0305
Z'
O
p 2. Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
V 1, Guy M. Anderson, P.E., attest that this application for Wayne Memorial Drive Water & Sewer Extension has been
LL 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
ce proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer Minimum Design Criteria
W . 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
V 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.
_
�a. Guy M. Anderson, P.E.
Professional Engineer Name
2b. City of Goldsboro
Engineering Firm
2c. P.O. Drawer A
Mailing Address
2d. Goldsboro 12e. NC 2f. 27533-9701
I City 1 State Zip
2g. [phone] 2h. [phone] 2i. [e-mail] 1
1 Telephone Facsimile E-mail
�ttM�fad/;/j 439
s,‘ttN CARD' r.
S Si
/y VG I NEB QT-
��i- ANt E
NC PE Seal, Signature & Date
FTA12/07

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
Flow Tracking/Acceptance for Sewer Extension Permit Applications
(1,1 SE —10/07)
Project Applicant Name: Wayne Memorial Drive Water & Sewer Extension
Project Name for which flow is being requested: Wayne Memorial Drive Water & Sewer Extension
More than one 1~ SE-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
b. WWTP Facility Permit #: NC0023949
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
0.041
6.79
0
6.831
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
Westbrook Pump Station 18 MGD 6.79 MGD
SEP 2 1 20C9
III. Certification Statement:
I, Joseph R 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 acceptance of
this wastewat flow.
Olcidl Signat� Date

The data represented on this map has been compiled by the best
methods available. Accuracy is contingent upon the source information
as compiled by venous agencies and departments both internal and
external to the City of Goldsboro, NC. Users of the data represented on
This map are hereby notified that the primary information sources should
be consulted for verification of the information contained herein. The City
Of Goldsboro and the companies contracted to develop these data assurne
no legal responsibilities for the information or accuracy contained on this
map. It is strictly forbidden to sell or reproduce these maps or data for any
reason without the written consent of the City of Goldsboro.
SEP 2 1 20G
NORTHWEST GOLDSBORO
USGS ENTITY ID MPTNC1093PP01
1 inch = 400 feet
11