WQ0044153_Application (FTSE)_20230130

Greenville
,X� Utilities
January 25, 2023
Mr. Robert Tankard
Assistant Regional Supervisor
North Carolina Division of Water Quality
943 Washington Square Mall
Washington, NC 27889
Subject: Pitt County Sheriff's Office
Sewer Main Extension
Dear Mr. Tankard:
JAN g d _)23
waw ouaft
Regb-A Opwdom secOon
Washington Rsglenal Office
We are submitting herewith one (1) original and one (1) copy of the executed Non -Discharge
Permit Application and Flow Tracking/Acceptance for Sewer Extension Permit Applications
along with a check for $480.00 for the subject project. We request your approval of the sewer
improvements.
We trust that you will find this submittal to be in order and that your approval will be
forthcoming. In the meantime, should you have any questions or require any additional
information, please let us know.
Sincerely,
4 � //
Clifton H. Cahoon, PE
Construction / Contracts Engineer
Enclosures
c: Mr. Randall D. Emory, PE, Director Water Resources
Mr. J. Stephen Janowski, PE, Rivers and Associates
Connected To You Post Office Box 1847 1 Greenville, North Carolina 27835-1847 1 guc.com 1 252-752-7166

(-41tievers ENBINEERS PLANNERS SURVEYORS
& ASSOCIATES, INC.
SANITARY SEWER NARRATIVE
PITT COUNTY SHERIFF'S OFFICE
October 25, 2022
LANDSCAPE ARCHITECTS
RECENED/NCDENWDWIj
JA N 3 0 2023
Water Quality
Regional OPerations Section
Washington Regional Office
This sewer system is to serve the new Pitt County Sheriff's Office off of New Hope Drive in Greenville,
North Carolina. The calculated design flow is 3,750 gpd. This permit is for the installation of 592 if of
new 8" sanitary sewer line and two sanitary sewer manholes.
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107 E. Second Street, Greenville, NC 27858 ■ PO Box 929, Greenville, NC 27835 ■ Phone: [phone] ■ Fax: [phone]
NCBELS Lic. No. F-0334 www.r[versandassoclates.com NCBOLA Lic. No. C-312

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State of North Carolina
Department of Environmental Quality
JAN 3 0 2023 Division of Water Resources
15A NCAC :QhM—FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
DlvWon of Water Resources rwoCORM: FTA 04-16 & SUPPORTING DOCUMENTATION
Waahington Recaonal otsng
This application is for sewer extensions involving gravity sewers, pump stations and force mains, or any combination that has been
certified by a professional engineer and the applicant that the project meets the requirements of 15A NCAC 02T and the Division's
Minimum Design Criteria and that plans, specifications and supporting documents have been prepared in accordance with, 15A
NCAC 02T, 15A NCAC 02T .0300, Division policies and good engineering practices.
While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02T .0305(b), design
documents must be prepared prior to submittal of a fast track permit application to the Division. This would include plans, design
calculations, and project specifications referenced in 15A NCAC 02T .0305 and the applicable minimum design criteria. These
documents shall be available upon request by the Division.
Projects that are deemed permitted (do not require a permit from the Division) are explained in 15A NCAC 02T.0303.
Projects not eligible for review via the fast track process (must be submitted for full technical review):
➢ Projects that require an environmental assessment in accordance with 15A NCAC 1 C .0100;
➢ Projects that do not meet any part of the minimum design criteria (MDC) document;
➢ Projects that involve a variance from the requirements of 15A NCAC 2T;
➢ Pressure sewer systems utilizing septic tank -effluent pumps (STEPs) or simplex grinder pumps;
➢ STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mains);
➢ Vacuum sewer systems.
General — When submitting an application, please use the following instructions as a checklist in order to ensure all required
items are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time
and reduce the amount of requested additional information. Failure to submit all required items will necessitate additional
processing and review time, and may result in return of the application. Unless otherwise noted, the Applicant shall submit
one original and one copy of the application and supporting documentation.
A. One Original and One Copy of Application and Supporting Documents
® Required unless otherwise noted
B. Cover Letter (Required for All Application Packages):
® List all items included in the application package, as well as a brief description of the requested permitting action.
➢ Be specific as to the system type, number of homes served, flow allocation required, etc.
➢ If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Major Modification Appffcatlon Packages):
® Submit a check or money order in the amount of $480.00 dated within 90 days of application submittal.
➢ Payable to North Carolina Department of Environmental Quality (NCDEQ)
D. Fast Track (Form: FTA 04-16) Application (Required for All Application Packages):
® Submit the completed and appropriately executed application.
➢ If necessary for clarity or due to space restrictions, attachments to the application may be made.
® If the Applicant Type in Item I.2 is a corporation or company, provide documentation it is registered for business with
the North Carolina Secretary of State.
❑ If the Applicant Type in Item 1.2 is a partnership or d/b/a, enclose a copy of the certificate filed with the Register of
Deeds in the county of business.
® The Project Name in Item H.1 shall be consistent with the project name on the flow acceptance letters, agreements, etc.
® The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North
Carolina licensed Professional En sneer.
® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T .0106(b).
Per 15A NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation letter is
provided from a person who meets the criteria in 15A NCAC 02T .0106(b).
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page I of 3

E. Flow Tracking/Acceptance Form (Form: FTSE 04-16) (If Applicable):
® Submit the completed and executed FTSE form from the owners of the downstream sewers and treatment facility.
➢ Multiple forms maybe required where the downstream sewer owner and wastewater treatment facility are different.
➢ The flow acceptance indicated in form FTSE must not expire prior to permit issuance and must be dated less than one
year prior to the application date.
➢ Submittal of this application and form FTSE indicates that owner has adequate capacity and will not violate G.S. 143-
215.67 a .
➢ Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific FTSE.
F. Site Maps (All Application Packages):
® Submit an 8.5-inch x 11-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project
area and closest surface waters.
➢ Location of the project (gravity sewer, pump stations & force main)
➢ Downstream connection points and permit number (if known) for the receiving sewer
® Include a street level map (aerial) showing general project area so that Division staff can easily locate it in the field.
G. Existing Permit (All Modification Packages):
❑ Submit the most recently issued existing permit.
❑ Provide a list of any items within the permit the Applicant would like the Division to address during the permit
modification (i.e., permit description, flow allocation, treatment facility, etc.).
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
❑ Per 15A NCAC 02T .0305(h)(1), submit documentation of power reliability for pumping stations.
➢ This alternative is only available for average daily flows less than 15,000 gallons per day
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is
compatible with the station. The Division will accept a letter signed by the applicant (see 15A NCAC 02T .0106(b)) or
proposed contractor, stating that "the portable power generation unit or portable, independently -powered pumping
units, associated appurtenances and personnel are available for distribution and operation of this pump 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 in the case of a multiple station power outage. (Required at time of certification)
I. Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per 15A NCAC 02T .0115(a)(1) provide the Certificate of Public Convenience and Necessity from the North Carolina
Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by
the sewer extension, or
❑ Provide a letter from the North Carolina Utilities Commission's Water and Sewer Division Public Staff stating an
application for a franchise has been received and that the service area is contiguous to an existing franchised area or
that franchise approval is expected.
J. Operational Agreements (Applications from HOA/POA and Developers for lots to be sold):
❑ Home/Property Owners' Associations
❑ Per 15A NCAC 02T .0115(c), submit the properly executed Operational Agreement (FORM: HOA).
❑ Per 15A NCAC 02T .0115(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
❑ Developers of lots to be sold
❑ Per 15A NCAC 02T .0115(b), submit the properly executed Operational Agreement (FORM: DEV).
For more information, visit the Division's collection systems website
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page 2 of 3

THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
2090 US Highway 70
Avery, Buncombe, Burke, Caldwell, Cherokee,
Water Quality Section
Swannanoa, North Carolina 28778
Clay, Graham, Haywood, Henderson, Jackson,
[phone]
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quality Section
Fayetteville, North Carolina 28301-5094
Montgomery, Moore, Robeson, Richmond,
[phone]
Sampson, Scotland
[phone] Fax
Mooresville Regional Office
610 E. Center Avenue
Alexander, Cabarrus, Catawba, Cleveland,
Water Quality Section
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone]
Stanly, Union
[phone] Fax
Ralelah Regional Office
1628 Mail Service Center
Chatham, Durham, Edgecombe, Franklin,
Water Quality Section
Raleigh, North Carolina 27699-1628
Granville, Halifax, Johnston, Lee, Nash,
[phone]
Northampton, Orange, Person, Vance, Wake,
[phone] Fax
Warren, Wilson
Washington Regional Office
943 Washington Square Mall
Beaufort, Bertie, Camden, Chowan, Craven,
Water Quality Section
Washington, North Carolina 27889
Currituck, Dare, Gates, Greene, Hertford, Hyde,
(252) 946-W1
Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wllmington ReCllonal Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus, Duplin, New
Water Quality Section
Wilmington, North Carolina 28405
Hanover, Onslow, Pender
[phone]
[phone] Fax
Winston-Salem Regional Office
450 W. Hanes Mill Road
Alamance, Alleghany, Ashe, Caswell, Davidson,
Water Quality Section
Suite 300
Davie, Forsyth, Guilford, Rockingham, Randolph,
Winston-Salem, North Carolina 27105
Stokes, Surry, Watauga, Wilkes, Yadkin
[phone]
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page 3 of 3

State of North Carolina
Department of Environmental Quality
Division of Water Resources
- = 15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Dlvislon of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
\ Application Number. W a� �i I (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Greenville Utilities Commission (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: Clifton H. Cahoon, PE per 15A NCAC 02T .0106(b)
Title: Copstruction/Contracts Engineer
4. Applicant's mailing address: PO Box 1847
City: Greenville State: NC Zip: 27835-
5. Applicant's contact information:
Phone number. 252) 551-3368 Email Address: CahoonchAguc.com
II. PROJECT INFORMATION:
1. Project name: Pitt County Sheriffs Office
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ00 and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Pitt
4. Approximate Coordinates (Decimal Degrees): Latitude: 35. 0315" Longitude:-77.3671840 L%
5. Parcel ID (if applicable): 07735
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer. J. Stephen Janowski, PE License Number. 12324
Finn: Rivers & Associates, Inc. Ztj,�% 1
Mailing address: 107 E. Second Street
City: Greenville State: NC Zip: 27858-
Phone number: 252 752-4135 Email Address: sianowski(d�versandassociates.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: GUC WWTP Permit Number. NC 0023931
Owner Name: Greenville Utilities Commission
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ not known Downstream (Receiving) Sewer Size: $ inch
System Wide Collection System Permit Number(s) (if applicable): WQCS NC 0023931
Owner Name(s): Greenville Utilites Commission
FORM: FTA 04-16 Page I of 5

V1. 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 Operational Agreement (FORM: DEV) been attached?
❑ Yes [:]No ®N/A
3. If the Applicant is a Home/Property Owners' Association has an Operational Agreement (FORM: HOA) been attached?
❑ Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply):
❑ Residential 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 / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: % Domestic/Commercial 100 % Commercial
% Industrial (See 15A NCAC 02T .0103(20))
*Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(fl? ❑ Yes ❑ No
➢ If yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(fl)
Daily Design Flow Bb
No. of Units
Flow
Gen Bus. and Office
25 gal/empl.
150
3750 GPD
gaU
GPD
gal/
GPD
gal/
GPD
gall
GPD
gal/
GPD
Total
3750 GPD
a See 15A NCAC 02T .0114(b), (d), (e)(1) and Wf2) 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.01141 shall
be determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 3750 GPD (per 15A NCAC 02T .0114)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number.
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-16 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
S"
592
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 requirement is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: - °
3. Design flow of the pump station: millions gallons per day (fum capacity)
4. Operational point(s) of the pump(s): gallons per minute at feet total dynamic head (TDIT)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15A NCAC 02T .0305(hxl):
❑ Standby power source or pump with 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
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(1)(C):
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
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 in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5

Ix. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T .0305(f) & (Q) ® Yes ❑ No
➢ 15A NCAC 02T.0305 contains minimum separations that shall be provided for sewers stems:
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below vertical
24 inches
Water mains vertical -water over sewer including in benched trenches
18 inches
Water 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
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 see item IX.2
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
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 is
10 feet
Final earth grade vertical
36 inches
➢ 15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webp ge
➢ If noncompliance with 02T.0305(fl or (g), see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ❑ Yes ❑ No ® N/A
➢ See the Division's draft separation requirements for situations where separation cannot be meet
➢ No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑ Yes ❑ No ®N/A
➢ This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project require coverage/authorization under a 404 Nationwide or ❑ Yes ® No
individual permits or 401 Water Quality Certifications?
➢ Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes [—]No
Per 15A NCAC 02T.0105(c)(6), directly related environmental permits or certification applications are 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.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ® No ❑ N/A
➢ 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 permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

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 Design Criteria (latest version) as applicable?
❑ Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents
for review. Approval of the request is required prior to submittal of the Fast Track Application and supporting
documents.
2. Professional Engineer's Certification:
I, J. Stephen Janowski, PE attest that this application for
(Professional Engineer's name from Application Item III.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, Gravity Sewer
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 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.
fy/�V.
North Carolina Professional Engineer's seal, signature, and date:CA
; ^ ► �`
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Applicant's Certification per 15A NCAC 02T .0106(b):
I, Clifton H. Cahoon, PE CprlJ%L/>✓QCirGlrr/CoN�/;/s L�hgiN�/" attest that this application for
(Signature'Authority's name & title from Application Item I.3.)
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 as well as civil penalties up to $25,000 per violation.
Signature:
_ale
Date:
FORM: FTA 04-16 Page 5 of 5

FIQ
Divlslon of Water &emmrces
Entity Requesting Allocation:
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Greenville Utilities Commission
Project Name for which flow is being requested: Pitt County Sheriffs Office
More than one ME may be requiredfor a single project if the owner of the WWTP is not responsible for allpump
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:
b. WWTP Facility Permit #
Greenville Utilities Commission
: NCO023931
All f lows are in MGD
c. WWTP facility's permitted flow 17.5
d. Estimated obligated flow not yet tributary to the WWTP 2.618
e. WWTP facility's actual avg. flow 9.779
£ Total flow for this specific request .0038
g. Total actual and obligated flows to the facility 12.400
h. Percent of permitted flow used 70.858
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
Obligated,
Pump
Average Daily
Approx.
Not Yet
Total Current
Station
Firm
Flow**
Current Avg.
Tributary
Flow Plus
(Name or
Capacity, *
(Firm / pf),
Daily Flow,
Daily Flow,
Obligated
Available
Number)
MGD
MGD
MGD
MGD
Flow
Capacity***
Northside
8.357
3.343
.635
.005
.640
2.703
* The Firm Capacity 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.
*** A Planning Assessment Addendum shall he attached for each pump station located
between the project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): Unknown
Downstream Permit Number: Unknown
Page 1 of 6
FTSE 04-16

III. Certification Statement:
I Clifton H. Cahoon, 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 addendum s for which I am the responsible party.
Signature of this form indicates acceptance of this wastewater flow.
Official Signature
K ,Us-;
Date
Page 2 of 6
FTSE 04-16

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I

Z�tiM„�i

1. • ..: the submitted system comply with 15A NCAQ02the Minimum Dg` . li .tl gt_ for . !i 1i'll.!! 11 ! .'. Pump 1!il
:14 F=e It !n a'". F.1 :'1 °•1the QM3ft c'i..x Minimum Design ! °J im!•7_°/! as applicable?
R Yea ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-I4) and supporting documents
fort review. Armroval of the reatim Is reauired Prior to submittal of the Fast Track-Aonllcatton and yon@ort#uug
documents.
I.
2. Professional Engineeds Certification:
I, ! J. Stephen Janowski, PE attest that this application for
(Professional Engineer's name from Application Item IlL 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, Gravity Sewer
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
potions 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 S 10,000, as well as civil penalties up to $25,000 per violation.
North Carolina Professional Englaeer's seal,:mature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106 ft
I, 1. Clifton H. Cahoon. PE attest that this application for
(Signature Authority's name & title from Application Item I.3.)
i
has been reviewed by me and is accurate and complete to the beat 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. 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,
iRNnctive 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
tat 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 as well as civil penalties up to $25,000 per violation.
I
Signature: Dater
FORM: FTA 04-16
Page 5 of 5

State of North Caroiina
Department of Environmental Quality
Division of Water Resources
— D WJ111-- 15A NCAC 02T AM — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
` DMslon eif Wob w Resomrces FTA W16 a SUPPORTING DOCUMENTATION
lic ation Number:
(m be-nVkeed by DWR)
1. Applicant's name: Gremville Utilities + on—iq&sioa (company. municipality, HOA, utility, etc.)
2. Applicant type: ❑ bAividual ® Corporation ❑ Cm ral Partnership ❑ Privately -Owned Public Utility
Federal State/County ❑ Mumcapal ❑ Other
3. Signat rre autbority's name: CUf on K COWOM PE per 15A NCAC 02T .Q106fb)
Title -
RECEIVED/NG'DENAIDWR
4. Applicant's mailing address: PO Boat 1 &47
City: �i ill State: -Q Zip: 27835-
5.' Applicant's contort information FEB 17 2023
Phone number. (20 551-33§$ Email Address: C hob llCaleitc.cortu Water Quality
Regional Operations Section
U. PROJECT INFORMATION: Washington Regional Office
1.. Project name: PimCutmty S�fft Offroe
2_ Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number. WQ00 and issued date:
if new construction but part of a master plan, provide the existing permit number. WQ00
3.. County where project is located: $E
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.640315° Longitude: 77 Z1�4°
5. Parcel ID (if applicable): 07735
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION: -
1. Professional Engineer: J. StB hm Janowski. PE License Number: 12324
F31'm: p:-•�,T, Aeerr��ePe_ inc
Mailing address:1" Sccbrtd:Street
City: GromyUk State: b Zap: 2785&,
Phone number. = 75Z-4135 Email Address:
TV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: GUC WWTP Permit Number: NC 0023931-
Owner Name: Greenville Utilities; Commission
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ not kna�m Downatteam (Receiving) Scorer Size: $inch
53m= WidrCollesgon SW= Permit Nwftds) (if applicable): WQCS NC 0023931
Owner Name(s�-
FORM: FTA 04-16
Page 1 of 5

VL GENERAL REQUIRKIW N TS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yea ❑No ®N/A
2. If the Applicant is a Developer of lots to be sold, has a Develaner's Qpgg tional Agannent (FORM: DEVI been attached?
❑ Yea []No ®N/A
3. If the Applicant is a Hortte/Pmbarty Owners' Assoeioti= has an Operational Agreament (FORM: HOA) been attached?
❑ Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply):
❑ Residential Owned ❑ Retail (stoics, centers, malls) ❑ Car Wash
❑ Residential Leased ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School / preschool / day car, e ❑ Medical / dental / veterinary facilities ❑ Swimming Pool /Clubhouse
❑ Food and drink facilities I ❑ Church ❑ Swimming Pool/Filter Backwash
Businesses /offices / factorSes ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: % Domestic/Commercial Bk% Commercial
% Industrial (See 15A NCAC 02T .0103(20))
0 Is there a Prefiwitment Program in effect? ❑ Yes ❑ No
i
6. Hasa flow reduction been approved under .15A NCAC OZT .0114(fYl ❑ Yea ® No
➢ 'U'vea, myvide a e m of flow rouca" approval Irmr
7. Summarize wastewater generated by project.
Establishment Type (see 02T.0114(f))
Daffy Dedpt Flow 0
No. of Units
Flow
Gen Bus. and Office
25 gal/empL
150
3750 GPD
gay
GPD
gay
GPD
j
gay
GPD
gay
GPD
gay
GPD
Total
3750 GPD
a See .15A NCAC 02T .0114(b). (d), (Oil) 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 looted south or cast of the Atlantic Intracoastal Waterway to be used as vacation rentals
as defined in G.S. 42A�).
b Per 15A NCAC 02T .0114(c� design flow rates for establishments not identified [in table 15A NCAC 0217:0114], shall
be determined using available flow data, water using fixtures, occupancy or operation patterns, and other measureddats.
8. Wastewater generated by project 3M GPD (per 15A NCAC 02T .Q 114)
➢ Do not include fixture flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-16 1 Page 2 of 5

I
I
VIEL GRAVITY SEWER DESIGN CRITERIA (If AppMeable) - 02T.0305 & MDC (GMYW SMMI.
1.. Summarize gravity sewer to be permitted:
Size (tmAes) Length (feet) Material
8" 592 PVC
> !':Section II & III of the MDC for Permitting of Gravity Sewers contains infbrination, related to design criteria
> Section Ell contains information related to nummum slopes for gravity sewer(s)
>
,Ovwddug Hoes to amet mbdrum dope requiremeat is not allowed and a vlolittlon of the MDC
VIII. PUMP STATION DESIGN. CRITERIA (if AppReable) MK'd'"M St%d0j"sMwm
CON[PJJ= FOR EACH PUMP STATION MCLUM IN THIS
I Pump station number or name:
Appn"dmatc Coor6mates; (Decimal Degrees): I.Atitude. - 0 Longitude: -
3. Design flaw of the Pump station: millions gallons per day (firm capacity)
4. Operational point(s) of The pump(s): gallons per minute at feet total dynamic bond (IDH)
5. Summarize the force main to be permitted (for this Pump Station):
6. Power reliability in accordance with
[3!�!Standby power Botum OT withautomatic activation and telemetry - 15A NCAC 02T -0305(hXIXB)j
I" Required for all pump stations with an average daily flaw greater than or equal to I 5,0D0 gallons per day.
> Must be permanent to facility
Axif the pump station has an average daily flow I= than 15,000 gallons per day:
❑ Portable power source with manual activation, quick lion receptacle and h4emetry - 15A NCAC 02T
".030.5(h)(IxC)
or
❑ il',Palrtible pumping unit with plugged emergency pumpootmection and telemetry -15A NCAC 02T.0305(hXIXC):
> I It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
i!and is compatble with the station.
> �jf the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations
istorage capacities and the rotation scledt& of the: portable power source or pump, inchiding travel timefimnes, shall be
;provided in the case of a multiple station power outage.
FORM: FrA 04-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T .0305(f) & (a)
➢ 15A NCAC: 02T_(1IMM contains minimum senamtinns that shall he nrnvi&A fnr sewer cvatrmv-
® Yes [—]No
Setback Parameter*
Sepamfion Required
Storm sewers and other utilities not listed below(vertical)
24 inches
Water mains vertical -water over sewer including in benched trenches
18 inches
Water mains(horizontal)
10 feet
Reclaimed water lines vertical - reclaimed over sewer)
18 inches
Reclaimed water lines orizontal - reclaimed over sewer
2 feet
**Any private or public water supply source, including any wells, WS-I waters of Class I or
Class H impounded reservoirs used as a source of drinking water
100 feet
**Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
high water or tide elevation) and wetlands see item DC2
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
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 (vertical)
36 inches
➢ 15A NCAC 02T.0305(a) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
➢ If noncompliance with 02T.0305(f) or (2). see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) [:]Yes ❑ No ® N/A
➢ See the Division's draft separation requirements for situations where separation cannot be meet
➢ No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCA_ C_02_B .020D? ❑ Yea ❑ No ® N/A
➢ This would include Trout Buffered Streams per 15A NCAC 213.0202
4. Does the project require coverage/authorization under a 404 Nationwide or ❑ Yes ® No
individual permits or 401 Water Quality Certifications?
➢ Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02T.0105(OM (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0105(c)(6), directly related environmental permits or certification applications are 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.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NCAC 02T.0402. "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ® No ❑ N/A
➢ If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority limes shall be Inspected by the permittee or lb representative at least once every di -months and
inspections documented per 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

Average Yearly Flow for:
Jan.2022
Feb.2022
Mar.2022
Apr.2022
May2022
Jun2022
Ju12022
Aug2022
Sept2022
Oct2O22
Nov2022
Dec2022
Facility name, Permit #
Permitted Flow:
10.6580645
10.8178571
10.2129032
9.9066667
9.5645161
9.1366667
9.816129
9.7677419
9.6966667
9.3935484
9.32
GUC
NCO025348
9.3387097
9.802455833 Avg. Flow
2022 % of Permitted Flow:
17.5
0.560140333
(<80%/90% 0K)