WQ0039728_Application (FTSE)_20221024

u DocuSiop Envelope ID: 2Bo3D126-92FA-4B97-8962-4B79E441594F
NC Dept of Environmental Quality State of North Carolina
Department of Environmental Quality
DWR GCi 2 4 2022 Division of Water Resources
Division of Water Resources FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Raleigh Rcgiona! Office FTA 06-21 & SUPPORTING DOCUMENTATION
Application Number: kwaZ] (to be completed by DWR)
Mo-P
All items must be completed or the application will be returned
1. APPLICANT INFORMATION:
I. Applicant's name: Town of Holly Springs
2. Applicant type: ❑ Individual ❑ Corporation
❑ Federal ❑ State%County
❑ General Partnership ❑ Privately -Owned Public Utility
® Municipal ❑ Other
3. Signature authority's name: Kendra D. Parrish- PE per 15A NCAC 02T .0106(b)
Title: Executive Director of Utilities & Infrastructure Service
4. Applicant's mailing address: 128 South Main Street PO Box 8
City: Holly Springs State: NC Zip: 27540
5. Applicant's contact information:
Phone number: [phone] Email Address: Kendra.ttarrishilhollysnrinesnc.eov
IL PROJECT INFORMATION:
. Project name: Thales Holly Springs Fxn �n (pPrmiLff_WQnn't.9 718 mp4i � ^
2. AppIication?"Project status: ❑ Proposed (New Permit) ® Existing Permit/Project
If a modification, provide the existing permit number: WQ00 39728 and issued date: January 10, 2018
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: Wake.
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.6600 Longitude:-78.8580
5. Parcel ID (if applicable) : 0649264181 (or Parcel ID to closest downstream sewer)
Ill. CONSULTANT INFORMATION:
1. Professional Engineer: Darcc F3artone, PE__ License Number: 1 ] 165
Firm: WithersRavenel, Inc_
Mailing address: 115 Mackenan Drive
City: Cary State: 1tiC Zip: 27511
Phone number: (919)_469-3340 Email Address:: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
I. Facility Name: Utley Creek Water Reclamation Facility- _ Permit Number: NCO063096
Owner Name: Town of Holly Sprints
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. PermitNumber(s): WQ00 3R149
2. Downstream (Receiving) Sewer Information: �8 inch N Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00192
Owner Name(s): Town of Holly Springs
FORM: FTA 06-21 Pagel of 5

DocuSign Envelope ID 2B03D126-92FA-4B97-8962-4B79E441594F
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 ® N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's O[)erational Agreement (FORM: DEV) been attached?
[—]Yes [-]No ® NIA
3. If the Applicant is a Home. -Property Owners' Association, has an HOAiP A Operational Agreement (FORM._HOA) and
supplementary documentation as required by 15A NCAC 02T.01 15(c) been attached?
❑ Yes ❑ No ®N2A
4. Origin of wastewater: (check all that apply):
❑ Residential (Individually Owned) ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential (Leased) ❑ Retail with food preparationlservice ❑ Hotel and/or Motels
® School i preschool / day care ❑ Medical / dental / veterinary facilities ❑ Swimming Pool/Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses i offices f factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic 0 % Commercial 0 % Industrial (See 15A NCAC 02T .0103(20))
If Industrial, is there a Pretreatment Program in effect? ❑ Yes❑ No
6. Has a flow reduction been approved under .I 5A NCAC 02T.,01 14(4? ❑ Yes ❑ No
➢ If yes, provide a cony of flow reduction apnroval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow a,b
No. of Units
Flow
Ex. School (Permitted #WQ0039728)
10 gall student
450
4,500 GPD
gal;'
GPD
Ex. School (to allow gym, cafeteria, etc)
5 gal! student
450
2,250 GPD
Ex. School (add students wl gym, cafeteria, a
15 gal! student
150
2,250 GPD
Proposed School (wl gym, cafeteria, etc)
15 gall student
600
9,000 GPD
gall
GPD
b5 13,500 is in a dition to the previously
�t3 permitted 4,500-18,000 GPD total to remain on application
Total
13,500 GPD
a See I SA NCAC 02T .01 14(b). (d). (e)(I t and (eN2) 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 C', S. 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.01141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
Wastewater generated by project: 13,500 GPD (per 15A NCAC 02T .0114) 13.500 GPD is in addition to the previousl-
➢ Do not include future flows or previously permitted allocations permitted 4,500-18.000 GPD total to reme
If permitted flow is zero, please indicate why: lvis
on application
❑ 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

. DocuSign Envelope ID: 2803D126-92FA-4B97-8962-4B79E441594F
V11. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC(Gravity Sewers :
1. Summarize gravity sewer to be permitted:
VIII.
2.
3.
3.
4.
5.
Size (inches) I Length (feet) I Material
prop, 8-inch
231
PVC
prop. 8-inch
68
DIP
ex. 8-inch
1,620
Ex. Sewer
➢ 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
PUMP STATION DESIGN CRITERIA (If Applicable) — 027' .0305 & MDC (Puma Stations/Force Mains):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
Pump station number or name:
Approximate Coordinates (Decimal Degrees): Latitude: _ Longitude: °
Total number of pumps at the pump station:
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.
Operational point(s) per pump(s): gallons per minute (GPM) at: feet total dynamic head (TDH)
Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
If any portion of the force main is less than 4-inches in diameter, please identify the method of solids reduction per
MDCPSFM Section 2.01C.I.b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with 15A NCAC 02T .0305th)t 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.
➢ 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

DocuSign Envelope ID: 2603D126-92FA-4B97-8962-4B79E441594F
IX. SETBACKS & SEPARATIONS (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separationslalternatives found in 15A NCAC 02T .0305tq & ? ® Yes ❑ No
15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems:
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
18 inches
ZWater mains (vertical - water over sewer preferred, including in benched trenches)
18 inches
ZWater 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-1 waters of Class I or
Class 11 impounded reservoirs used as a source of drinking water, and associated wetlands.
100 feet
50 feet
10 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)
**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.
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 or see Section X.I of this application
*I 5A NCA5� 02T-0305W contains alternatives where separations in 02T.0305(o 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 webpa
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,
signedisealed 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
D Please provide supplementary information identifying the areas of non-conformance.
➢ See the Division's draft. separation reau imments for situations where separation cannot be met.
D 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: Cape Fcar [] 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 I SA 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_0I05 rt 6) (additional permitsicertifications)? ® Yes ❑ No
Per I SA NCAC 02T.0I05(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 I SA 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 4 of 5

DocuSign Envelope ID: 2B03D126-92FAAB97-89624B79E441594F
X. CERTIFICATIONS:
I. 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 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 proiects requirine a variance approval may be subiect to Ionizer
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 re uired.
2. Professional Engineer's Certification:
I, Dave Bartone, PE , attest that this application for Vales Holly Springs Expansion (permu sWQ0039728 modification)
(Professional Engineer's name from Application Item I11.1.) (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. 1 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 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 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 143-215.613, 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 56.0701)
North Carolina Professional Engineer's seal, signature, and date: 1
Coocus
�0PAa�F�s'0��'
50794�A.:g
031365
BAR,s�w
°pn•°caao,aeo
3. Applicant's Certification per 15A NCAC 02T .0106(b):
1, Kendra D. Parrish, PE _, attest that this application for rhales Flolly Springs Expansion (permit 4WQ0039728 modification)
(Signature Authority Name from Application Item 1.3.) (Project Name from Application Item I[_I )
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. 1 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 143-215.6A and 14-2.13,4.13, 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.
J J,DocuSigned by,
Signature: Date:
10/14/2022
pw�.wwcr�►14r. _,
FORM: FTA 06-21 Page 5 of 5

DocuSign Envelope ID 2402CD3E-2775-4BiF-BF29-22759Al3BB1F
Division of Miter Resoffrres
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Town of Holly Springs
Project Name for which flow is being requested. Thales Academy HS Exp-WQ0039728M
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 wastewaterJlow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name. Utley Creek Wastewater Treatment Plant
b. WWTP Facility Permit 4: NCO063096
All flows are in MGD
c. WWTP facility's permitted flow 6.000
d. Estimated obligated flow not yet tributary to the WWTP 1.551
e. WWTP facility's actual avg. flow 2.829
f. Total flow for this specific request 0.014-above existing permit
g. Total actual and obligated flows to the facility 4.394
h. Percent of permitted flow used 73.2%
H. 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 Pump Daily Current Not Yet Current
Station station Firm Flow** Avg. Daily Tributary Flow Plus
(Name or Permit Capacity, * (Firm 1 po, Flow, Daily Flow, Obligated
Available
Number) No. MGD MGD MGD MGD Flow
Capacity***
12 Oaks W 0030814M 1.944 0.778 0.517 0.028 0.545
0.233
* 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): 12 Oaks Pump Station
Downstream Permit Number: WQ0030814M
Page 1 of 6
FTSE 10-18

DocuSign Envelope ID: 24D2CD3E-2775-4B1F-BF29-22759A1313131F
III. Certification Statement:
I Kendra D. Parrish 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.
FUoeuSipned by.
� Lf� -- 10/17/2022
Signing rcia ignalure Date
Exec Director of utilities and Infrastructure
Title of Signing Official
Page 2 of d
FTSE 10-18

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DccuSign Envelope ID: 2B03D126-92FA-4B97-8962-4B79E441594F
4 _...._+r~ THE TOWN OF
October 10, 2022
Director, Division of Water Resources
Raleigh Regional Office
Water Quality Operation Section
3800 Barrett Drive
Raleigh, NC 27609
Re: Application for Sewer Extension Permit
Project: Thales Academy Holly Springs Expansion
Dear Sir or Madam:
prings
NC Dept of Environmental Qualit"
GCT 2 4 2022
Raleigh Regional Office
Please find enclosed the following items in application for a sewer extension permit to the Town
of Holly Springs existing sewer distribution system:
0 One original and one copy cover letter including a project narrative
o A check in the amount of $480.00
0 One original and one copy of the State of North Carolina Fast Track Sewer System
Extension Application (FTA 04-16)
0 Two copies of FTSE 04-16 Flow Tracking/Acceptance Form
0 Two color copies of a 8.5-inch by 11-inch portion of a 7.5 minute USGS Topographic
Map showing project area
0 Two copies of a street level map showing all relevant project areas
0 One copy of the locally -required Design and Application Certification
Feel free to contact me at 919-577-3150 should you have any questions or need additional
information in order to process this application.
Sincerely,
og
cu5lpned by:
Rachel Ingham
Kehdrd3D.3ftffigh, P.E., CFM
Executive Director of Utilities and Infrastructure Utility Engineer
KP/tr
cc: Project Consultant Engineer, Dave Bartone, PE
Rachel Ingham, Utility Engineer
Drew Johnson, Development Construction Manager
Theresa Randall, Utility Permitting Specialist
Project file/Correspondence #42024
3002
04 172018
Utilities and Infrastructure Services
P.O. Box 8 - 128 S. Main Street - Holly Springs, NC 27540 - www.hollyspringsnc.gov

Docu9.0j n Envelope ID; 2B03D126-92FA-4B97-8962-4B79E441594F
10 WithersRavenel
■■ OtEr People. Your Success.
August 30, 2022
Department of Environmental Quality
Water Quality Section
Attn: Jason Robinson
3800 Barrett Drive
Raleigh, NC 27609
NC I)ep' urt;nvEr()Rinti(ltit! Qualit
GCT24*
Regional orrice
RE: WQ0039728 Permit Modification
Thales Academy Holly Springs Expansion - Sewer System Extension Permit
Dear Mr. Robinson,
On behalf of Thales Academy/CaptiveAire, Inc., please find the attached documentation in support of a Fast
Track Permit Modification (FTA 06-21) for the Thales Academy Holly Springs Expansion project. As noted
in the application, this project will include the addition of 231 LF 8" PVC and 68 LF of 8" DIP sewer main
that will serve the Thales Academy Holly Springs Expansion development site (in addition to the 1,620 linear
feet of 8" sewer previously permitted).
The proposed project permit modification will meet all of DWR's minimum design criteria for sanitary sewer
extensions. Permit #WQ0039728 previously approved a flow of 4,500 gpd, while the current project
proposed to increase the flow by 13,500 GPD to a calculated total of 18,000 GPD (based on NCAC 2T Rules
for wastewater flow rates by schools with cafeteria, gym and showers). The proposed sanitary sewer line
sizes are more than adequate to convey the design flow rates.
Please find attached the following information in support of the application:
• Fast Track Sewer System Extension Application (FTA 06-21)
• Flow Tracking/Acceptance Form for Sewer Extension Applications (FTSE 10-18)
• USGS Map
• Street Level Map
• $480 Check for payment of Application Fee
• Copy of the previously approved permit WQ0039728
If you have any questions regarding this request or if you require any additional information, please feel free
to contact me at 919-469-3340 or dbartonewithersravenel.com.
Sincerely
1NiVhsnrr,Ravene1
IV
DocuSbnedd by,
ou+�t�, +/ • bayf61n ,
D5DF2U713AA941A
Dave Bartone, PE
Project Manager - Site/Civil
11.5 WcKeimn Ds ivi- I Cary. NC 27511
t: 91 `/ 469.3340 j f: 919.467.600 3 1 1 U(—..rw;r No C 08 i,'
ciry i Greensboro } Pitisboro f Ralr-1;'h � Wili,tinglon