WQ0044054_Application (FTSE)_20230105

DWR
Division of Water Resources
Application Number:
State of North Carolina
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 06-21 & SUPPORTING DOCUMENTATION
by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Apphcant's name. City of Rocky Mount (company, municipality, HOA, utility, etc_)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State. -County ® Municipal
3. Signature authority's name: Peter Varney per 15A.NCAC 2T _01%(bl
Title: Interim City Manager
4. Applicant's mailing address: 331 S. Franklin Street
City: Rocky Mount State: NC Zip: 27802-
5. Applicant's contact information:
Phone number Q2 ) 972-1325 Email Address: peter.varney(tZroekymountnc.gov
If. PROJECT INFORMATION:
❑ Privately -Owned Public Utility
❑ Other
NC Dept of Environmental Quality
JAN 5 - 2023
Raleigh Regional Office
1. Project name: Autumn RidFc SID (Section B}
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Pro:ei:
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: Nash
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.591217' Longitude:-77.511 104:'
5. Parcel ID (if applicable): 2831.1295.3294 (or Parcel ID to closest downstream sewer)
Ill. CONSULTANT INFORMATION:
1. Professional Engineer: David C. Revoir License Number: 26959
Firm: Appian Consulting Engineers, P.A.
Mailing address: 154 Roundabout Ct./ PO Box 7966
City: Rocky Mount State: NC Zip: 27804-
Phone number: [phone] Email Address: drevoi anpianensinecrs.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: City of Rocky Mount Wastewater Treatment Plant Permit Number: NCO030317
Owner Name: QLy of Rocky Mount
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ Unknown
2. Downstream (Receiving) Sewer Information: inch 1D Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCSQQLI
Owner Name(s): City of Rocky Mount
FORM: FTA 06-21 Page 1 of 5

Vl. GENERAL. REQUIREMENTS
I. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑ No ® NIA
2. If the Applicant is a Developer of lots to be sold, has a Developer's. QperationaLAgreel nt(FORM: DPY}been attached?
❑ Yes ❑ No ® N/A
3. If the Applicant is a Home/Property Owners' Association, has an QNEQA Operational Asrecrnent f DORM: IiOAI and
supplementary documentation as required by 15A NCAC 02T.0 i 15(c) been attached?
❑ Yes ❑ No ®N/A
4. Origin of wastewater: (check all that apply):
® Residential (Individually Owned) ❑ Retail (stores, centers, mails) ❑ 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: 100 % Domestic % Commercial % 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 15A I ? ❑ Yes ® No
➢ If Yes, provide a copy of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(0)
Daily Design Flow' a
No. of Units
Flow
Residential (3 Bed/Unit)
120 gal/Bedroom
46
16,560 GPD
gall
GPD
gall
GPD
gall
GPD
gal/
GPD
gall
GPD
Total
16,560 GPD
a See I i N929 92T xQ j 14Ib1, fdl- lel( Ll t01.6:1Q1 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 QT,0114] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 16,560 GPD (per ]3A 4 02 .0114)
➢ 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 MDC (Gravity Sewers),:
L Summarize gravity sewer to be permitted. -
Size (inches) Length (feet) Material
B" 1100 PVC
➢ Section 11 & 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
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC trump Stations/Force Mains):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: NIA
2. Approximate Coordinates (Decimal Degrees): Latitude: 0Longitude: -
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 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 2.0 tC. Lb. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(I l
❑ 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 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)):
1 Does the project comply with all separations -'alternatives found in J g_ li t�� ._0305(f) &_Lg)? ® Yes ❑ No
15A NCAC 02T.0305(n contains minimum separations that shall be provided for sewer systems:
Setback Parameter*
Separation Required
Storm sewers and other uti;ities not listed below (vertical)
18 inches
'Water mains (vertical - water over sewer preferred, including in benched trenches)
18 inches
'Water mains (horizonta.)
10 feet
Reclaimed water lines (vertical - reclaimed over sewer)
18 inches
Reclaimed water lines (horizontal - reclaimed over sewer)
2 feet
**Any private or pubic water supply source, including any wells, WS-I waters of Class I or
Class II impounded reservoirs used as a source of drinking water, and associated wetlands.
100 feet
**Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
high water (or tide elevation) and wetlands associated with these waters (see item IX.2)
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches, as well as wetlands associated with these waters or classified as WL
10 feet
Any building foundation (horizontal)
5 feet
Any basement (horizontal)
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade (vertical)
36 inches
➢ If noncompliance with 02T.0305(A or (g), see Section X.I of this application
*15A NCAC. 02T.0305fp1 contains alternatives where separations in 02T.0305 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 Sgrilace Watgl ClaSsificalions wcb a c
2. Does this protect comply with the minimum separation requirements for water mains? ® Yes [—]No ❑ MA
➢ 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 drab Separation re airemetrts 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 15A NCAC 02B .02D0? ® Yes ❑ No
➢ This includes Trout Buffered Streams per 15A NCAC 28.020
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 15A NC I c 6) (additional permits/certifications)? ® Yes ❑ No
Per I SA NCAC 02LQ 5i0 (ck61, 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 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

X. CERTIFICATIONS:
I. Does the submitted system comply with 15A NC:AC 021`, the Miuimum Msign C'rom—ki for the Permitlir7-a Of 't .r lP S1411 tms
and Vorce Mains (latest version), and the Q v_ersio 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 protects requiring a variance approval may be subiect to longer
review times. For proiects r"uiring two or more variances or where the variance is determined by the Division to be a
significant portion of the protect, the full technical review is required.
2. Professional Engineer's Certification:
I. David C. Revoir , attest that this application for Autumn Ridge S/D: Section B
(Professional Engineer's name from App; (cation Item III ..) (Project Name from Application Item IL 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. l further
attest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable regulations,
Mininnim Design Crilcriu for Umvily SL wersTl st version , and the Minimum I gigM Criteria for Ilw EW-Back Ilertrikiirts:
lit' I'itmit Statitms and Fume Mains f latest version}. Although other professionals may have developed certain portions of this
submittal package, inclusion ol'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 Genera, 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 weal 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 ties and d ign criteria, may subject
the North Carolina -licensed Professional: Engineer to referral to the licensing board. (2J�C 56.11) n
North Carolina Professional Engineer's seal, signature, and date:
INE��
Applicant's Certification per 1 SA NCAC 02T .0106(b):
I, Peter Varney , attest that this application 11or Autumn Ri c SID: Section B _
(Signature Authority Name tram Application Item 1.3.) (Prupet Name from Application Item 11. t J
attest that this application has been reviewed by me and is accurate and complete to the best of my knowledge.
l 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-215.bA and 143-211M , 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 we'I as civil penalties up to $25,000 per violation.
Signature:
FORM: FTA 06-21 Page 5 of 5

' 1VCDepr of Environ State of North Carolina
Iflmental Qaaplepartment of Environmental Quality
Division of Water Resources
JA1V 9 — 202 Flow Tracking for Sewer Extension Applications
Raleigh (FTSE 10-18)
Entity Requesting Allocation: City of Rocky 1Vlp �i�
Project Name for which flow is being requested: Autumn Ridge Subdivision
hlore 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 wastewater flow.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Tar River Regional WWTP
b. WWTP Facility Permit #: NCO030317
All flows are in MGD
c. WWTP facility's permitted flow 21.0
d. Estimated obligated flow not yet tributary to the WWTP 0,814
e. WWTP facility's actual avg. flow 10.83
f Total flow for this specific request 0.017
g. Total actual and obligated flows to the facility 11.645
h. Percent of permitted flow used 55.45%
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
Obligated,
Pump
Pump
Average
Approx.
Not Yet
Total Current
Station
Station
Firm
Daily Flow**
Current
Tributary
Flow Plus
(Name or
Permit
Capacity, *
(Firm / pf),
Avg, Daily
Daily Flow,
Obligated
Available
Number)
No.
MGD
MGD
Flow, MGD
MGD
Flow
Capacity***
97 Lift
30
12
6.5
0.814
7.31
4,69
* 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): Tar River Regional WWTP
Downstream Permit Number: NC 0030317
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I Scott Miles, 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.
t- q-z.
Official Signature Date
ASS i S P%r"a T C (-rz j^4 <"I!C et_ ` I.J P-�'L- ��oviCcL
Title of Signing Official
Page 2 of 6
FTSE 10-18

December 28, 2022
NCDEQ DWR
3800 Barrett Drive
Raleigh, NC 27609
RE: Autumn Ridge S/D:
Section B
Rocky Mount, NC
Proposed New Sewer Line
To whom it may concern:
�nnr�r
NC Dept of Environmental Quality
JAN 5 - 20D
Raleigh Regional Office
The following fast track sewer system extension application is being submitted on behalf of the City of
Rocky Mount for section B of Autumn Ridge Subdivision. The sewer lines are proposed to be located in
the subdivision on Moss Creek Way, Peppermill Way, Peppermill Trail, and Peppermill Court in Rocky
Mount, NC (Nash County). Site design proposes 1100 linear feet of 8" PVC. The proposed sewer lines will
supply 46 residential units with the estimated flow of 16,560 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
• Sewer Permit Application Permit Fee
• Aerial Map of Project
• USGS Map of Area with Proposed General Vicinity of Sewer
Please let us know if you have any questions regarding the project.
Sincerely,
Appian Consulting Engineers, PA
Ryan Joyner
[e-mail]
Cc: David Revoir, PE
P.O. Box 7966 • Rocky Mount, NC 27804 • [phone]
www.appianengineers.com • [e-mail]

NC Dept of Environmental Quality
JA N 5 - 2023
Raleigh Regional Office
DATE;
REV.11-2-22 AERIAL MAP CONSULTING ENGINEERS, P.A.
SHEET /: CIVIL. MUNICIPAL k STRUCTURAL ENGINEERS jr }fir
COMPREHENSIVE ENVIRONMENTAL SERVICES
1 OF 1 f�� P.O. Box 7966 / Rocky Mount. N.C. 27804
SCALE: I" w zoo' AUTUMN RIDGE S/D Phone: [phone]
Fax: [phone]
SECTION B www.oppionengineors.corn
J.N. 19-053 E Mail: admin0appianengineers.com CONSULTING ENGINEERS, PA

NC Dept of Environmental Quality

VrIninir
EEEE
CONSU TI G ENGINEERS, 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.applanengineers.com
LETTER OF TRANSMITTAL
DATE: December 29, 2022 APPIAN JOB NO.: 19-053-1
TO:
PROJECT:
NCDEQ Water Quality Section
3800 Barrett Drive C Dept of Environmental Quality
Raleigh, NC 27609
919-791-4200
—..JAN ft _ ?l1}
Autumn Ridge SID: Section B Raleigh Regional Office
GENTLEMEN: We are sending you ❑ herewith ❑ under separate cover:
SUBMITTAL FOR:
CODE
FOR APPROVAL
1
FOR YOUR USE
2
❑
AS REQUESTED
3
❑
SID TAB DISTRIBUTION
4
❑
APPROVED PERMITS
5
❑
PRINT
COPIES
1
1
1
1
DRAWING NUMBER
(REVISION NO. OR DATE)
ACTION
CODE
APPROVED
A
❑
APPROVED AS NOTED
S
❑
NOT APPROVED
C
❑
REVISE AND RESUBMIT
D
❑
PLEASE SIGN AND RETURN
E
❑
DESCRIPTION
Cover letter
USGS and Aerial Map
Sewer Pemit application and related documents
$480 check for application fee
REMARKS:
Here are the items for the review of the Autumn Ridge SID: Section B sewer permit application.
Thank you,
Ryan
Sent by: First Class Mail
®
N enclosures received are not as listed above, kindly noSfy at once.
UPS Next Day ! AM
❑
Thank you.
UPS Next 2nd Day
❑
Federal Express
❑
12-29-22
Faxed
❑
BY Ryan Joyner Date
Hand Delivered
❑
[e-mail]
Pick Up
❑
Received By Date
ce File
T—
CODE
t ..

r,rr
*T10GLENAGINLEERS,
uCOPA
CIVIL, MUNICIPAL a 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: January 4, 2022 APPIAN JOB NO.: 19-053-1
TO:
NCDEQ Water Quality Section
3800 Barrett Drive
Raleigh, NC 27609 NC bcpr of Fnvironmc�
919-791-4200 r�1
PROJECT:
Autumn Ridge SID: Section B BAN 9 _ 202,E
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
6
❑
PRINT DRAWING NUMBER
COPIES (REVISION NO. OR DATE)
1 FTSE
ACTION
CODE
APPROVED
A
❑
APPROVED AS NOTED
B
❑
NOT APPROVED
C
❑
REVISE AND RESUBMIT
D
❑
PLEASE SIGN AND RETURN
E
❑
REMARKS:
Here is the remaining form for the review of the Autumn Ridge SID: Section B sewer permit
application. Thank you,
Ryan
1o11a] pfrice
Sentby: First Class Mail
®
if enclosures received are not as listed above, kindly notify at once.
UPS Next Day l AM
❑
Thank you.
UPS Next 2nd Day
❑
Federal Express
❑
1-4-22
Faxed
❑
By Ryan Joyner Date
Hand Delivered
❑
[e-mail]
Pick Up
❑
Received By Date
cc: File