WQ0044466 Application 06022023

Q,WR
State of North Carolina
Department of Cnvit-onmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 06-21 & SUPPORTING DOCUMENTATION
tl1
Application Number:
(to be completed by DWR)
All items must be completed or the a p fliention will be returned
1. APPLICANT INFORMATION:
Applicant's name: Two Farms, Inc. (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual
® Corporation ❑ General Partnership
❑ Federal
❑ State/County ❑ Municipal
3. Signature authority's name: Chris Bollino per 15A 1NCA-C. 02T_,01044)
Title: Delegated Agent
4. Applicant's mailing address: 3611 Roland Ave.
City: Baltimore State: MD
Zip: 21211
5. Applicanl's contact information:
Phone number: [phone]
Email Address: [e-mail]
If. PROJECT INFORMATION:
JUN -2 20?3
Raleigh Regional 0#ficf
❑ Privalely-Owned Public Utility
❑ Other
I. Project name: Royal Farms Store,#537
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ00. and issued date: ,
For modifications, also attach a detailed narrative description as described in Item G of the checklist.
If new construction, but part of a master plan, provide the existing permit number: WQOO
3. County where project is located: Wilson
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.7620711 Longitude:-77996333'
5. Parcel ID (if applicable); 2793723965.01 (or Parcel ID to closest downstream sewer)
Ili. CONSULTANT INFORMATION:
I. Professional Engineer: J. Dantzler Wilhers, P.E. License Number:38746
Firm: Ark Consulting Group, PLLC,
Mailing address: 2755-B Charles Blvd.
City: Greenville State: NC Zip: 27858-
Phone number: [phone] Email Address: danA ithers rrarkconsultinggroup.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Homine Creek Water Reclamation Facility Permit Number: NC 0023906
Owner Name: City of Wllson
V. RECEIVING DOWNSTREAM SEINER INFORMATION:
1. Permit Number(s): WQ Unknown
2. Downstream (Receiving) ScAver Information: 12 inch ® Gravity O Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00021
Owner Name(s): Cily of Wilson
FORM: FTA 06-21 Page I 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 ®N/A
2. If the Applicant is a Developer of lots lobe sold, has a Lkvcloper's OPeraliona) Agreemerxt (FORM; DEV I been attached?
[:]Yes ❑ No ® NIA
3. If the Applicant is a Home/Properly Owners' Association, has an f IQA/POA QD ratioal AgNen,etit F � � and
supplementary documentation as required by 15A NCAC 02T.0115(c) been attached? n
❑ Yes ❑ No ® N/A
4. Origin of wastewater: (cheek all that apply):
❑ Residential (Individually Owned) ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential (Leased) ® Retail with food preparatiori/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 100 % Commercial _ % Industrial (See 15A NCAC 02T _0102())
If Industrial, is there a Pretreatment Program in effect? ❑ Yes❑ No
6. Has a flow reduction been approved under jA_NCAC.0ZT ,01 L4LO? ❑ Yes ® No
➢ If es provide a copy of flow reduction a m roval letter with this Apiffleation
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(t))
Daily Design Flow'-b
No. of Units
Flow
Restaurant, carry out only
50 gal/100 sq fi floor space
52
2600
Service stations, gas stations
250 gal/plumbing fixture
6
1500
Total
4100 GPD
a See j, A.NC .Q T QI 14fb). (d). f<e aFtd (gj(2) for caveats to wastewater design flow rates (i.e„ minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S..42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table t 5A NCAC 02T.0 i_i4j shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
Wastewater generated by project: 4100 GPD (per 15A NC_A(:" 0'Tj'' .Q 114)
➢ Do not include fixture flows or previously permitted a[localions
If permitted flow is zero, please Indicate why:
❑ Pump Slation/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 timefranic for permitting upstream sewers with flow.
❑ Flow has already been allocated in Permit Number: __ Issuance Date:
❑ Rehabilitation or replacement of existing severs with no new flow expected
❑ Other (Explain): _ _ _
FORM: FTA O6-21 Page 2 of 5

VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 021.0305 & M Dt-C' Gravit Sewers
I. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
D Section 11 & Ill of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirements is not allowed and a violation of the MDC
Vlll. PUMP STATION DESIGN CRITERIA (if Applicable) — 2T.0305 & MDC (Puma Stet( n- rct Malnsl:
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: Royal Farms #537
2. Approaimale Coordinates (Decimal Degrees): Lalitude: 35.76400 Longitude:-77.99200
3. Tolal number of pumps at the pump station: 2
3. Design flow of the pump station: 0.1152 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): 80 gallons per minute (GPM) at .l8 feel total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station);
Size (inches)
Length (feet)
Material
3
240
PVC
--E
I f 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 1 SA NC.AC 02T .03051h:
❑ Standby power source or ❑ Standby punmp
➢ Must have automatic activationm and iclenietry - 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 fneility 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)(I)(C):
® Portable power source with mammal activation, quick -connection receptacle and telemetry -
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry:
➢ Include documental ion that the portable source is owned or Conlracted by the applicant and is compatible with the station.
D If lime 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 powersource or pump, including travel tiniefranies, shall be provided
as part of this permit application in the case of a multiple station power outage.
FORM: I -TA 06-21 Page 3 of 5

IX.
SETBACKS & SEPARATIONS - (0213.0200 & 15A NCAC 021' .0305(f));
1. Does the project comply with all separations/alternolives found in UA NCAC 02T .43D5tf1 &. W? ® Yes [-]No
15A NCAC 02T.0305(f) contains minimum separations that shall be urovided for sewer systems:
Setback Parameter* _
Storm sewers and other utilities not listed below (vertical)
'Water mains (vertical - water over sewer preferred, including in benched trenches)
Separation Required
18 inches
18 inches
10 feet
'Water mains (horizontal)
Reclaimed water lines (vertical - reclaimed over sewer)
18 inches
Reclaimed water lines (horizontal - reclaimed over sewer)
2 feet
100 feet
50 feet
**Any private or public water supply source, including any wells, WS-I waters of Class I or
Class I I impounded reservoirs used as a source of drinking water, and associated wetlands.
"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)
**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
5 feet _
10 feet
Any building foundation (horizontal)
Any basement (horizontal)
Top slope of embankment or cuts of 2 feet or more vertical height
10 feel
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade (vertical) 36 inches
➢ If noncompliance with UZT.0305(1) or f rtl, see Section X.1 of this application
*15A NCAC 021,030�(g) contains alternatives where separations in U O3D M 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 War i#jcatgets wtbuartc
2. Does this project comply with the minimum separation requirements for water mains? ®Yes ❑ No ❑ N/A
➢ 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 ® NIA
➢ Please provide supplementary information identifying the areas of non-conformance.
➢ See the Division's draft separation tMfrem ma for situations where separation cannot be met.
➢ No variance is required if the alternative design criteria specified is utilized in design and construction.
4. Is the project located in a river basin subject to any State buffer rules? ® Yes Basin name: Neuse ❑ No
If yes, does the project comply with setbacks found in flue river basin rules per 15A NCA 02L3. 01 ? ® Yes ❑ No
➢ This includes Trout Buffered Streams per I A NCAC 213.0202
5. Does the project require coverage/at (horization 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 I5A NCAC 021."0 t 05(c)(6) (additional permits/cerlifrcations)? ® Yes ❑ No
Per 15A NCAC 02T.0105tc1t61, 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 perm its (erosion
and sedimentation control plans, stornwaler 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 slreambanks that are subject to erosion that undermines or deteriorates the sewer.
Siphons And sewers suspended through hiterference/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 pernrittee or its representative at least once every six -months and
inspections documented per 15A NCAC 021'.0403(a)(5) or the pernilitee's individual System -wide Collection permit.
rORM: FTA 06-21 Page 4 of 5

X. CERTIFICATIONS:
1. Does the subutitted system comply with 15A NCAC 02"I', the p�linimum-13csign Criteria for the 11crmildlis of 111111111 Stations
and Force Mains (latest version), and lite Ciravi(y Sewer Minimum Design Criteria latest version as applicable?
® Yes ❑ No
If no, for projects requiring a single variance, complete and submit lite Variance/Ailernalive Design Request application
(VADC 10-14) and supporting documents for roview to the Central Office. Anuroval of the renuesl will be Issued
Concurrently with the approval of the Ierutit and pro eats re. uirin a variance n 1 rroval way be subject to longer
review blues. For proiecis reatilr111e two or nloeevariareeg 41. Where ilia vnelance is detcr,nined by the Division to be a
dianiflcant portion of (lie ni•oleel, (lie full technical review Is required.
2. 11rofossional Engineer's Certification:
I, J. Daritzler Withers, PE , attest flint this application for Royal Farms Store 11537
(Professional Migincer's name from Application Item Ill. I.) (Project Name mom APIAicalion 11em Il. 1)
has been revlewcd by me and Is accurate, complete nail consistent with (Ise information supplied In the plats,
specifientions, engineering calculntions, and nil other supporting doctmnculaflon to lite best of my knowledge. I farther
attest flint to (he best of my knowledge the proposed design has been prepared in accordance Willi the applicable regulations,
Mininitlm Design Criteria for Gravity Sewers (latest version), and (he Mininwin Design Criteria for ilia Fast -Track Permittine
of Pump Stations and Force Mains (latest version). Although other professionals inay have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies flint I have reviewed this material and
have judged it to be consistent With the proposed design.
NUM -- 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 spay
include a fine not to exceed $10,000, ns well as civil penalties tip to $25,000 per violation. Misrepresentation of Ilia application
information, including failure to disclose any design non-compliance Willi the applicable Rulcs and design criteria, may subject
the North Carolina -licensed Professional Engineer to referral to Ilia licensing board. (21 NCAC 56.0701)
North Carolina Professionni Engineer's sent, signature, nil(] dnte:
3. Applicaul's Cerlificnlion per 15A NCAC 02'r .010G(b):
I, Chris Bollino, Delegated Agent , attest flnat this application for Two Farms, Inc.
(Signature Aullrorily Name from Application Item 1.3.) (Project Name from Application Itcm If. 1)
attest flint (Ills application has been reviewed by tine and is necm•nte and complete to lite best of my knowledge.
1 understand tinat if all required parts of this application are not completed and flint if all required supporting (loctamenlation
and attachments are not included, this application package is subject to being returned as incomplete. I understand flint any
discharge of wastewater from this non -discharge. system to surface waters or ilia land will restill in nil immediate enforcement
action that may include civil penalties, injunctive relief, and/or criminal prosecution. I will npnke no claim against the Division
of Water Resources should a condition of this permit be violated. I also understand flint if all required parts of tills application
package are not completed and flint if all required supporting information and attachments are not included, this application
package Will be returned to nne as incomplete.
NOTE -- In accordance Willi General Slatutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, represetit r cc ie , tification in any application package shall be guilty of a Class 2 misdenneanor, which cony
include a fine at�exceed $10,000 as well as civil penalties tip to $25,000 per violation.
Signnitlt
I-ORM: FTA 06- Page. 5 of 5

?r; J.,kf-
State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources INSTRUCTIONS FOR FORM: FTA 06-21 & SUPPORTING DOCUMENTATION
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 nreels the requirements of 15A NCAC 02T and Ibe Division's
Minimum Design Criteria (Gravi Sgwcr & PLk.Mp ignslForce Main&) and that pinns, specifications and supporting documents
have been prepared in nccordance with 15A NCAC 02T, I �A NCAC.' 02T .0300. Division policies, and good gngineering practices.
While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02T .0305(b), design
documents nest 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 LSA MCA T ,030i and the applicable minimum design criteria. These
documents shall be imnredintely 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 fill[ technical review):
➢ Projects that do not meet any part of the minimum design criteria (MDC) documents;
➢ Projects that involve more than one variance from the requirements of 15A NCAC 02T;
➢ Pressure sewer systems utilizing simplex septic lank -effluent pumps (STEPS) or simplex grinder pumps;
➢ Simplex 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 Ibe 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
(line, 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 (secant] copy may be digital) of Application and Supporting Documents
® Required unless otherwise noted. Signatures on original must be "wet ink" or secure digital signatures.
Please do not submit engineering design plans with the application unless specifically requested.
B. Cover Letter/Narrative Description (Required for All Applicatlon Pacicnges):
® 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.
➢ Include the permit number/status of any other required sewer permits (dovnstreanr/tipstreanr)
➢ If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Modification Application Pnekages):
® Submit it check or money order in the amount of $480.00, dated no more than 90 days prior to application submittal.
➢ Payable to North Carolina Department of Environmental Quality (NCDEQ)
D. Fast Track Application (Required for All Application Packages, Form FI'A 06-21):
® 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 1.2 is a corporation or company, provide documentation it is registered for business with lite
Norlh Carolina 5rcrdaU of Slatc.
❑ If the Applicant Type in Item 1.2 is a partnership or d/b/a, enclose a copy of file certificate filed with the Register of Deeds ill
the county of business.
❑ The Project Name in Item 11.1 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, seated and dated by a Nonlr Catalina
licensed Professional _ r1&inter.
® The Applicant's Certification on Page 5 of the application shall be signed in accordance with a3.&NC`AC OZ7' ,0106tb t. Per
15A NCAC 021' .0106(c), an alternate person may be designated as fire signing official if a delegation letter is provided front
a person who nnects the criteria in 15A NCAC 02T .010G(b).
INSTRUCTIONS FOR CORM: PTA 06-21 & SUPPORTING DOCUMENTATION Page I of 3

E. Flow Tracking/Acceptance form (norm: FTSE 04-16) (if Applicable):
IR Submif the completed and executed FTSE form from the owners of file downstream sewers and treatmcnt 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 Icss 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_5. 143-2 l 5.6 7ta}_
➢ Intergovernmental agreements or other contracts will not be accepted in licit of a project -specific FTSE.
I-. Site Maps (Ali Application Pacicnges):
® Submit an 8.5-inch x 1 I -inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project area,
including the closest surface wafers.
D General location of the project components (gravity sewer, pump stations, & force main)
D Downstream connection points and permit number (ifknown) for the receiving sewer
® Include an aerial location map showing general project area (such as street names or latitude/longitude) so that Division staff
can easily locate it in the field.
G. Existing Permit (Application Packages for Modif entions to an Existing Permit):
❑ Submit a copy of 1he most recently issued existing permit.
❑ Include a descriptive and clear narrative identifying the previously permitted items to remain in the permit, items to be
added, and/or items to be modified (the application form itself should include only include items to be added/modified). The
narrative should also include whether any previously permitted items have been certified.
❑ The narrative should clearly identify the requested permitting action and accurately describe the sewers to be listed in
file final permit.
FF. Power Relinbility Plan (Required if portable reliability option utilized for Pump Station):
❑ Per 15A NCAC 02T .0305(h LU, submit documentation of power reliability for pumping stations.
D This alternative is only available for average daily flows less than 15,000 gallons per day
D 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 I5A 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."
D If file portable power source or pump is dedicnied to multiple pump stations, an evaluation of all tine pump stations'
storage capacities and file rotation schedule of fire portable power source or pump, Including travel tiniefrannes, shall
be provided in the case of a multiple station power outage. (Required at time of certification)
Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per 15A NCAC Js&) LJU (J provide the Certificate of Public Convenience and Necessity from the North Carulil►a l3tihiirs
('QWrnissipn 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 mmi si _q's Water and 5ewtr Division Public: SnatT 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 NOA/POA and Developers for lots to be sold):
❑ Honne/Properly Owners' Associations
❑ Per Sri NCAC.Q2TaQ 111W, submit the properly executed OpgE9knal Agreemem (FORM: MA).
❑ 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 I5A NCAC 02T _0115fb), submit the properly executed Operational Agretnnent (FORM; U£Y�
For more information, vish file Division's collection sjulems irebsire
INSTRUCTIONS FOR FORM: FTA 05-21 & SUPPORTING DOCUMENTATION Page 2 of 3

THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD DE 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 28778-8211
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 28301-5095
Montgomery, Moore, Robeson, Richmond,
[phone]
Sampson, Scotland
[phone] Fax
Ngowsy111e Regional Office
610 E. Center Avenue
Alexander, Cabarrus, Catawba, Cleveland,
Wa r u 11 Section
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone]
Slanly, Union
[phone] Fax
Raleigh Regional Office
3800 Barrett Drive
Chatham, Durham, Edgecombe, Franklin,
Water Quality Section
Raleigh, North Carolina 27609
Granville, Halifax, Johnston, Lee, Nash,
[phone]
Northampton, Orange, Person, Vance, Wake,
[phone] Fax
943 Washington Square Mail
Warren, Wilson
Beaufort, Bertie, Camden, Chowan, Craven,
02glonal Office
Water Quality Sectlon
Washington, North Carolina 27889
Currituck, Dare, Gates, Greene, Hertford, Hyde,
[phone]
Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wliminaton Regional Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus, Duplin, New
Water Quality Section
Wilmington, North Carolina 28405
Hanover, Onslow, Pander
[phone]
[phone] Fax
ffinsion:§gIgM Regional Offic
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]
[phone] Fax
INSTRUCTIONS FOR FORM: PTA 05-21 & SUPPORTING DOCUMENTATION Page 3 of

NC Dept of Fnvironmental Quality State of North Carolina
,r
Department of Environmental Quality
Division of Water Resources
llivi4rcr, n! 11l.tE,, ltotie„rrc i f Ufa — 2 2023 Flow Tracking for Server Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Two Farms Inc.
Project Name for which flow is being requested: Royal Farms Store #537
Afore than one FTSE r►ray be requiredfar a single prolect jrhe owner of the WWTP Is not responsiblefor all puurp
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: Hominy Creek Water Reclamation Facility
b. WWTP Facility Permit #: NCO023906
All flows are in MGD
c. WWTP facility's permitted flow 14.00
d. Estimated obligated flow not yet tributary to the WWTP 0.501
e. WWTP facility's actual avg. flow 7.27
f. Total flow for this specific request 0.0041
g. Total actual and obligated flows to the facility 7.7751
h. Percent of permitted flow used 55.53
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 Daily Current Not Yet Current Flow
Pump Station Station Firm Flow** Avg. Daily Tributary Phis
(Name or Permit Capacity, * (Firm / pf), Flow, Daily Flow, Obligated Available
Number) No. MGD MGD MGD MGD Flow Capacity***
Finch 0.576 0.230 0.0964 0.012 0.109 0.093
Contentnea #36001 4.320 1.728 0.94 0.248 1.1879 0.540
Southside 6.264 2.506 1.52 0.248 1.7693 0.736
* 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 It pealdng 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
behveen the project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): City of Wilson
Downstream Permit Number: W CS00021
Page 1 of 6
FTSE 10-18

Ill. Certification Statement:
I Kyle P. Mannin& PE _ _ certify to the best of my knowledge that the addition of
the volume of wastewater to be permitted in this project has been evaluated along the route to the receiving
wastewater treatment facility and that the flow from this project is not anticipated to cause any capacity
related sanitary sewer overflows or overburden any downstream pump station en route to the receiving
treatment plant under normal circumstances, given the implementation of the planned improvements
identified in the planning assessment where applicable. This analysis has been performed in accordance
with local established policies and procedures using the best available data. This certification applies to
those items listed above in Sections I and II plus all attached planning assessment addendums for which I
am the responsible party. Signature of this form certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
Signing Official Signalin-e bare
V�0%ems
Title of Signing Official
Page 2 of G
vrSE 10-18

f ,r a 1n % OUICO. UWS FORHS FA05 FEES NEWS d EVENTS •130U1 COFIA' 1 APPON WWS 51GN IN
NC Dept of Erivi"Onmentai Qualt
a'' Secretary of State
'• ` li. z Elaine ar. Marshall LAN! I West To. Divistans Topics OntM Services P
.ti._t JUN --2 2021
!ir=reury et Saes . v rx+ FI ram . arch . &e u . Sustmil ConNxitan Raleigh Regional Office
FAe an AnMuA Qtiiy a[E i f'�F FjM • Ordel a [kgvr mt ON,rsC • Q
to .fir ma r flE ar A.tf1 • 6 ng§ ' Print a Prc:NIA01W Annual Re op�r ! rq_m �rtM �n
amended a Annual Rem Business Registration
Business Corporation
1.0991 Name
Two Farms Mc
Information
SOV& 2314521
Status Currenl.Active G
Date Formed imrm i
CMZenship Foreign
State of bveorporation: MD
Flscat Vicath Decen tm
Awwal R rt Due Date Apni ISM
Annual Report Status: Conent
Registered Agent- A ' ed Jnc
Addresses
Reg Office
176 Mine Lake Court Ste I DO
Raleigh PIC 27615
Reg Mailing
176 Mine Lake Court. Ste 1 Jv
Ra►ergh NC .17615
Mailing
U I I Roland Ave
Bamniore Lit') -21211-2406
Principal, Office
M I I Roland Ave
Sa4idno1e MD 21241-2.108
Searches +
Links +
Online Filing

ccrrlarynf Stolr
i+wfK.' 1N.'1hiJ
Contact
Nofftj cmuhnd riCifelay Of SIAL
2 SOuM S&Sbury 5l
Reklgh NG:17WI ?90"
919-814'5400
Hours of Operation
M1=slwam-,500Wtl
"Off* 1 want 70. - a4YISAms - Topics - OFAMO Services u
Links of Interest
&- SAY
Lh.q.mf 1jmqalq of-tle+r
Plmh "iohna.t}w t�71 #s !L) l
llufth Cm via [?q;r;Rminl OI47cntmme
Follow Us
(j)
OV
Y+wTJ.r
�% i h.I�G 6n
�SJF{.P.d
Data Provided Via SOSKB

CONSULTING
GROUP, PLLC
To:
NCDEQ - Div. of Water Resources
Water Quality Regional Operations Section
3800 Barrett Drive
Raleigh, NC 27609
NC Debt of bivironmental Qu-,11W,'
TRANSMITTAL LETTER
Ralelg.h Regional Office
DATE: PROJECT NO.
June 1, 2023 21094
ATTENTION:
SUBJECT:
Royal Farms #537
Fast Track Application - Sanitary Sewer Main
City of Wilson, Wilson County, North Carolina
WE ARE SENDING YOU:
® Attached ❑ Under Separate Cover Via: [Type text here] the following items:
❑ Copy of Letter ❑ Plans ❑ Specifications ® Other:
❑ Shop Drawings ❑ Prints ® Permits
❑ Change Order ❑ Reproducible ❑ Samples
COPIES
1
2
2
2
2
2
1
DATE
DWG. #
DESCRIPTION
Cover Letter for Fast Track Applications (Public and Private)
Fast -Track Permit Application - (Public and Private)
Documentation of Corporation Registration with Secretary of Stat
Flow Tracking /Acceptance Form (Public and Private)
USGS Topo Quad Site Map (Public and Private)
Street Level Map (Public and Private)
Application Fees ($480.00 for Public and Private)
5/30/2023
5/30/2023
5/30/2023
6/1/2023
e (Private)
THESE ITEMS ARE TRANSMITTED AS CHECKED BELOW:
®
For Approval
❑
Approved as Submitted
I ❑
Submit copies for approval
❑
For Your Use
❑
Approved as Noted
I ❑
Submit copies for distribution
❑
As Requested
❑
Returned for Corrections
❑
Return corrected prints
®
For Review & Comment
❑
Disapproved
❑
Other:
COMMENTS:
You can reach me at 252.646.2257 or dan.withersdparkconsultinmgrouo.com. Thank youl
COPY T0:
DCwV W itW.rk, P.E.
Signature

NC Dept of Environmental Quality
CONSULTING
GROUP, PLLC
May 30, 2023
Division of Water Resources — Water Quality Section
Raleigh Regional Office
1628 Mail Service Center
Raleigh, NC 27699-1628
Subject: Fast -Track Application
Royal Farms Store #537
City of Wilson, Wilson County, North Carolina
Dear Water Quality Section Staff:
JUN - 2 2023
On behalf of Two Farms, Inc., we respectfully submit a Fast -Track Application for Royal Farms #537 project located on the
northeast corner of Raleigh Road Parkway West and Bloomery Road in the City of Wilson, Wilson County, North Carolina.
The proposed project consists of constructing a new gas station and convenience store. This application consists of
approximately 240 LF of 3" PVC force main sewer from a private pump station to a new 4" force main in the right of way
of Bloomery Road. The 4" force main and downstream tie-in to the existing City of Wilson gravity sewer system is being
permitted under a separate application. The new main and pump station proposed by the application will be owned and
maintained by the developer, Two Farms, Inc. As calculated using 15A NCAC 2T .0114, the new flow generated by the
proposed project is 4100 gpd:
• 5200 SF at 50 gal/100 SF floor space
• 6 service station plumbing fixtures at 250 gal/plumbing fixture
Enclosed for your use is the application fee in the amount of $480.00 for the private permit along with one original and
one copy of the documents listed below:
• Fast -Track Application for Gravity Sewers, Pump Stations and Force Mains (FTA 06-21 and FTSE 10-18)
• USGS Topo Quad Site Map
• Street Level Map
• Documentation of Corporation Registration with the Secretary of State
Thank you for your assistance with this project. Should you have any questions or require additional information, please
do not hesitate to contact our office.
Respectfully submitted,
Ark Consulting Group, PLLC
Dan Withers, P.E.
Project Manager
PHONE WEB

F THE INTE
1,0 USGS U.S. DEPARTMENT
U.S. GEOLOGICAL SURVEY RIOR
iciancslbrachaoyiay world
G
a
11'rlltc:lrs �
A7i!llinitd�
-uF
iEF
_� of
w
MN .
1
GN
Ya'
iT7 ML!
rn
]I NIL6
111N �i0.1e W6]p19 NAp6Er{ rW0.TN
OFRINATWNAT CEMTFfl OF r�YFT
S item
I: 500 1000 2000
Fed
1 19M
comroYr WONAL rarm
wpm. Nlneu.l n.rlul wwaE nu
m....r.,..w— r.mu e. r.rw
IM.e•u F- I��y. N lgp..eMll SINK. 1011
•weuCN. fk —l.na.xn[M ryNlsnsrl .•Iw+O.r!
WINSTEAD CROSSROADS QUADRANGLE
NORTH CAROLINA
7.5-MINUTE SERIES
f
Av1ASlotN
9L
-vI
Wilson
Industrial
Air Center
LV
9,ye�0
`�tR• ISM 0 0 ->r
Alt
6
WINSTEAD CROSSROADS, NG
2019
Project Mgr JDW Project No. 21094 NC Umnu: P-1199 SITE LOCATION PLAN EXHIBIT
Drawn By MJ Scale ASSS.M AD CONSULTING
Checked By �Ow Date GROUP.P«C ROYAL FARMS Store #537
osro2r22 USGS QUAD MAP
Engineers B Planners
2755.8 Charles Blvd. I Greenville NC 27858 CITY OF 1MLSON, LMLSON COUNTY, NORTH GAROLINA
�tc
4-