WQ0044646_Application (FTSE)_20230711

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McDAVIDAsSOCUTES, INC.
CORPORATE OFFICE
Engineers • Planners • Land Surveyors
[phone] • Fax [phone]
E-maih [e-mail]
3714 N. Main Sweet • P.O. Drawer 49
FarmAlle, NC 27828
June 2, 2023
Robert Tankard
Assistant Regional Supervisor
Washington Regional Office
Division of Water Resources
NC Department of Environmental Quality
GOLDSBORO OFFICE
Engineer" • Planners
[phone] • Fax [phone]
E-maih [e-mail]
109 E. Walnut Street • P.O. Box 1776
Goldsboro, NC 27533
RECWW/NCDENR/DWR
JUL 112023
943 Washington Square Mall Water quality
Washington, North Carolina 27889 Regional operations Section
Washington Regional Office
Subject: Fast Track Application
2023 Sewer System Improvements
CN 295 — Wawa Water and Sewer
Fork Township Sanitary District
Wayne County, NC
Dear Mr. Tankard:
A proposed convenience store development requires the extension of an 12" gravity sewer across
the development's frontage.
The property is currently used for a single residential dwelling with on -site septic. The developer plans
to construct a,5,915 SF convenience store with food preparation.
Projected daily sewer flow from the site based on 2T rules will be 3,549 gallons — 60 gallons/100 SF
for a convenience store with food preparation @ 5,915 SF= 3,549 gpd.
Please find attached the following items supporting this application:
1. Fast -Track Application (FTA 06-21) (one original and one copy)
2. Check in the amount of $480.00 from Goldsboro (Hwy 70) WW, LLC (Check No. 111,
dated 01 /23 /23 )
3. Flow Tracking/Acceptance for Sewer Applications Form (FTSE 10-18) completed by
Fork Township Sanitary District to address their downstream pump station
4. Flow Tracking/Acceptance for Sewer Applications Form (FTSD 10-18) completed by the
City of Goldsboro to address their downstream pump stations and their acceptance of the
flow at the WWTP
5. USGS Topographic Map
6. Aerial View
\\G-Gi10S\D1005\DEG\2023 1 230602
FTSD-CM295-Wawa water and Sewer-FTA-LTRdocx

Please process the Fast Track Application as soon as possible. Should you have any questions, do
not hesitate to call me.
Sincerely,
McDAVID ASSOCIATES, INC.
David E. Gurley, III, P.E.
Goldsboro Office
DEG: ]nb
Attachments
cc: FTSD (w/attach)
\\G-G10S\D 100 sDEG\20?3
FrSD-CN295-Wawa Water and Sewer-FTA-LTRdocx
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2

State of North Carolina
WD004H(04(o
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
DIv noW of Water Resources FTA 06-21 & SUPPORTING DOCUMENTATION
Application Number:
(to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Fork Township Sanitary District (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: Henry Braswell per 15A NCAC 02T .0106(b)
Title: Chairman
4. Applicant's mailing address: P.O. Box 1515
City: Goldsboro State: NC Zip: 27530
5. Applicant's contact information:
Phone number: [phone] Email Address: ftsd(iDbellsouth.net
II. PROJECT INFORMATION:
1. Project name: 2023 Sanitary Sewer Improvements CN 295- Wawa Water and Sewer
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: WQ00
3. County where project is located: Wayne /
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.4279' Longitude:-78.0642' V/
5. Parcel ID (if applicable): 2671815879 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION: 1/1
1. Professional Engineer: David E. Gurley, III License Number: 22956
Firm: McDavid Associates, Inc.
Mailing address: P.O. Box 1776
City: Goldsboro State: N.C. Zip: 27533-1776
Phone number: 919 136-7630 Email Address: deg(a7,mcda) vid-inc,com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Goldsboro WWTP Permit Number: 0023949
Owner Name: City of Goldsboro
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): Unknown
2. Downstream (Receiving) Sewer Information: 12 inch ® Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s): Fork Township Sanitary District
FORM: FTA 06-21 Page 1 of 5

VL 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 HOA/POA Operational Agreement (FORM: HOA) and
supplementary documentation as required by 15A NCAC 02T.0115(c) been attached?
❑ Yes ❑ No ® N/A
4. Origin of wastewater: (check all that apply):
❑ Residential (Individually Owned) ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential (Leased) ® Retail with food preparation/service ❑ Hotel and/or Motels
❑ School / preschool / day care ❑ Medical / dental / veterinary facilities ❑ Swimming Pool/Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: % Domestic 100 % Commercial % Industrial (See 15A NCAC 02T .0103(20))
If Industrial, 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 with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow 10
No. of Units
Flow
Convenience Store w/ food prep
60 gal/100 SF
5,915 SF
3,549 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
3,549 GPD
a See 15A NCAC 02T .0114(b), (d), (e)(l) 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 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: GPD (per 15A NCAC 02T .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):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
12
838
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 requirements is not allowed and a violation of the MDC
VM. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: N/A
2. Approximate Coordinates (Decimal Degrees): Latitude: °
3. Total number of pumps at the pump station:
Longitude: - °
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 2.01C.Lb. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1):
❑ Standby power source or ❑ Standby pump
➢ Must have automatic activation and telemetry - 15A NCAC 02T.0305(hxl)(B)_
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility and may not be portable
Or if the pump station has an average daily flow less than 15,000 gallons per day 15A NCACO2T.0305(h)(1)(C):
❑ Portable power source with manual activation, quick -connection receptacle and telemetry -
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry:
➢ Include documentation that the portable source is owned or contracted by the applicant and is compatible with the station.
➢ If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided
as part of this permit application in the case of a multiple station power outage.
FORM: FTA 06-21 Page 3 of 5

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13L SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(i)):
1. Does the project comply with all separations/alternatives found in 15A NCAC A&D O ? ® Yes ❑ No
15A NCAC 02T.0305(fl contains minimum separations that shall be provided for sewer systems:
Setback Parameter*
ration Required
Storm sewers and other utilities not listed below (vertical)
18 inches
'Water mains (vertical - water over sewer preferred, including in benched trenches)
18 inches
2Water mains (horizontal)
10 feet
Reclaimed water lines (vertical - reclaimed over sewer)
18 inches
Reclaimed water lines (horizontal - reclaimed over sewer)
2 feet
**Any private or public water supply source, including any wells, WS-I waters of Class I or
Class II impounded reservoirs used as a source of drinking water, and associated wetlands.
100 f9
**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 DX.2)
w
50 !ley
**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 f
Any building foundation (horizontal)
5 f
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 f or (g,). see Section X.1 of this application
*15A NCAC 02T.0305(tt) contains alternatives where separations in 02T.005(fl cannot be achieved Please check `yes"
above if these alternatives are used and provide narrative information to explain.
**Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
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 ®N/A
➢ Please provide supplementary information identifying the areas of non-conformance.
➢ See the Division's draft separation requirements 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 the river basin rules per 15A NCAC 02B .0200? ® Yes ❑ No
➢ This includes Trout Buffered Streams per 15A NCAC 213.0202
5. Does the project require coveragelauthorization 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 NCAC 02T.0105(c)( (additional permits/certifications)? ®Yes ❑ No
Per 15A NCAC 02T.0105(c)(6), directly related environmental permits or certification applications must be being prepared,
have been applied for, or have been obtained Issuance of this permit is contingent on issuance of dependent permits (erosion
and sedimentation control plans, stormwater management plans, etc.).
7. Does this project include any sewer collection lines that are deemed "high -priority?" ❑ Yes ® No
Per 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 permtttee' 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-Wi0e Collection permit.
FORM: FTA 06-21 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, for projects requiring a single variance, complete and submit the Variance/Alterriative 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 projects requiring a variance approval may be subject to loneer
review times. For projects requiring two or more variances or where the variance is determined by the Division to be a
significant portion of the project, the full technical review is required.
2. Professional Engineer's Certification:
I, David E, CTurley, III , attest that this application for CN 295- Wawa Water and Sewer
(Professional Engineer's name from Application Item 111.1.) (Project Name from Application Item II.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,
Minimum Desi," 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 143-215.6B, 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. Misrepresentation of the application
information, including failure to disclose any design non-compliance with the applica u sand design criteria, may subject
the North Carolina -licensed Professional Engineer to referral to the licensing boar AC 56.0701)
North Carolina Professional Engineer's seal, signature, and da \� 1 C A R//
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3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, Henry Braswell attest that this application for CN 295- Wawa Water and Sewer
(Signature Authority Name from Application Item 1.3.) (Project Name from Application Item I1.1)
attest that this application has been reviewed by me and is accurate and complete to the beat 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 infortnation 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.
Date: June 2 2023
FORM: FTA 06-21 Page 5 of 5

State of North Carolina
Department of Environmental Quality
Division of Water Resources
fDivlslon of Waster Resources Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Fork Township Sanitary District
Project Name for which flow is being requested: CN295 - WaWa Water and Sewer
More than one FISE 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.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name:: Goldsboro Wastewater Plant
b. WWTP Facility Permit #: NC0023949
All flows are in MGD
c. WWTP facility's permitted flow 14.20000.
d. Estimated obligated flow not yet tributary to the WWTP 0.37742
e. WWTP facility's actual avg. flow ' 7.62333
f. Total flow for this specific request 0.00355
g. Total actual and obligated flows to the facility 8.00430
h. Percent of permitted flow used 56.37.
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,
Average Daily Approx. Not Yet
Total Current
Pump Station Firm Flow* * Current Avg. Tributary
Flow Plus
(Name or Capacity, * (Firm / p fl, Daily Flow, Daily Flow,
Obligated
Available
Number) MGD MGD MGD MGD
Flow
Capacity***
LittleCherry 0.65 0.26 0.123 0.C43.
0.165.
0.095
Big Cherry. 1.0. 0.40 .0.130. 0.043..
0.172
0.228 . -
HWX 117 T I 2.84 0.809 0.205.
.1.014.
1.826
Westbrook .. 40.0 16.00 6.060 _ _ . 0.381
6.441
., 9.559
* 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 be attached for each pump station located
between the project connection point and the WVVTP where the Available. Capacity is < 0.
Downstream Facility Name (Sewer): City.of Goldsboro.
Downstream Permit Number: NC0023949 'JUL 112023
Water Quawy
Page 1 of 6 Regional
FTSE May"

III. Certification` Statement:
I 'r/�it y M • ��.�.� 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 indicates acceptance of this wastewater flow.
Signing ciaFSignature
.� E 1
Date
Page 2 of 6
FTSE 044 6

DIvlsIon of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Fork Township Sanitary District
Project Name for which flow is being requested: CN295- Wawa Water and Sewer
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposed 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 #:
All flows are in MGD
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
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) (DrB+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 / p fl, Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow, MGD MGD Flow Capacity* * *
PS #1 0.460 0.184 0.021 0.00 0.021 0.163
PS #2 0.576 0.230 0.033 0.00 0.033 0.197
* 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 static located
between the project connection point and the WWTP where the Available Capacity i /NGM"WR
Downstream Facility Name (Sewer): Fork Township Sanitary District
Downstream Permit Number: WQ0031074 QUL 112023
water aw ty
SegkxW operatons Secthn
Page 1 of 6 Washington Regional 0M66
FTSE 10-18

III. Certification Statement:
I Henry Braswell 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.
Official
of Signing
Date
3
Page 2 of 6

Average Yearly Flow for:
Jan.2022
Feb.2022
M a r.2022
Apr.2022
M ay2022
Jun2022
Ju12022
Aug2022
Sept2022
oct2O22
Nov2022
Dec2022
City of Goldsboro, NCO023949
Permitted Flow:
9.1519355
9.3242857
8.6309677
7.8643333
7.5725807
6.5576667
7.8490323
7.3709677
7.0516667
M84
6.476
6.6664516
7.625490658 Avg. Flow
2022 % of Permitted Flow:
14.2
0.537006384
(< 80% / 90% OK)

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4 Fork Township Sanitary District
CN 295- Wawa Water and Sewer
USGS Map (Northwest Goldsboro)