WQ0043889_Application (FTSE)_20221104

Wa
44.
Engineering
Landscape Architecture
Surveying
October 26, 2022
Mr. Trent Allen, Reg. Supervisor
NCDEQ— Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301-5095
Re: Town of Fairmont
Influent Pumping System Improvements
Fast -Track Sewer Application
Mr. Allen,
OCT 2 8 2022
OEO-FAYET T EVILLE REGIONAL.
Regarding the above referenced project, please find the following items:
1. One original & one copy of the Fast Track application and supporting documents
2. One check for the $480.00 application fee
The project involves the removal and replacement or rehabilitation of components of the
existing Brown Street Pump Station. This work at the Brown Street Station includes the
replacement of pump controls, electrical switchgear, and the generator and automatic transfer
switch; the rehabilitation of station piping and valves and concrete structures. The project also
includes the construction of an intermediate pump station along NC Hwy 130, the replacement
of five (5) air release valves along the existing force main, and the installation of two (2) new air
release valves along the existing force main.
This project will not serve any new customers and therefore shows zero new flow.
If you have any questions, please do not hesitate to contact me at [phone] or by email at
[e-mail].
Sincerely,
LKC Engineering, PLLC
Samuel E. Tracy, E.I.
/f.v
LKC Engineering, PLLC, 140 Aqua Shed Court,
Aberdeen, North Carolina 28315
PH: 910/420-1437 * FAX: [phone] * License No. P-1095

1
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 06-21 & SUPPORTING DOCUMENTATION
Application Number:
completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
I. Applicant's name: Town of Fairmont (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State/County ® Municipal
3. Signature authority's name: Jerome Chestnut per 15A NCAC 02T .0I 06(b)
Title: Town Manager
4. Applicant's mailing address: 421 South Main Street
City: Fairmont State: NC Zip: 28340-
5. Applicant's contact information:
Phone number: (910) 628-976 Email Address: jchestnutfairmontnc.gov
❑ Privately -Owned Public Utility
❑ Other
11. PROJECT INFORMATION:
1. Project name: Influent Pumping System Improvements to Serve Fairmont
2. ApplicationiProject status: ® Proposed (New Permit) ❑ Existing Permit/Project
Ifa 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: Robeson
4. Approximate Coordinates (Decimal Degrees): Latitude: 34.463503` Longitude:-79.041884-'
5. Parcel ID (if applicable): (or Parcel ID to closest downstream sewer)
111. CONSULTANT INFORMATION:
1. Professional Engineer: Mark Lacy. P.E. License Number: 036286
Firm: LKC Engineering, PLLC
Mailing address: 140 Aqua Shed Court
City: Aberdeen State: NC Zip: 28315-
Phone number: [phone] Email Address: Mark a,LKCengineering.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Fairmont Regional WWTP Permit Number: NC0086550
Owner Name: Town of Fairmont
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ
2. Downstream (Receiving) Sewer Information: 15-inch L Gravity Q Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s): Town of Fairmont
FORM: FTA 06-21
Page 1 of 6

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 ® NIA
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational ,Aireement (FORM: DEVI been attached?
❑ Yes ❑ No ®N'A
3. if the Applicant is a Home/Property Owners' Association, has an HOA POA Operational Agreement FORM. HOA) and
supplementary documentation as required by 15A NCAC 02T.0115(c) been attached?
❑Yes No ZNA
4. Origin of wastewater: (check all that apply):
® Residential (Individually Owned)
® Residential (Leased)
Z School preschool day care
® Food and drink facilities
® Businesses offices factories
® Retail (stores, centers, malls)
® Retail with food preparation service
Medical dental veterinary facilities
® Church
❑ Nursing Home
® Car Wash
❑ Hotel and/or Motels
❑ Swimming Pool, Clubhouse
❑ Swimming Pooffilter Backwash
❑ Other (Explain in Attachment)
5. Nature of wastewater : 100 °o Domestic °0 Commercial °o Industrial (See 15A NCAC 02T .0103(201)
If Industrial, is there a Pretreatment Program in effect? ❑ Yes❑ No
6. Has a flow reduction been approved under l5A NCAC 02T .01 141E)? ❑ Yes ® No
➢ If yes. provide a copy of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(0)
Daily Design Flow a,b
No. of Units
Flow
No new flow planned in this project
gal/
GPD
gal.'
GPD
gal;'
GPD
gal,
GPD
gal
GPD
Total
0.00 GPD
a See I5A NCAC 02T .O1 141b), ld►, te(e1(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 15A NCAC 02T.0 114] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: _ GPD (per 15A NCAC 02T .01 14)
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.
0 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 6

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewer*
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
> Section 1I & 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
V III. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations; Force Mainsl:
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: Intermediate Pump Station
2. Approximate Coordinates (Decimal Degrees): Latitude: 34.463503 Longitude: -79.041884
3. Total number of pumps at the pump station: 3
3. Design flow of the pump station: 0.77 million 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): 720 gallons per minute (GPM) at 105 feet total dynamic head (TDH)
1,020 gallons per minute (GPM) at 190 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
f any portion of the force main is less than 4-inches in diameter, please identify the me hod of solids reduction per
MDCPSFM Section 2.01C.1.b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with IS A N.C`AC 021� .03USth)(.1J:
® 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)(I)(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 6

> 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 4 of 6

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(0):
1. Does the project comply with all separations/alternatives found in 15A NCAC 02T 0305jfQR111?
15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems:
® Yes ❑ No
Setback Parameter*
Separation Requi red
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
➢ If noncompliance with 02T_0305(f) or (g), see Section X.l of this application
*15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(f) 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 S trf a Willer Classifications webpage
2. Does this project comply with the minimum separation requirements for water mains? ® Yes 0 No 0 NIA
D. 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 0 No 0 NIA
➢ Please provide supplementary information identifying the areas of non-conformance.
➢ See the Division's draft separation requirements 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? 0 Yes Basin name: ® No
Ifyes, does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .02009 0 Yes 0 No
➢ This includes Trout Buffered Streams per ISA NCAC 2E3,0202
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.lpermitting status in the cover letter if coverage/authorization is required.
6. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes 0 No
Per 152kNCAC 02T.0104c 61, 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 15 k 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 6

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains (latest version). and the Gravity Sewer Minimum Desi,ttn Criteria Platt versionj as applicable?
®Yes 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 proiects requiring a variance approval may be subject to longer
review times. For proiects requiring two or more variances or where the variance is determined b_y the Division to be a
significant portion of the project, the full technical review is required.
2. Professional Engineer's Certification:
1, Mark Lacy, attest that this application for Influent Pumping System Improvements to Serve Fairmont
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,
P2tlifijmuin Design Criteria for Gravit` Sewers jlatest versionl, and the Minimum Design Criteria for the Fast -Track Permitting
of Pomp Station$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 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 56.070i)
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 1SA NCAC 02T .0106(b):
\\\:I
NC A /1g/
r.• .•
Q. SEAL 1,'�'
• 1N...AC•A\
I, ,attest that this application for 1nfiuent Pumping system11 'lmprovements to Serve Fairmont
"11(Signature Authority Name from Application Item [.3 } (Project Name from Application Item 11 1)
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. 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.
/O• 1 t-•ZZ
NOTE - In accordance with General Statutes 143-215,GA 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.
Signature:
l/YY `C- C/bthVt4-t Date: / 17,a0/a'O0'oZ
FORM: FTA 06-21 Page 6 of 6

Divi
Water Resources
Application Number:
State of North Carolina
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 06-21 & SUPPORTING DOCUMENTATION
(4`b
be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Town of Fairmont (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual
❑ Corporation ❑ General Partnership
❑ Privately -Owned Public Utility
❑ Federal ❑ State/County /1 Municipal ❑ Other
3. Signature authority's name: Jerome Chestnut per 15A NCAC 02T .0106(b)
Title: Town Manager
4. Applicant's mailing address: 421 South Main Street
City: Fairmont State: NC Zip: 28340-
5. Applicant's contact information:
Phone number: (910) 628-976 Email Address: jchestnut(c�fairmontnc.gov
11. PROJECT INFORMATION:
1. Project name: Influent Pumping System Improvements to Serve Fairmont
2. Application Project status:
►�I
Proposed (New Permit) El Existing Permit/Project
Ifa 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: Robeson
4. Approximate Coordinates (Decimal Degrees): Latitude: 34.463503 Longitude: -79.041884
5. Parcel ID (if applicable): (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Mark Lacy, P.E. License Number: 036286
Firm: LKC Engineering, PLLC
Mailing address: 140 Aqua Shed Court
City: Aberdeen State: NC Zip: 28315-
LKC ENGINEERING, PLLC
PO Box 888
Aberdeen, NC 28315
[phone]
PAY TO THE
ORDER OF d
�zu( L-,nA red.
(4-.1 Fidelity
, RIG YOU
'Z
FOR ir-`..l a
cal �/t cc-)
DATE 1 ' � Co " `DQ
EZ9HIFLU•,
66-358/531
$ LSD.
DOLLARS