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HomeMy WebLinkAboutWQ0045474_Application (FTSE)_20240502Burd, Tina J From: Burd, Tina J Sent: Friday, May 31, 2024 12:02 PM To: 'bill.marlowe4@gmail.com'; Ron Cullipher Cc: Cocanower, Jordan M; Tharrington, Tom Subject: WQ0045474 - M&H Storage Sewer The Wilmington Regional Office of the Division of Water Resources, Water Quality Operations Section received the Fast Track Sewer System Extension Application (FTA) and $600.00 fee for the subject project on May 2, 2024. The project has been assigned to Jordan Cocanower, cc'd. Please note that the FTA has been revised and requests the applicant to identify if this project is ARPA funded. If you omitted this information from the FTA, please contact Bryan Lievre, email below, so that we can update our records. Otherwise, you will be contacted by the applicable staff member if additional information is needed. Staff Reviewer Counties Served Contact Information Tyler Benson Brunswick, Columbus, Duplin & Pender C.yler.benson de,q,nG.g©y Jordan Cocanower Carteret, New Hanover & Onslow grdan.cocanower @ de .nc. Bryan Lievre All - ARPA Projects Only Bryan lieVre eq.nc gov Tom Tharrington All —Coordinator, Please Copy on All Emails tom.tharrinRton(rDdea.nr.Pc 1. Please provide a copy of the entire application in digital format to your assigned reviewer indicated above. The application and drawings should be provided as separate files. 2. Please indicate in the subject line of the email the permit number (if available), name of the project, and county where the project is located. Please be advised that the construction of the proposed activities may not commence until the sewer permit is issued. Best Regards, Tina Burd Administrative Associate II Wilmington Regional Office Division of Environmental Assistance & Customer Service Phone 910-796-7324 New email: tina.burd@deq.nc,gov NCDEQ Wilmington Regional Office 127 Cardinal Drive Ext. Wilmington, NC 28405 #_av' and "?),.I � � r f Pf i � �r Y b ..� , c„ r,� < u o tiro 4,farli _ Cr THE CULLIPHER GROUP, P.A. ENGINEERING & SURVEYING SERVICES C-4482 June 5, 2024 Division of Water Resources 127 Cardinal Drive Ext Wilmington, North Carolina 28405 Re: Narrative - Sewer Collection System for M&H Storage in `Beaufort, NC This is a request to permit domestic sewage flow from M&H Storage to the Town of Beaufort's W WTP, Permit#: NCO021831. M&H Storage is a proposed self -storage facility with an office space. There are a total of 635 storage spaces proposed at l gallon per unit. The office is designed for 25 gal/employee with a maximum of 1 employee on shift and is totaled as follows: Unit Type Units Unit Flow Total Flow Warehouse —self storage 635 1 gal/unit 635 GPD General office facilities (1 employee per shift) 1 25 gal/employee 25 GPD Grand Total now ; 660 GPD Sewer shall be conveyed via gravity line to a 1,000 gallon pump tank with duplex grinder pumps. Flow from the tank will then pump through a proposed 1-1/2" force main and tap into the existing 12" force main on the northwest side of Live Oak Street. There is a total of 497 LF of PVC force main. Items included in this permit application package are an original and a copy of: 1. This Cover Letter 2. One check for $600.00 3. Fast Track Sewer Extension Application, FTA 10-23 4. Flow Tracking Application, FTSE 10-23, Signed by Town of Beaufort 5. Design Calculations 6. Secretary of State Documentation for M&H Storage, LLC 7. USGS Topographic Map 8. Google Earth Aerial Vicinity Map Please review and let me know if you need additional information. erely, Ro ald D. Cullipher, P.E. DWR Division of Water Resources IN" This application is for sewer extensions involvin certified by a professional engineer and the appl, Minimum Design Criteria (Gravity Sewer & Pun. have been prepared in accordance with 15A NC While no upfront engineering design documents documents must be prepared prior to submittal of calculations, and project specifications reference( documents shall be immediately available upon Projects that are deemed permitted (do not require a State of North Carolina Department of Environmental Quality k�k f �l{fS�S S•�'+�'ccp ���� by�.�rf Division of Water Resources ?XTENSION APPLICATION RTING DOCUMENTATION any combination that has been NCAC 02T and the Division's is and supporting documents d 2ood engineering practices. NCAC 02T .0305(b), design s would include plans, design iimum design criteria. These C 02T.0303. Projects not eligible for review via the fast track pro ➢ Projects that do not meet any part of the mi ➢ Projects that involve more than one variant ➢ Pressure sewer systems utilizing simplex se __......� pumps (ST'EPs) 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 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 E 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): E 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 (downstream/upstream) ➢ If necessary for clarity, include attachments to the application form. ➢ If the project is funded by American Rescue Plan Act (ARPA) funds, please include the ARPA project number in the cover letter and in parentheses under Project Name (Section I1.1. of the application). C. Application Fee (All New and Modification Application Packages): E Submit a check or money order in the amount of S600.00, 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 10-23): E Submit the completed and appropriately executed application. ➢ If necessary for clarity or due to space restrictions, attachments to the application may be made. E If the Applicant Type in Item 1.2 is a corporation or company, provide documentation it is registered for business with the North Carolina Secreta of State. ❑ If the Applicant Type in Item I.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. . E The Project Name in Item Il.l shall be consistent with the project name on the floes N19QM&PW#eements, etc. E The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North Carolina licensed Professional Engineer. MAY 0 2 2024 Water auaiity Regional INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION operations section Page I of3 Wilmington Regionai office ® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T .0106(b). Per 15A NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation letter is provided from a person who meets the criteria in 15A NCAC 02T .0106(b). E. Flow Tracking/Acceptance Form (Form: FTSE 10-23) (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 1 1-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. G. 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(h)(1), submit documentation of power reliability for pumping stations. ➢ This alternative is only available for average daily flows less than 15,000 gallons per day ➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is compatible with the station. The Division will accept a letter signed by the applicant (see 15A NCAC 02T .0106(b)) or proposed contractor, stating that "the portable power generation unit or portable, independently -powered pumping units, associated appurtenances and personnel are available for distribution and operation of this pump station." ➢ If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall he provided in the case of a multiple station power outage. (Required at time of certification) I. Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities): ❑ Per 15A NCAC 02T .0115(a)(1) provide the Certificate of Public Convenience and Necessity from the North Carolina Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by the sewer extension, or ❑ Provide a letter from the North Carolina Utilities Commission's Water and Sewer Division Public Staff stating an application for a franchise has been received and that the service area is contiguous to an existing franchised area or that franchise approval is expected. Operational Agreements (Applications from HOA/POA and Developers for lots to be sold): ❑ Home/Property Owners' Associations ❑ Per 15A NCAC 02T .0115 c , submit the properly executed Operational Agreement (FORM: HOA). ❑ Per 15A NCAC 02T .01 15(c), submit a copy of the Articles of incorporation, Declarations and By-laws. ❑ Developers of lots to be sold ❑ Per 15A NCAC 02T .0115 b submit the properly executed Operational Agreement (FORM: DEV). For more information, visit the Division's collection systems ivebsite INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION Page 2 of 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, (828) 296-4500 Macon, Madison, McDowell, Mitchell, Polk, (828) 299-7043 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, (910) 433-3300 Sampson, Scotland (910) 486-0707 Fax Mooresville Regional Office 610 E. Center Avenue Alexander, Cabarrus, Catawba, Cleveland, Water Quality Section Mooresville, North Carolina 28115 Gaston, Iredell, Lincoln, Mecklenburg, Rowan, (704) 663-1699 Stanly, Union (704) 663-6040 Fax Raleigh Regional Office 3800 Barrett Drive Chatham, Durham, Edgecombe, Franklin, Water Quality Section Raleigh, North Carolina 27609 Granville, Halifax, Johnston, Lee, Nash, (919) 791-4200 Northampton, Orange, Person, Vance, Wake, (919) 571-4718 Fax Warren, Wilson Washington Regional Office 943 Washington Square Mall Beaufort, Bertie, Camden, Chowan, Craven, Water Quality Section Washington, North Carolina 27889 Currituck, Dare, Gates, Greene, Hertford, Hyde, (252) 946-6481 Jones, Lenoir, Martin, Pamlico, Pasquotank, (252) 975-3716 Fax Perquimans, Pitt, Tyrrell, Washington, Wayne Wilmington Regional Office 127 Cardinal Drive Extension Brunswick, Carteret, Columbus, Duplin, New Water Quality Section Wilmington, North Carolina 28405 Hanover, Onslow, Pender (910) 796-7215 (910) 350-2004 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 (336) 776-9800 (336) 776-9797 Fax INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION Page 3 of 3 State of North Carolina Department of Environmental Quality DWR Division of Water Resources FAST TRACK SEWER SYSTEM EXTENSION APPLICATION Dlvislon of Water Resotirces FTA 10-23 & SUPPORTING DOCUMENTATION Application Number: WQ O C)15 4 (to be completed by DWR) All items must be completed or the application will be returned 1. APPLICANT INFORMATION: . Applicant's name: M&H Storage, LLC (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: William A. Marlowe, III per 15A NCAC 02T .0106(b) Title: Manager 4. Applicant's mailing address: 3700 Computer Drive Suite 280 City: Raleigh State: NC Zip: 27609- 5. Applicant's contact information: Phone number: (919) 645-1660 Email Address: bill.marlowe4 mail-com II. PROJECT INFORMATION: 1. Project name: M&H Storage 2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project ❑ ARPA funded 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: Carteret 4. Approximate Coordinates (Decimal Degrees): Latitude: 34.732' Longitude:-76.640' 5. Parcel ID (if applicable): 730612866063000 (or Parcel ID to closest downstream sewer) Ill. CONSULTANT INFORMATION: 1. Professional Engineer: Ronald D. Cullipher License Number: 13343 Firm: The Cullipher Group, PA RECEIVEOMCDENNI)WR Mailing address: 151A NC Hwy 24 City: Morehead City State: NC Zip: 28557- MAY a 20�4 Phone number: (252) 773-0090 Email Address: ron(@tcgpa.com Water Quality Regional operations Section Wilmington Regional 01floe IV, WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION: 1. Facility Name: Town of Beaufort Wastewater Treatment Plant Permit Number: NCO021831 Owner Name: Town of Beaufort V. RECEIVING DOWNSTREAM SEWER INFORMATION: 1, Permit Number(s): WQ 2. Downstream (Receiving) Sewer Information: 12 inch ❑ Gravity N Force Main 3. System Wide Collection System Permit Number(s) (if applicable): WQCS00102 Owner Name(s): FORM: FTA 10-23 Page I of 5 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 ® 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 ® NIA 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.01 15(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 I offices I 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 ? ❑ Yes ® No ➢ If Yes, provide a cony of flow reduction approval letter with this application 7. Summarize wastewater generated by project: Establishment Type (see 02T.0114(f)) Daily Design Flow a-b No. of Units Flow Warehouse - self storage I gal/unit 635 635 GPD General office facilities 25 gal/employee/shift 1 per shift 25 GPD gall GPD gall GPD gall GPD gall GPD Total 660 GPD a See 15A NCAC 02T .0114 b d e 1 and e 2 for caveats to wastewater design flow rates (i.e, 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: 660 GPD (per 15A NCAC 02T .0114 and G.S. 143-215.1) ➢ 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): RECFIVFD/NCDENRlDWR MAY 0 2 2024 Water 0oatity Regional operations Section Wilmington Regional Office FORM: FTA 10-23 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 ➢ Section lI & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria ➢ Section III contains information related to minimum slopes for gravity sewer(s) ➢ Oversizing lines to meet minimum slope requirements is not allowed and a violation of the MDC VIII. PUMP STATION DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (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: l 2. Approximate Coordinates (Decimal Degrees): Latitude: 34.731 ° Longitude:-76.640' 3. Total number of pumps at the pump station; 2 3. Design flow of the pump station: 0.00165 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): 33 gallons per minute (GPM) at 72.53 feet total dynamic head (TDH) 5. Summarize the force main to be permitted (for this Pump Station): Size (inches) Length (feet) Material 1.5 497 PVC 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.1.b. ® 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 Owner will purchase standby pump and keep on -site ➢ Must have automatic activation and telemetry - l5A NCAC 02T.0305(h)(1)(B)_ ➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day ➢ Must be permanent to facility and may not be portable Or if the pump station has an average daily flow less than 15,000 gallons per day 15A NCACO2T.0305(h)(t)(C): ❑ Portable power source with manual activation, Quick -connection receptacle and telemetry - or ❑ Portable pumping unit with plugged emergency pump' connection and telemetry: ➢ Include documen'taiioii'ifiat')lie p8iRable source is owAU'ibr contracted l y 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 10-23 Page 3 of IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)): Does the project comply with all separations/alternatives found in 15A NCAC 02T .0305(�t &(g)? ® Yes ❑ No 15A NCAC 02T.0305(fl contains minimum separations that shall be provided for sewer systems -- 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-I waters of Class I or Class 11 impounded reservoirs used as a source of drinking water, and associated wetlands. 100 feet **Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal high water (or tide elevation) and wetlands associated with these waters (see item IX.2) 50 feet **Any other stream, lake, impoundment, or ground water lowering and surface drainage ditches, as well as wetlands associated with these waters or classified as WL. 10 feet Any building foundation (horizontal) 5 feet Any basement (horizontal) I0 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(fl or (gZ see Section X.l of this application * t5A NCAC 02T.0305 contains alternatives where separations in 02T.0305(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 webpMe 2. Does this project comply with the minimum separation requirements for water mains? ® Yes [:]No ❑ NIA ➢ 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 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 ➢ This includes Trout Buffered Streams per 15A NCAC 213.0202 5. Does the project require coverage/authorization under a 404 Nationwide/individual permits ❑ Yes ® No or 401 Water Quality Certifications? ➢ Please provide the permit number/permitting status in the cover letter if coverage/authorization is required. 6. Does project comply with 15A NCAC 02T,0105(c)(6) (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 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 10-23 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 Gravi Sewer Minimum Design Criteria latest 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. AAparoval of the request will be issued concurrently with the avoroval of the permit, and ro'ects reguiring a variance approval may be subject to longer review times. For prolects reguiring two or more variances or where the variance is determined by the Division to be a si nificant portion of the vrolect, the full technical review is re wired. 2. Professional Engineer's Certification: I,n A1(1 �Aph�..fi.. attest that this application for ffrm I111.) (Project Name from Appli lion Item 11.1) 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 Design Criteria for Gravi1y Sewers latest version), and the Minimum Design Criteria for the Fast -Track Permitting of PumD Stations and Force Mains latest version). Although other professionals may have developed certain portions of this submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and have judged it to be consistent with the proposed design. NOTE -- In accordance with General Statutes 143-215.6A and 143-215.613, any person who knowingly makes any false statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may include a fine not to exceed $10,000, as well as civil penalties up to $25,000 per violation. 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 date: RECEIVED/NCDENR/DWR MAY 4 2 2024 Water Quality R e9wat operations section wirnogton Regional Otf;ce Applicant's Certification per 15A NCAC 02T .0106(b): C A RO // Ss� •,l�'� ` � •.gyp O•. - SEAL r 13343 cif, ' �NGI N eEL• (C�` 1, 6; ([ R-^ � • ! `Pr'1an►t 11� N!attest that this application for M � k S6`fr-til4 (Signature Authority Name from Application item 1.3) (Project Name from Appfication Item IL 1) 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. I understand that any discharge of wastewater from this non -discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition of this permit be violated. I also understand that if all required parts of this application package are not completed and that if all required supporting information and attachments are not included, this application package will be returned to me as incomplete. NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation. Signature: Date: FORM: FTA ] 0-23 Page 5 of 5 ON r f rfr ,' `f ` Ski Y� r ` . 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E £21 Y W V RECEIVED/NCDENR/DVVR MAY 0 2 2024 Water quality Regional Operations Section Wilmington Regionaf office CA202207602236 SOSID: 2302608 Date Filed: 3/17/2022 LIMITED LIABILITY COMPANY ANNUAL REPORT Elaine F. ;Marshall 02 North Carolina Secretary of State irW20022CA2022 076 02236 NAME OF LIMITED LIABILITY COMPANY: M&H Storage, LLC SECRETARY OF STATE ID NUMBER: 2302608 STATE OF FORMATION: NC Filing Office US-9-1551i REPORT FOR THE CALENDAR YEAR: 2022 0 19 F'N SECTION A: REGISTERED AGENT'S INFORMATION 0 ®Changes 1. NAME OF REGISTERED AGENT: W. Anderson Marlowe, III 2. SIGNATURE OF THE NEW REGISTERED AGENT: SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT 3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS 3700 Computer Drive Suite 280 3700 Computer Drive Suite 280 Raleigh, NC 27609 Wake Raleigh, NC 27609 Wake SECTION B: PRINCIPAL OFFICE INFORMATION 1. DESCRIPTION OF NATURE OF BUSINESS: Real Estate Development & Rentals 2. PRINCIPAL OFFICE PHONE NUMBER; 9� 645-1600 3. PRINCIPAL OFFICE EMAI Privacy Redaction 4. PRINCIPAL OFFICE STREET ADDRESS 5. PRINCIPAL OFFICE MAILING ADDRESS COMM ion 3700 Computer Drive Suite 280 3700 Computer Drive Suite 280 Raleigh ; NC 27609 Wake Raleigh, NC 27609 Wake 6. Select one of the following if applicable. (Optional see instructions) ❑ The company is a veteran -owned small business ❑ The company is a service -disabled veteran -owned small business SECTION C: COMPANY OFFICIALS (Enter additional company officials in Section E.) NAME: W. Anderson Marlowe, III NAME: TITLE: Manager TITLE: ADDRESS: 3700 Computer Drive Suite 280 Raleigh, NC 27609 Wake ADDRESS: RECEIVED/NCDENR/DWR MAY 0 2 2024 Water Quality Regional Operations Section Wilmington Regional Office NAME: TITLE: ADDRESS: SECTIONN : CERTIFICATION OF ANNUAL REPORT, Seciii D must be completed in its entirety by a person/businass entity, SIGNATURE DATE Form must be signed by a Company Official fisted under Section C of This form. WILLAIM A MARLOWE, III MANAGER Print or Type Name of Company Official Print or Type Titla of Company Official SUBMIT THIS ANNUAL REPORT WITH THE REQUIRED FILING FEE OF $200 MAIL TO: Secretary of State, Business Registration Division, Post Office Box 29525, Raleigh, NC 2762"525 State of North Carolina Department of Environmental Quality Division of Water Resources Flow Tracking for Sewer Extension Applications (FTSE 10-23) Entity Requesting Allocation: M&H Storage, LLC Project Name for which flow is being requested: M&H Storage More than: one FTSE may be required for a single project if the owner of the WWTP is not responsible for ell primp 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: Town of Beaufort Wastewater Treatment Plant b. WWTP Facility Permit #: NCO021831 A11 flows are in MGD c. WWTP facility's permitted flow 1.5 d. Estimated obligated flow not yet tributary to the WWTP 0.2556 e. WWTP facility's actual avg. flow 0.9345 f. Total flow for this specific request 0.0007 g. Total actual and obligated flows to the facility 1.1908 h. Percent of permitted flow used 79% II. Complete this section for each pump station you are responsible for along the route of this proposed wastewater flow. List pump stations located between the project connection point and the WWTP: (A) (B) (C) (D)=(B+C) (E)=(A-D) Design Obligated, Pump Pump Average Approx. Not Yet Total Current Station Station Firm Daily Flow** Current Tributary Flow Plus (Name or Permit Capacity, * (Firm / pf), Avg. Daily Daily Flow, Obligated Available Number) No. MGD MGD Flow, MGD MGD Flow Capacity*** NIA * 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 (po 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 b 14'F bINCI)ENR/Dv,,- project connection point and the WWTP where the Available Capacity is < 0. Downstream Facility Name (Sewer): Town of Beaufort MAY 0 2 2024 Downstream Permit Number: WQCS00102 Water Quality Fieeion, Page 1 of 6 Operations section g Wilmington Rraglanal off,,. FTSE 10-23 III. Certification Statement: I Todd Clark 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, , Of cial Town Manager Tille of Signing Official Dale Page 2 of 6 FTSE I0-23