WQ0044657_Application (FTSE)_20230928

HILLIARD
ENGINEERING
September 26, 2023
NCDEQ, DWR, Raleigh Regional Office
Water Quality Section
1628 Mail Service Center
Raleigh, NC 27699-1628
Re: 211 S. Currie Drive Sewer Extension
HE#: SF2306
Please find enclosed the following:
1. One (1)-Original and One (1)-Copy of Fast -Track Application and FTSE
2. One (1) -Topo map zoomed into the project area
3. One (1)-Aerial map of the project area
Per email on 9/20/23, please find enclosed the revised forms as requested.
If you have any questions, or require additional information related to the aforementioned
project, please do not hesitate to contact me at this office.
Sincerely,
Jarrod E. Hilliard, PE, CFM
Hilliard Engineering, PLLC
Copy to: File: SF2103
Page 1
P.O. Sox 249, Sanford. NC 27331 NC License No.: P-0836
phone: [phone] [e-mail]

DocuSign Envelope ID: DACC29E5-7C23-4983-A28D-4DD8085DOA53
State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Divlslon 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 meets the requirements of 15A NCAC .Q T and the Division's
Minimum Design Criteria (Gravity Sewer & Pump StationslForce Mains) and that plans, specifications and supporting documents
have been prepared in accordance with 15A NCAC 02T, 15A NCAC 02T.0300. Division policies, and mod 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 plan design
calculations, and project specifications referenced in 15A NCAC 02T .0305 and the applicable minimum design criter-. These
documents shall be immediately available upon request by the Division.
Projects that are deemed permitted (do not require a permit from the Division) are explained in 15A h!CAC 040M3. o
t�
Projects not eligible for review via the fast track process (must be submitted for full technical review):
> Projects that do not meet any part of the minimum design criteria (MDC) documents;' o
> Projects that involve more than one variance from the requirements of 15A NCAC 02T;
> Pressure sewer systems utilizing simplex septic tank -effluent pumps (STEPS) or simplex grinder pumps; � . �Dy�
Simplex STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mains); ✓'y Q'i
> Vacuum sewer systems. Q�
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 (second 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 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.
> Include the permit number.."status of any other required sewer permits (down stream/upstream)
> If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Modification Application Packages):
® Submit a 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 FTA 05-21):
® 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 I.2 is a corporation or company, provide documentation it is registered for business with the
North Carolina Secretkry 9`tate.
❑ 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. l 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 Caroiint@
li ensed Professional Engineer.
® The Applicant's Certification on Page 5 of the application shall be signed in accordance with I SA 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 06-21 & SUPPORTING DOCUMENTATION Pagel of3

DocuSign Envelope ID: DACC29E5-7C23-4983-A28D4DD8085DOA53
E. Flow True ki ng/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 I I -inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project area,
including the closest surface waters.
> General location of the project components (gravity sewer, pump stations, & force main)
> Downstream connection points and permit number (if known) 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.
C. Existing Permit (Application Packages for Modifications to an Existing Permit):
❑ Submit a copy of the 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
the final permit.
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
❑ Per 15A NCAC 02T .0305(hJ(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 .01 15(a)(1 } provide the Certificate of Public Convenience and Necessity from the No rib 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 Sip ff 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/Prone Owners' Associations
❑ Per 15A NCAC 02T .01 15(c), submit the properly executed Operational Agreement (FORM: HOA).
ElPer 15A NCAC 02T .0115(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
❑ Developers of lots to be sold
❑ Per 1 SA NCAC 02T "01 I5(bf_ submit the properly executed terational Agreement F ,4,..DE.V),
For more information, visit the Division's collection systems it
INSTRUCTIONS FOR FORM: FTA 05-21 & SUPPORTING DOCUMENTATION Page 2 of 3

DocuSign Envelope ID DACC29E5-7C23-4983-A28D4DD8085DOA53
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 28778-8211
Clay, Graham, Haywood, Henderson, Jackson,
[phone]
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Favettevillg Reg`ionjl Office
225 Green Street Suite 714
Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quali Section
Fayetteville, North Carolina 28301-5095
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
Raleigh Realonal Office
3800 Barrett Drive
Chatham, Durham, Edgecombe, Franklin,
Water Quailly Section
Raleigh, North Carolina 27609
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,
[phone]
Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wilmington Regional Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus, Duplin, New
Water Quelity, Section
Wilmington, North Carolina 28405
Hanover, Onsiow, 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]
[phone] Fax
INSTRUCTIONS FOR FORM: FTA 05-21 & SUPPORTING DOCUMENTATION Page 3 of 3

DocuSign Envelope ID: DACC29E5-7C23-4983-A28D-4DD8085DOA53
DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 06-21 & SUPPORTING DOCUMENTATION
Application Number:c_ (to be completed by DWR)
All items must be completed or the application will be returned
1. APPLICANT INFORMATION:
1. Applicant's name: City of Sanford (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State/County ® Municipal
3. Signature authority's name: Paul M. Weeks, Jr., PE per I5A NC'AEC Q2T .0106tb)
Title: Utilities and Engineering Director
4. Applicant's mailing address: 225 E. Weathersnoon Street
City: Sanford State: NC Zip: 27331-
5. Applicant's contact information:
Phone number: [phone] Email Address: naul.weeksCg�sanfordnc.net
11. PROJECT INFORMATION:
❑ Privately -Owned Public Utility
❑ Other
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1p�s
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1. Project name: 211 S. Currie Drive Sewer Extension
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: Lee
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.4662 ' Longitude:-79.2064'
5. Parcel ID (if applicable): 9632-84-5693-00 (or Parcel 1D to closest downstream sewer)
Ill. CONSULTANT INFORMATION:
I. Professional Engineer: Jarrod E. Hilliard License Number: 035670
Firm: Hilliard Engineerine, PLLC
Mailing address: PO Box 249
City: Sanford State: NC Zip: 27331-
Phone number: [phone] Email Address: ihilliard(a?,hilliarden ing eering com
1V. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Big Buffalo Waste Water Treatment Plant Permit Number: NCO024147
Owner Name: City of Sanford
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ34106
2, Downstream (Receiving) Sewer Information: 8 inch ® Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00047
Owner Name(s): City of Sanford
FORM: FTA 06-21 Page l of 5

DocuSign Envelope ID: DACC29E5-7C23-4983-A28D-40D8085f)OA53
V1. GENERAL REQUIREMENTS
I . If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑ No ® NlA
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational A reemen�FORM: DEV) been attached?
❑ Yes [-]No ® N.-'A
3. If the Applicant is a Home/Property Owners' Association, has an HOAfPOA,Ogerational Agreement (FORM,; HQAJ and
supplementary documentation as required by 15A NCAC 02T.0115(c) been attached?
❑ Yes ❑ No ® N/A
4. Origin of wastewater: (check at l that apply):
® Residential (Individually Owned) ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential (Leased) ❑ Retail with food preparation/service ❑ Hotel and, -or Motels
❑ School 1 preschool l day care ❑ Medical 1 dental ? veterinary facilities ❑ Swimming PoollClubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses! offices l factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic % Commercial % Industrial (Sec 15A NCAC 02T ,0103( 0))
If Industrial, is there a Pretreatment Program in effect? ❑ Yes❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .0114(f)? ❑ Yes ® No
7 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 e.h
No. of Units
Flow
3-bedroom Residential
120 gal/day/bedroom
4
1,440 GPD
gall
GPD
gale
GPD
gall
GPD
gall
GPD
gall
GPD
Total
1,440 GPD
a See 15A NC, `. 2T M 14(bb). (d), (elf 1) and (ems) 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.0114 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 1,440 GPD (per 15A NCAC 02T .0114)
Do not include future flows or previously permitted allocations
If permitted flow is zero, please indicate why:
❑ Pump StatioWForce 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): T
FORM: FTA 06-21 Page 2 of 5

DocuSign Envelope ID: DACC29E5-7C23-4983-A28D-4DD8085DOA53
VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 52 SDR 26 PVC
➢ Section 11 & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section 111 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
VI ll. 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:
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: -
3. Total number of pumps at the pump station:
3. Design flow of the pump station: millions gallons per day (firm capacity)
➢ This should reflect the total GPM for the pump station with the largest pump out of service.
4. Operational point(s) per pump(s): gallons per minute (GPM) at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
If any portion of the force main is less than 4-inches in diameter, please identify the method of solids reduction per
MDCPSFM Section 2.01 C.I .b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with 1.5.A N('A(:_92T .0305(h)( I ):
❑ Standby power source or ❑ Standby pump
➢ Must have automatic activation and telemetry - 15A NCAC 02T.0305(h)(1)(B)'
7 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

DocuSign Envelope ID: DACC29E5-7C234983-A28D4DD8085DOA53
IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations/alternatives found in 15A NCAC 02T .0305(f1 & (g)? ® 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)
18 inches
'Water mains (vertical - water over sewer preferred, 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-1 waters of Class 1 or
Class 11 impounded reservoirs used as a source of drinking water, and associated wetlands.
100 feet
**Waters classified WS (except WS-1 or WS-V), B, SA, ORW, HQW, or 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.U05(f) qr f �], see Section X.1 of this application
* 15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(0 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 webtjUe
2. Does this project comply with the minimum separation requirements for water mains? ® Yes ❑ No ❑ N/A
7 if no, please refer to 15A NCAC I SC.0906(f) for documentation requirements and submit a separate document,
signedisealed 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
7 Please provide supplementary information identifying the areas of non-conformance.
9 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: ® No
If yes, does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑ Yes ❑ No
:e This includes Trout Buffered Streams per 15A NCAC 2113_0202
5. Does the project require coveragWauthorization under a 404 Nationwideiindividual permits ❑ Yes ® No
or 401 Water Quality Certifications?
i� Please provide the permit numberipermitting status in the cover letter if coverage! authorization is required.
6. Does project comply with IAA NCAC 02T.0145f cl(6) (additional permitslcertif cations)? ® Yes ❑ No
Per j5A NC 02T.0105fc]f6, 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

_ DbcuSign Envelope IDS DACC29E5-7C23-4983-A2BD4DD8085DOA53
X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design C'riteria for the.Perrpitting of Pump Stations
and Force Mains (latest ver Inn), and the Graves Sewer Minimum Desi�ul Criteria flalest version) 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 proiects reauirint_ a variance approval may be subject to longer
review times. For proiects_reguiring 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 reauired.
2. Professional Engineer's Certification:
1, Jarrod E. Hilliard , attest that this application for 211 S. Currie Drive Sewer Extension
(Professional Engineer's name from Application [tern 111.1 ) (Project Name from Application Item II 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,
Minimum Design Criteria filr Gravity SeyNrs flalest version), and the Minimum.Desirxn Criteria for the Fast -Track Permitting
of Pump Stations-4nd 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 wbo 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 applicable Rules and design criteria, may subject
the North Carolina -licensed Professional Engineer to referral to the licensing board. (21 NCAC 56.0701)
North Carolina Professional Engineer's seal, signature, and
3. Applicant's Certification per I SA NCAC 02T .0106(b):
y/Z�/Z3
1, Paul M. Weeks, Jr, PE , attest that this application for 211 S. Currie Drive Sewer Extension
(Signature Authority Name from Application Item 13 ) (Project Name from Application Item [I. I)
attest that this application has been reviewed by me and is accurate and complete to the best of my knowledge.
I understand that if all required parts of this application are not completed and that if all required supporting documentation
and attachments are not included, this application package is subject to being returned as incomplete. 1 understand that any
discharge of wastewater from this non -discharge system to surface waters or the land will result in an immediate enforcement
action that may include civil penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the Division
of Water Resources should a condition of this permit be violated. I also understand that if all required parts of this application
package are not completed and that if all required supporting information and attachments are not included, this application
package will be returned to me as incomplete.
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.
DocuSigned by: S
P At. (b"S Jr. P.f. . 9/22/2023
Signature: e9c9BE8(iti7B44ae Date:
FORM: FTA 06-21 Page 5 of 5

A
O)cv5 gn Envelope ID D53E44FD-DAEE-4901-B2B7-B7AEOD25FOFD
State of North Carolina
,ac=
pivlsion of Water Resources
Department of Environmental Quality
Division of Water Resources
now Tracking for Sewer Extension Applications
THE 10-18)
Entity Requesting Allocation: City of Sanford NC
Project Nam: for which flow is being requested: 211 S. Curie Dr.
More than one FTSE may be reyuiledfor a single project if the owner of the WIM is not responsible for allprtm ,stations along the
route of they proposed wastewaterflow �<
f. Complete this section only ifyou are the owner of the wastewater treatrront plant,
a. WWTP Facility name: Big Buffalo 'sty
b. WWTP Facility Pemit ti: NCO024147 f�fj
All flows are in MrGD
c. WWTP fachys Pen -rifted Sow 12
d. Esti+rated obligated Sow not yet tribti ary to the WWTP 2.3006
e. WWTP fads actual average Sow 4-139 f
f. Total Sow for this specific request 0.0014
g Total actual and obligated flows to the facility 6.44 t�
IL Percent ofpemiRted Sow used 53.68% ~
Ill. Complete this section for each pump station your are responsible for along the route of this proposed wastewater flow
List pump station located between the project connection point and the WWTP.
(A) (B) (C) (D)=(B+C) (E)=(A-D)
Purnp Pump Design Approx Obligated Total Cturerri
Station Station FirmAverage Daily Cirnent Not Yet Flow Phis Available
(Name or Penh Capacity, * Flow** Avg. Daily Tnbtitary Obligated Capacity***
Number) No. MGD (FinnYpo Flow Daily Flow Flow MGD
MGD MGD MGD MGD
* The Fum Capacity of any pump station is deCnned as the nvminum 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 whetY the Available Capacity is :5 0.
Downstream Facility Nance (Sewer): 2Big_Buffalo
Downstream Permit Number (Sewer): NC0024147
Page 1 of 6
FTSE 10-18

f)ocuSign Envelope ID: 053E44FD-DAEE4901-B2B7-B7AEOD25FOFD
III. Certification Statenrent
1, Paul Weeks, certify to the best of my knowledge that the addition of the vohane 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 dus project is not anticipated to cause arty capacity related sanitary
sewer overflows or oveiburden any downstream purrp station en route to the receiving treatment plant
under non- al citcur stances, given the lhhplementation ofthe planned inprovernem identified in the
planning assessment where applicable. This analysis has been perk mhed 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 phis all attached planning assessment addendurm for which I am die
responsible party. S&tttre of this form indicates acceptance of this wastewater flow.
E OacuSigned
by:
otU�, k, "S Y. P.f, .
8BC39E86678"Bg
Signing Official Signature
Utilities and Eagb erne D'uector
Title of Sighing Official
9/22/2023
01,
Page 2 of 6
FTSE 10-18

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DWR
Dhrlslon of Water Resources
State of North Carolina
NCDept of Fnvir()111ne111al Qua lily
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
AU6 823 FTA 06-21 & SUPPORTING DOCUMENTATION
Applit � ��77 (to becompleted'a� DWRi
All items must be completed or the application will be returned
1. APPLICANT INFORMATION:
1. Applicant's name: City of Sanford (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State/County ® Municipal
3. Signature authority's name: Paul M. Weeks, Jr., PE per 15A NCAC 02T .010G(UI
Title: Utilities and Engineering Director
4. Applicant's mailing address: 225 E. Weatherspoon Street
City: Sanford State: NC Zip: 27331-
5. Applicant's contact information:
Phone number: [phone] Email Address: Rau l.weeks a sanfordnc.net
IL PROJECT INFORMATION:
❑ Privately -Owned Public Utility
❑ Other
I. Project name: 211 S. Currie Drive Sewer Extension
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: Lee
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.4662 Longitude:-79.2064'
5. Parcel ID (if applicable): 9632-84-5693-00 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
I. Professional Engineer: Jarrod E. Hilliard License Number: 035670
Firm: Hilliard Engineering, PLLC
Mailing address: PO Box 249
City: Sanford State: NC Zip: 27331-
Phone number: [phone] Email Address: jilliard cr hilliardengineerint;.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Big Buffalo Waste Water Treatment Plant Permit Number: NCO024147
Owner Name: City of Sanford
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ34106
2. Downstream (Receiving) Sewer Information: 8 inch E Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00047
Owner Name(s): City of Sanford
FORM: FTA 06-21 Pagel of 5