WQ0043505_Application (FTSE)_20231229

NC Dept of Environmental Quality
State of North Carohtna
Department of Environmental Quality
DWR DEC 19 20'2 Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 06-21 & SUPPORTING DOCUMENTATION
Raleigh Regional Office
Application Number: UUG' 0 t ti S �_G < _ (tu be completed by DWR)
MOD
All items must be completed or the application will be returned
1, APPLICANT INFORMATION:
I. Applicant's name_ Ciix-qf Rocker Mount (company, municipality, HOA, utility, etc.)
2. Applicant type• ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3. Signature authority's name: Peter Varney per I A.NCAC Q2T ,0106rb)
Title: Interim City Manager
4. Applicant's mai:ing address: 331 S. Franklin Street
City: Rocky Mount State: NC Zip: 27802-
5. Applicant's contact information:
Phone number: [phone] Email Address: etg er.vameyArockymountnc.M
11. PROJECT INFORMATION:
I. Project name: _it rho_.. [)art S[rcet E'ayinr� Ptojtct: Emerald. Cora[I_ Tub
2. ApplicationlPro}ect status: ❑ Proposed (New Permit) ® Existing Permit/Rroject
If a modification, provide the existing permit number. • WQ0043505 and issued date: 6-27- 22,
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: Edgecombe
4. Approximate Coordinates (Decimal Degrees), Latitude_ 35.963553' Longitude:-77.747138
5. Parcel ID (if applicable): 387008702700 (or Parcel ID to closest downstream sewer)
Ill. CONSULTANT INFORMATION:
I. Professional Engineer: David Revoir License Number. 26959
Firm: Appian Consulting Engineers. P.A.
Mailing address: 154 Roundabout Ct./P.O. Box 7966
City: Rocky Mount State: NC Zip: 27804-
Phone number: (252) 972 - 7703 Email Address: drevoin'e_appiancngincers.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
I. Facility Name: Rocky Mount WastewaterTreatment Plant Permit Number: NCO030317
Owner Name: City of Rocky Mount
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Numbcr(s): WQ
2. Downstream (Receiving) Sewer Information: 8 inch 0 Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00021
Owner Name(s): City of Rocky Mount
FORM: FTA 06-21 Page I of 5

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
�. If the Applicant is a Developer of lots to be sold, has a Dcyel 'sgpqrtitmaI A rnent LK Rh{..EV}been attached"
❑ Yes ❑ No ® NfA
3, If the Applicant is a Home/Property Owners' Association, has an }A/POA Ot ggio0st.Al txicrtt LfORM. Fi{}Aj 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) ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential (Leased) ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School / preschool / day care ❑ Medical / dental / veterinary facilities ❑ Swimming Pool. Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool?Filter Backwash
❑ Businesses I offices I factories ❑ Nursing Home ❑ Other (Explain in Attachment)
S. Nature of wastewater: 100 % Domestic % Commercial % Industrial (Sec l $A AAC 021: 0103 )
If Industrial, is there a Pretreatment Program in effect? ❑ Yes❑ No
6 Has a flow reduction been approved under LEA -C 02T _0! 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 s,b
No. of Units
Flow
Residential
120 gal/Bedroom
20
7200 GPD
gal/
GPD
gall
GPD
gall
GPD
gall
GPD
gall
GPD
Total
7200 GPD
a See 15A NCAC 021' _01 I4(b),.Ld),(,l(] 1 and (Q17JttiltJ 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 .01 14(c), design flow rates for establishments not identified (in table iSA 8CAC 02-T.1 4] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 5400 GPD (per IAA ULAC 02T .011
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) - 02T .0305 & HQC (Gmylfy Sneers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8" 2,960 PVC
➢ Section It & 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
VI11. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & N1DC (Pump Stattonsr Faree Maim):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
I. Pump station number or name: NIA
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)
D 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 less than 4-inches in diameter, please identify the method of solids reduction per
MDCPSFM Section 2.01 C.l.b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with I A ".02T .0305ft I is
❑ 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.
D 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 timeframcs, 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 & I5A NCAC 02T .0305(f)):
1. Does the project comply with all separations. alternatives found in I SA :NCAC Q21 .0305( ALW? ® Yes ❑ No
15A NCAC 02T_030SM 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
'Water 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 1 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 SS 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.03 if) or{gJ, sec Section X.l of this application
*t5A NCA. QJ,Qj contains alternatives where separations in 02T.0 05 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 MC Surfacc Waicr Ciaxsitications webvutx
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 ricauirCsriIMLS 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. Tar River ❑ No
if yes, does the project comply with setbacks found in the river basin rules per OAN� ZO- 0„� '.' ® Yes ❑ No
➢ This includes Trout Buffered Streams per 15A NCAC 213.0,202
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/permitting status in the cover letter if coverage/authorization is required.
6. Does project comply with A NCAC 02T.41MCI[fr) (additional permits/certifications)? ® Yes ❑ No
Per I AA NCAC 02T,0tG5tcX6I, 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'tC IC 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.
D 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

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum [)as kn Citerje fur the Pcrmitling of Pun1u Stations
and ore Mains (latgll,vcrsion). and the �;ravjty Scwcr Minimum f3Drgu, Criteria tcs v'o
cbn 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 ipermit. and Projects requiring a variance anproval. may be sub ect to longer
reviewtimes. For Projects r uirinp-wo or more variances or where the variance is determined by the Division to be a
si nificant portion of the project, the full technical review is re uired.
2. Professional Engineer's Certification:
I, David Revoir, attest that this application for City of Rocky Mount Dirt 5trect Paving Project: Emerald, Coral. Toaaz
(Professional Engineer's name Pram Application Item IILL) (Project Name from Application Item 11 l )
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,
ray4y SttSm • ygrsitt , and the Mininium MsignCriieria for the Fast -Track Permittin
f1t?mp Simions..arit Force lul>iins{it vCrsian J. 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 143-215.613, 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. Misre sentation of the application
information, including failure to disclose any design non-compliance with the applicable Rules design criteria, may subject
the North Carolina -licensed Professional Engineer to referral to the licensing bo. (21 N 1)
North Carolina Professional Engineer's seal, signature, and
Applicant's Certification per ISA NCAC 02T .0106(b):
1, Peter Varney , attest that this application for City, of Rocky Mount Dirt Street Paving Project: Emerald, Coral Topai
(Signature Authority Name from Applicaton Item I.3.) (Project Name from Application Item It ' 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. 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. 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.
DOTE In accordance with General Statutes 143-215.6A and 143.21 �, , 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 tine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: _ . �_ ANpaw; z — ! I- % L
FORM: FTA 06-21 Page 5 of 5

December 14, 2022
NCDEQ DWR
3800 Barrett Drive
Raleigh, NC 27609
RE: City of Rocky Mount Dirt Street Paving Project:
Emerald Lane, Coral Drive, Topaz Avenue
Rocky Mount, NC
Proposed New Sewer Line
To whom it may concern:
NC Dept of Environmental Quality
DEL" 9
Raleigh Regional o f'ice
The following fast track sewer system extension application is being submitted on behalf of the City of
Rocky Mount for the City of Rocky Mount Dirt Street Paving Project. The sewer lines are proposed to be
located on Emerald Lane, Coral Drive, Topaz Avenue, Cox Avenue in Rocky Mount, NC (Edgecombe
County). This project was previously approved on June 27, 2022(Permit Number: WQ0043505). The
original site design proposed 1400 linear feet of 8" PVC and 1400 linear feet of 8" DIP. The new design
will feature approximately 2,960 linear feet of 8" PVC. The proposed sewer lines will supply 20 residential
units with the estimated flow of 7200 gallons per day; all tributary to the Rocky Mount Wastewater
Treatment Plant. The project is located in Tar River basin and is subject to State Buffer rules.
Please find attached:
• Fast Track Sewer Permit Application
• Aerial Map of Project
• USGS Map of Area with Proposed General Vicinity of Sewer
• Approved Permit WQ0043505
Please let us know if you have any questions regarding the project.
Sincerely,
Appian Consulting Engineers, PA
Ryan Joyner
[e-mail]
Cc: David C. Revoir, PE
P.O. Box 7966 • Rocky Mount, NC 27804 - [phone]
www.appianengineers.com • [e-mail]

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DATE: 1-14-22 APPIAN CONSULTING ENGINEERS P.A.
o REV. CIVIL, MUNICIPAL 6: STRUCTURAL ENGINE9RS n n n r
SHEET /. COMPREHENSIVE ENVIRONMENTAL SERVICES
C OF P.O. Box 7966 / Rocky Mount, N.C. 27804 ❑ ❑ ❑ ❑
o Phone: [phone] www.appianeng,neers com
SCALE: 1"=800' Fax. [phone] E-Mai: adminOappioneng, nears com
�; J.N. 21-136 BOUNDARY DESCRIPTION SHOWN IS NOT FOR RECORDATION

I*T1CONGINEERS, PA
CIVIL, MUNICIPAL & STRUCTURAL ENGINEERS
COMPREHENSIVE ENVIRONMENTAL SERVICES
P.O. Box 7966
Rocky Mount, North Carolina 27804
252.972.7703 Phone
252.972.7638 Fax
[e-mail]
www.appianengineers.com
LETTER OF TRANSMITTAL
DATE: December 27, 2022 APP17#ig'
TO:
NCDWR RRO
3800 Barrett Drive DEC 2 9
Raleigh, NC 27609
919-791-4200 Raleigh Regional C
PROJECT:
City of Rocky Mount Dirt Street Paving Project:
Emerald, Coral, Topaz
GENTLEMEN: We are sending you ❑ herewith ❑ under separate cover:
SUBMITTAL FOR:
CODE
FOR APPROVAL
1
❑
FOR YOUR USE
2
❑
AS REQUESTED
3
❑
BID TAB DISTRIBUTION
4
❑
APPROVED PERMITS
5
❑
PRINT I DRAWING NUMBER
COPIES (REVISION NO. OR DATE)
REMARKS:
ACTION
CODE
APPROVED
A
❑
APPROVED AS NOTED
B
❑
NOT APPROVED
C
❑
REVISE AND RESUBMIT
D
❑
PLEASE SIGN AND RETURN
E
❑
DESCRIPTION
$480 Check for Sewer Permit Application Modification
Here is the check for the modification application to the Approved permit WQ0043505 for the Rocky Mount Dirt
Streets Project.
Thank you,
Ryan
Sent by: First Class Mail
®
if enclosures received are not as listed above, kindly notify at once.
UPS Next Day 1 AM
❑
Thank you.
UPS Next 2nd Day
❑
Federal Express
❑
12-27-22
Faxed
❑
BY Ryan Joyner Date
Hand Delivered
❑
[e-mail]
Pick Up
❑
Received By Date
cc: File
CODE