HomeMy WebLinkAboutWQ0043874_Application (FTSE)_20220930DWR
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 Numberl q Q hT (ro be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
Applicant's name: Community Christian School (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership ['Privately -Owned Public Utility
❑ Federal ❑ State/County ❑ Municipal
3. Signature authority's name: Robert S. Bartlett per 15A NCAC 02T.0I06tb1
Title: Board Member
4. Applicant's mailing address: 1906 Nash St. N.
City: Wilson State: NC Zip: 27893-
5. Applicant's contact information:
Phone number: (252) 399-0704 Email Address: robert@bartletteng.com
❑ Other
NC Dept of Environmental Quaiit�
')EP 3 i 2022
Raleigh Regional Office
I1. PROJECT INFORMATION:
I. Project name: Community Christian School-2022 Additions
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: Wilson
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.784.• Longitude: -77.968 `
5. Parcel ID (if applicable): 3704-51-9610 (or Parcel ID to closest downstream sewer)
111. CONSULTANT INFORMATION:
I. Professional Engineer: Robert S. Bartlett, PE License Number: 20106
Firm: Bartlett Engineering & Surveying, PC
Mailing address: 1906 Nash St. N.
City: Wilson State: NC Zip: 27893-
Phone number: (252) 399-0704 Email Address: robera,bartletteng.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
I. Facility Name: Hominy Creek Water Reclamation Facility Permit Number: NC0023906
Owner Name: City of Wilson
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
I. Permit Number(s): WQ004 1572
2. Downstream (Receiving) Sewer Information: 8 inch
® Gravity T. Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s): _
FORM: FTA 06-21
Page 1 of 5
VI. GENERAL REQUIREMENTS
I. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑ No ® N.'A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational A, ,reement ( FORM: DEV) been attached?
El Yes El No ®N..A
3. If the Applicant is a Home/'Property Owners' Association, has an HOAIPOA Operational Agreement (FORM: HOA) and
supplementary documentation as required by 1 5A NCAC 02T.01 15(c) been attached?
El Yes ❑No ®N'A
4. Origin of wastewater: (check all that apply):
❑ Residential (Individually Owned)
❑ Residential (Leased)
® School/ preschool .. day care
❑ Food and drink facilities
❑ Businesses offices f factories
❑ Retail (stores, centers, malls)
❑ Retail with food preparation:'service
❑ Medical dental ' veterinary facilities
❑ Church
❑ Nursing Horne
❑ Car Wash
❑ Hotel and:'or Motels
❑ Swimming Pool/Clubhouse
❑ Swimming Pool/Filter Backwash
❑ Other (Explain in Attachment)
5. Nature of wastewater : % Domestic 100 % Commercial °ro Industrial (See 15A NCAC 02T _0103(20))
If Industrial, is there a Pretreatment Program in effect? ❑ Yes El No
6. Has a flow reduction been approved under 15A NCAC 02T ,01 14(f)? ❑ 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(f))
Daily Design Flow 0
No. of Units
Flow
Gymnasium (17,000 S.F.)
50 gal/I00 S.F.
NIA
8,550 GPD
(6) Classroom (±15 Students ea.)
10 gal/Student
N/A
900 GPD
gall
GPD
gal/
GPD
gall
GPD
gal/
GPD
Total
9,450 GPD
a See I5A NCAC 02T .01 14Lbj, LdJ, Le)( I) and(e)(2) 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.0I 14] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project 9,450 GPD (per 15A NCAC 02T .0114)
Do not include future flows or previously pennitted 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 tirneframe for permitting upstream sewers with flow.
['Flow has already been allocated in Pennit 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) • 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
710
PVC
➢ Section II & 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
Vlll. 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 puinp out of service.
4. Operational point(s) per pump(s): gallons per minute (GPM) at
5. Summarize the force main to be permitted (for this Pump Station):
feet total dynamic head (TDH)
Size (inches)
Length (feet)
Material
If any portion of the force main is less than 4-inches in diameter, please identify the me hod of solids reduction per
MDCPSFM Section 2.01 C.I.b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with I SA NCAC 02T .03050h111
❑ Standby power source or ❑ Standby pump
➢ Must have automatic activation and telemetry - 15A NCAC 02T.0305(h)(I)(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 I5A 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.
➢ if the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided
as part of this permit application in the case of a multiple station power outage.
FORM: FTA 06-21 Page 3 of 5
IX. SETBACKS & SEPARATIONS .. (02B .0200 & 15A NCAC 02T .0305(f)):
I. Does the project comply with all separations/alternatives found in 15A NCAC 02T .0305(0 & (g)?
15A NCAC 02T.0305(f) contains minimum separations that slrall be provided for sewer systerns•
® Yes ❑ No
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
18 inches
'Water mains (vertical - water over sewer preferred, including in benched trenches)
18 inches
'Water mains (horizontal)
10 feet
Reclaimed water lines (vertical - reclaired 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 11 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
➢ 1f noncompliance with 02T.Q30jQ orb, see Section X.1 of this application
*I5A NCAC 02T.030S(g) contains alternatives where separations in 02T_0305(1) cannot be achieved. Please check "yes"
above if these alternatives are used and provide narrative information to explain.
**Stream classifications can be identified using the Division's NC Surface Water Classifications webnage
2. Does this project comply with the minimum separation requirements for water mains? ® Yes ❑ No ❑ NIA
> 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 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? ® Yes Basin name: Neuse ❑ 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 I5A NCAC 2B.0202
5. Does the project require coverage?authorization under a 404 Nationwide.'individual permits ❑ Yes ® No
or 401 Water Quality Certifications?
D Please provide the permit number'permitting status in the cover letter if coverage:authorization is required.
6. Does project comply with I5A NCAC 02T.0105(c146) (additional permits'certifications)? ® Yes ❑ No
Per I5A NCAC 02T.0105(cX6), 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, storrnwater 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 strearnbanks 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 I5A NCAC 02T.0403(a)(5) or the permittee's individual System -Wide Collection permit.
FORM: FTA 06-21 Page 4 of 5
X. CERTIFICATIONS:
Does the submitted system comply r►ith 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stationk
and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteria (latest version) 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 projects requiring a variance approval may be subject to longer
review times. For projects requiring two or more variances or where the variance is determined by the Division to be a
significant portion of the project, the full technical review is required.
2. Professional Engineer's Certification:
1, _Robert S. Bartlett, PE, attest that this application for Community Christian School-2022 Additions
(Professional Engineer's name from Application Item III 1) (Project Name from Application Item II I)
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 Design Criteria for Gravity S,S wers,Llatest 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
statement, representation, or certification in any application
include a fine not to exceed $10,000, as well as civil penalties
information, including failure to disclose any design non-com
the North Carolina -licensed Professional Engineer to referral
and I43-215.6B, any person who knowingly makes any false
package shall be guilty of a Class 2 misdemeanor, which may
up to $25,000 per violation. Misrepresentation of the application
pliance with the applicable Rules and design criteria, may subject
to the licensing board. (21 NCAC 56.0701)
North Carolina Professional Engineer's seal, signature, and date
3. Applicant's Certification per 15A NCAC 02T .0106(b):
CA
9l•
SEAL = �ti
20106 CW'r
;6i; Z\Z:NGfNE�;� V�,
Morrinii it it 00
I, Robert S. Bartlett, Board Member, attest that this application for Community Christian School-2022 Additions
(Signature Authority Name from Application Item 1.3.) (Project !flame 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.
1 understand that if all required parts of this application are not completed and that if all required supporting documentation
and attachments are not included, this application package is subject to being returned as incomplete. 1 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.
NOTE In accordance with General Statutes I43-215.6A 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 fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature:
Date: {/1011-
FORM: FTA 06-21
Page 5 of 5
R
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Community Christian School
Project Name for which flow is being requested: Community Christian School 2022 Addt'
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for al! 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: Hominey Creek Water Reclamation Facility
b. WWTP Facility Permit #: NC0023906
All flows are in MGD
c. WWTP facility's permitted flow 14.00
d. Estimated obligated flow not yet tributary to the WWTP 0.399
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
9.700
0.00945
10.11
72.20
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:
(A) (B) (C) (D)=(B+C) (E)=(A-D)
Design
Average Approx. Obligated, Total
Pump Daily Current Not Yet Current
Pump Station Station Firm Flow** Avg. Daily Tributary Flow Plus
(Name or Permit Capacity, * (Firm ! pf), Flow, Daily Flow, Obligated Available
Number) No. MGD MGD MGD MGD Flow Capacity***
Windemere 17071 0.288 0.115 0.0610 0.00945 .07045 0.04455
Longview 40018 _ 10.896 4.359 2.52 0.10945 2.62945 1.72955
Stantonsburg 41431 16.128 6.451 2.76 0.10945 2.86945 3.58155
* 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): City of Wilson
Downstream Permit Number: WQCS00021
Page 1 of 6
FTSE 10-18
111. Certification Statement:
I Kyle F. Manning, PE 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 II 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
0:cec eQmob\,436tNt.s w.t. v
Title of Signing Official
a19V2
Date
Page 2 of 6
FTSE 10-18
ENGINEERING REPORT
PRIVATE SEWER SYSTEM EXTENSION
COMMUNITY CHRISTIAN SCHOOL-2022 ADDITIONS
CITY OF WILSON, NORTH CAROLINA
SEPTEMBER 27, 2022
Wastewater Treatment Facility
Hominy Creek Water Reclamation Facility
NPDES Permit No. NC0023906
Applicant/Owner Name & Address
Community Christian School
1906 Nash St. N.
Wilson, North Carolina 27893
Project Name & Location
Community Christian School-2022 Additions
5160 Packhouse Road
Wilson, North Carolina
Project Summary
The project is for additions to an existing school facility. The proposed additions consist of a
17,100 S.F. Gymnasium & a 5,739 S.F. Classroom Building and is approximately ±0.11 miles west
of Hunting Ridge Road SW. The site will include the installation of 8" Private gravity sewer
mains that will serve the proposed gymnasium & 6" PVC services serving the proposed
gymnasium & classroom.
Project to include approximately 710 linear feet of 8-inch diameter PVC private gravity sewer
line, three (3) standard manholes, and other necessary appurtenances. This sewer system will
connect to the existing 8-inch gravity sanitary sewer main that branches out from the sewer
main along the rear of the property.
-1.
P \_Pk0J1?CT FILI:S\CC.S12022 ADDITIONS\Permits"Sewerl2I -204 Engineering Report doc
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Mapped, edited, and published by the Geological Survey
A••••
p Control by USGS, NOS/NOAA, and North Carolina Geodetic Survey
N. 0� Topography by photogrammetric methods from aerial
photographs taken 1974. Field checked 1974
Projection and 10,000-foot grid ticks: North Carolina coordinate
system (Lambert conformal conic)
1000 meter Universal Transverse Mercator grid ticks.
zone 18, shown in blue. 1927 North American datum
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Wilson County Parcel Report
PIN: 3704-51-9610.000
Parcel Number: 3704519610,000
Current Owner ID: 69943441
Owner & Address: COMMUNITY CHRISTIAN SCHOOL
5160 PACKHOUSE RD
Date Sold:
Deed Reference: 1800 - 17
Deed Year: 2001
Plat Reference: 29 - 236
Deed Acres 28.26
Actual Year Built: 2000
Effective Year Built: 2000
Main improvement
Finished Area: 32630
Tax Year: 2022
Assessed Current $258,687
Land Value:
Assessed Current
Improvement Value: $4,949,565
Total Assessed
55,208,252
Current Value:
Current Land Use N
Yes or No:
Current Land Use Value: $258,687
Current Land $258,687
Fair Market Value:
Current Improvement
Fair Market Value: $4,949,565
Current Total 85 208 252
Fair Market Value:
Grantor:
Previous ParcelNumber:
Previous Deed Reference:
Plat Book/Page:
5160 PACKHOUSE RD NW
Legal Description: 28.26AC
01 COMB 3704514599 & 3704
Sales Amount: $0
Sales Instrument:
Sales Instrument Description:
Sales Disqualifaction Code:
Sales Disqualifaction Code Description:
Date Sold:
Vacant Improved Code:
Land Current Usage Code:
Land Rate: AC - ACRES
Fair Market Value 7200
Land Rate Code:
Parcel Description Code 1: 72 - SCHOOL,COLLEGE-PRIVATE
Parcel Description Code 2: 04 - BUSINESS
Multiple Land Segments:
GIS Calculated Acres
28.16
of Selected Polygon:
Quantity: 8
Road Frontage:
Current Use Code Main Improvement:
Main Improvement Decription Code: 7204 - 889
Main Improvement Description: BUSINESS - SCHOOL -COLLEGE PRIVATE
Construction Quality Grade Decription Code: B-10 - B-10 GRADE
Depreciation Table: C60
Number of Bedrooms:
Number of Full Bathrooms:
Number of Half Bathrooms:
HVAC:
Fireplace Yes or No:
Basement Yes or No:
Attached Garage Yes or No:
Percent of Construction Complete:
Number of Improvements:
Neighborhood Code:
City:
Tax District:
Township:
Area:
Vicinity Map
•
0
Orthophotoraphy Map
FORCED AIR HEAT W/ AC - 32630 SF
N-
N-
N-
100°%
001
8381 - WILSON_NORTHWEST_A-1
WLSN - WILSON
31 - CICIWI-WILSON
6-TAYLORS
31 - MKT ZONE-WILSON CITY N
Search Results
Records Found: 1 Search Type: Starting Search Criteria: Community Christian School
Search Time: 9/26/2022 03:49 PM Search Again
Entity Name
Sos Id
Date Formed
Status
Type
Community Christian School
0550957
5/24/2000
Current - Active
Non - Profit Corporation
NC Dept of Environmental Qualls
SEP 3 fl 2022
Raleigh Regional Office
BARTLETT
ENGINEERING & SURVEYING, PC
1906 Nash Street North Wilson, NC 27893-1726
Phone: (252) 399-0704 Fax: (252) 399-0804
www bartlett us.com
September 27, 2022
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
Raleigh Regional Office
1628 Mail Service Center
Raleigh, North Carolina 27699-1628
Reference: Fast Track Application for Gravity Sewers
Private Sewer Extension
Community Christian School-2022 Additions
5160 Packhouse Road
Wilson, North Carolina
To Whom It May Concern:
Enclosed for your review and approval are two (2) copies of the following items related to the
above referenced project:
• Fast Track Application for Gravity Sewers
• Engineering Report
• Flow Tracking / Acceptance Form
■ USGS Topographic Map
a Feature Report
■ GIS Aerial Location Map
• Secretary of State Business Registration
Please see attached Engineer's Report for Project Narrative/Summary.
Also enclosed is the $480.00 sewer permit application fee. Should you have any questions or
require further information during your review, please let us know.
Respectful)
Steve Oliverio
Project Manager
Enclosures
P. PROJLCT 1-11.1:S\CCS12022 ADDITIONS\PerrrlitsLSewerl2l-204 NCDENR Pnv Sew Cover Lever doc