HomeMy WebLinkAboutWQ0043752_Application (FTSE)_20220823NC Dept of Environmental Quality
DWR
Division of Water Resources
ABS 2 u 2D22
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Raleigh RegikACK SEWER SYSTEM EXTENSION APPLICATION
FTA 06-21 & SUPPORTING DOCUMENTATION
Application Number: idQD 645 732fto be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: City of Henderson (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/Count ® Municipal ❑ Other
3. Signature authority's name: 10.� per 15A NCAC 02T .0106(b1
Title: LaN1 Nkhct
4. Applicant's mailing address: 1, ' s kte_
City: Henderson State: NC Zip: 215`
5. Applicant's contact information:
Phone number: [ , 'aa45 /0 Email Address: .,.ritON,a CnCrr t\e•rttce rCee* • t1C • 1.•11V
II. PROJECT INFORMATION:
1. Project name: Bearpond Commons
2. Application/Project status: ® Proposed (New Permit)
❑ 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: Vance
4. Approximate Coordinates (Decimal Degrees): Latitude: 36.27513 ' Longitude: -78.35912
5. Parcel ID (if applicable): 045305005A (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
I. Professional Engineer: Mike Schneider License Number: 030856
Firm: Piedmont Land Design. LLP
Mailing address: 8522-204 Six Forks Rd
City: Raleign State: NV Zip: 27616-
Phone number: (919) 845-7600 Email Address: MikeSQPiedmontlanddesign.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
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1. Facility Name: %•.4Th Permit Number: N L v 0 Z� o s'
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Owner Name: G'T.1 ai $'.AIPaaSort
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ DODO
2. Downstream (Receiving) Sewer Information: inch
L] Gravity I5Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s):
FORM: FTA 06-21
Page 1 of 5
NC Dept of Environmental Quality
VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Publ`' venience and Necessity been attached?
�oanpetph Regional Office
❑ Yes ❑ No ® N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEY) been attached?
El Yes El No ®N..A
3. If the Applicant is a Home/Property Owners' Association, has an E ]0.iPOA Operational Agreement (FORM: HOA) and
supplementary documentation as required by 15A NCAC 02T.0115(c) been attached?
❑ Yes ❑No ®N.A
4. Origin of wastewater: (check all that apply):
❑ Residential (Individually Owned)
❑ Residential (Leased)
❑ School ! preschool r day care
❑ Food and drinlc facilities
❑ Businesses i offices ? factories
® Retail (stores, centers, malls)
❑ Retail with food preparation/service
❑ Medical 1 dental veterinary facilities
❑ Church
❑ Nursing Home
❑ Car Wash
❑ Hotel and/or Motels
❑ Swimming Pool/Clubhouse
❑ Swimming Pool/Filter Backwash
❑ Other (Explain in Attachment)
5. Nature of wastewater : "o Domestic 100 0o Commercial °lo Industrial (See 15A NCA(' 02T .Q1P3 (
If Industrial, is there a Pretreatment Program in effect? ❑ Yes0 No
6. Has a flow reduction been approved under 15A NCAC 02T .01 14(f)? ❑ Yes G No
D If ves. provide a copy of flow reduction approval letter with this application
7. Summarize wastewater generated by projec :
Establishment Type (see 02T.0114(f))
Daily Design Flow'')
No. of Units
Flow
General business and office
1880 gal/day
/ he, GPD
gat
GPD
gal/
GPD
gal/
GPD
gall
GPD
gall
GPD
Total
! fit) GPD
a See , A NKAC 02T .01140). (cl), lel( ] ] and (ei; 21 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 G.S. 42A 4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table I5A NCAC 02T.0114] shall
be determined using available flow data, water using fixtures, occupancy or operation pattems, and other measured data.
8. Wastewater generated by project: 1880 GPD (per 15A_NCAC 02T .0110
D Do not include future flows or previously permitted allocations
If permitted flow is zero, please indicate why:
❑ Pump Station/Force Main or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line.
Please provide supplementary information 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
VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 021 .0305 & MDC (Gravity Sewers):
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1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
181
PVC
➢ Section 11 & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III 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 (Pump Stations/Force Mains):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: ▪ Longitude: - . _
3. Total number of pumps at the pump station:
3. Design flow of the pump station: 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): gallons per minute (GPM) at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
If any portion of the force main is Tess 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 NCAC 02T .0305(h)(1):
❑ Standby power source or ❑ Standby pump
➢ Must have automatic activation and telemetry - 15A NCAC 02T.0305(h)(1)(B)_
➢ 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 15A 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.
FORM: FTA 06-21 Page 3 of 5
➢ 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.
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nmentai Quality
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FORM: FTA 06-21 Page 4 of 5
IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(0):
1. Does the project comply with all separations/alternatives found in 15A NCAC 02T .05(f} Ate1$hRcgicgt
ilt0
15A NCAC 02T.0305(f1 contains minimum separations that shall be vrovided for sewer systems:
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
18 inches
2Water mains (vertical - water over sewer preferred, including in benched trenches)
18 inches
2Water mains (horizontal)
10 feet
Reclaimed water lines (vertical - reclaimed over sewer)
18 inches
Reclaimed water lines (horizontal - reclaimed over sewer)
2 feet
**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.
100 feet
**Waters classified WS (except WS-1 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)
50 feet
**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.
10 feet
Any building foundation (horizontal)
5 feet
Any basement (horizontal)
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade (vertical)
36 inches
am., Dept ofEnvironniental Quality
AUG 23207?
No
➢ if noncompliance with 02T.0305ff1 or ig , see Section X.1 of this application
*,15A NCAC 02T.0305(gj contains alternatives where separations in 02T.0305(fl cannot be achieved. Please check "yes"
above if these altematives are used and provide narrative information to explain.
**Stream classifications can be identified using the Division's NC Surface Water Classifications webpagc
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(f) 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? ❑ Yes ❑ No ® N. A
➢ Please provide supplementary information identifying the areas of non-conformance.
➢ See the Division's draft separation rcquiremcnL for situations where separation cannot be met.
➢ No variance is required if the 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: _ ® No
If yes, does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑ Yes ❑ No
➢ This includes Trout Buffered Streams per 15A NCAC 2B.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 numberipermitting status in the cover letter if coverage. authorization is required.
6. Does project comply with 15A NCAC 02T_01051.) (additional permits.'certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0105(c)(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?" ❑ Yes ® No
Per 15A 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.
➢ If 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 5 of 5
NC Dept of Environmental Quality
X. CERTIFICATIONS:
1. Does the submitted system comply with I A i1CAC 02T. the Minimum Dasign Criteria for
and force Mains [latest version), and the Gravity Sewer Rini Irwin Design Criteria (lat t version
®Yes El No
If no, for projects requiring a single variance, complete and submit the Variance/Alternative Design Request application
(VADC 10-14) and supporting documents for review to the Central Office. Approval of the request will be issued
concurrently with the approval of the permit, and nroiects reauiring a variance annroval may be subiect to longer
review times. For proiects reauiring two or more variances or where the variance is determined by the Division to be
a significant portion of the nroiect. the foil technical review is required.
2. Professional Engineer's Certification:
I, Mlle; , attest that this application for
(Professional Engineer's name from Application Item 111.1.)
AIM 2 L 7l*
01.0 C-e►m�tc� J
f l'urnkSatitans
anioe
(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. I further
attest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable regulations,
Minimum Desirpn Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track
Permitting of Pump Stations and Force Mains (latest version). 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 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 lie,W111 1 NCAC 56.0701)
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North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
—
I, E 1'st pC, pry , attest that this application for
(Signature Authority Name from Application Item 1.3.)
030856
7/1
eaR e-A,n e602n1 a+u S
(Project Name from Application Item ll.l)
attest that this application 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 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. I will make no claim against the
Division of Water Resources should a condition of this permit be violated. I 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 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 s well as civil penalties up to $25,000 per violation.
Signature:
FORM: FTA 06-21
1,
Date;
Page 6 of 5
Division of ktatr r Resotiri eat
NC Dept of Environmental Quality State of North Carolina
• Department of Environmental Quality
AUr, 2.' 2677 Division of Water Resources
Flow Tracking for Sewer Extension Applications
Raleigh Rcgfonai p face (FTSE 10-18)
Entity Requesting Allocation: G /i i or Netir �sdA-)
Project Name for which flow is being requested: Bearpond Commons
More than one FTSE 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: Henderson Water Reclamation Facility
b. WWTP Facility Permit #: NC0020559
All flows are in MGD
c. WWTP facility's permitted flow 4.14
d. Estimated obligated flow not yet tributary to the WWTP .5900
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
2.011
.00188
2.60
48.5%
11. 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:
(A) (B) (C) (D)=(B+C) (E)=(A-D)
Design
Average Obligated, Total
Pump Daily Approx. Not Yet Current
Pump Station Station Firm Flow** Current Tributary Flow Plus
(Name or Permit Capacity, * (Firm; pi), Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow, MGD MGD Flow Capacity***
HV2
MartinsCreek
Sandycreek
1.17MGD 0.47MGD .167MGD 0 .167 .30
3.16MGD 7.9MGD .554MGD 0 .555 7.35
* The Firm Capacity (design flow) of any pump station is defined as the maximum pumped flow
that can be achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor
(pf) not less than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer):
Downstream Permit Number:
Page 1 of 6
FTSE 10-18
III. Certification Statement: —�/
K4101/\ certify to the best of my knowledge that 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, given the implementation of the planned improvements
identified in the planning assessment where applicable. 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 1I plus all attached planning assessment addendums for which I
am the responsible party. Signature of this form certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
Signing Official Signature
Title of Signing pjficial
Page 2 of 6
8hobdo a�
Date
NC
'Pro14
FTSE 10-18
Qua"
N
c Dot of ttiv'T'v4
pub 71127
itae1tpReo
coaaace
Bearpond Commons is a proposed commercial office / flex space building located
in Vance County, North Carolina. The project consists of one building with 12
proposed units & will have an estimated total sewer flow of 1,880 gpd. The
requested permit is for 8" gravity sewer.
Bearpond Commons
Project Narrative / Cover Letter
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PLD
Piedmont Land Design, LLP
8522-204 Six Forks Road • Raleigh, RC 27615 • (919) 845-7600 • Fax: (919) 845-7703
TRANSMITTAL
DATE August 17, 2022
TO NCDEQ-DWR
3800 Barrett Drive
Raleigh NC 27609
ATTENTION Raleigh Regional Office
REFERENCE Bearpond Commons — sewer permit
application
COPIES DESCRIPTION
1
1
1
1
1
2
1
FTA Instructions
$480.00 check
Cover letter
USGS Topo map
Site map
FTA Applications (1 original, 1 copy)
Flow Tracking for Sewer Ext. App
(FTSE10-18)
COMMENTS
Please let us kno►v if you have any questions. Thanks you for your help.
Atbem
4/4114,402012
All/ p
FAX NO.
PAGES
FOR YOUR REVIEW
❑x FOR YOUR COMMENT
O FOR YOUR APPROVAL
❑ FOR YOUR USE
FROM Mike Schneider
COPY
JOB CODE AHVIP
Civil Engineers • Landscape Architects • Land Planners
coo
ACCENT
[IMAGING Date: s-! a3 , 2O3
Tied rnoPI+ Land De5+'5r►, LLP
Address: 5521.- ao4 Six Forks -Road
City: "Rai ; State: r'L L Zip: Al 6 I S
Contacts 1.t1nrf'ZK C )ri5i- aa1J Phone: (' tq ) 34S-'i�ao
Shipper:
Delivery
Manifest
IBm Shipper 0 Collect From consignee
NCDE - D o
Address: 38•cn. darrc-ff Dr.
City: Ra 1,4.i q State: NC, Zip: 7 (0 d,
Contact:fit ,ii k ; i Phone: ( ) -
Consignee::.=:
Number of
• Packages
(3 included in price)
Summary
Delivery Zone Charge
Additional Packages (Over 3) X $1.00
Cargo Van Charge X $10.00
Re -Delivery Charge X $7.50
:Total Charge
PickUp`Sid attires-
Shipper
Pick Up Driver
164
Time Picked Up Q `
To
Zone.
i
'pelivery.Slgnatures .
Consignee
Delivery Driver
Time Delivered
919/782-3332 Fax: 919/534-0455
8121 Brownleigh Drive Raleigh, NC 27617
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