WQ0044015_Application_20221205

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
ISA NCAC 02T .0300 — ALTERNATIVE SEWER EXTENSION APPLICATION
Division of Water Resources ASEA 04-16 & SUPPORTING DOCUMENTATION
Application Number: _ (to be completed by DWR)
I. APPLICANT INFORMATION:
1. Applicant's name: Cape Fear Public Utility Authority (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State ❑ Municipal ®Authority
3. Signature authority's name: Jeff Theberge. PE per 15A NCAC 02T .0106(b)
Title: Engineering Manager
4. Applicant's mailing address: 325 Government Center Dr.
City: Wilmington State: NC Zip: 28403-
5. Applicant's contact information:
Phone number: [phone] Email Address:. ieff.theberge@,cfpua.org
II. PROJECT INFORMATION:
1. Project name: Castle Hayne Habitat for Humanity
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ00 and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: New Hanover
4. Approximate Coordinates (Decimal Degrees): Latitude: 34.303706' Longitude:-77.922117'
III. CONSULTANT INFORMATION:
1. Professional Engineer: Phillip G. Trip n License Number: 17374
Firm: Tripp Engineering
Mailing address: 419 Chestnut Street
City: Wilmington State: NC Zip: 28401-
Phone number: [phone] Email Address: office@trimen ine eering com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: James A Loughlin WW'1P Permit Number: NCO023965
Owner Name: Cape Fear Public Utility Authority
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s):
System Wide Collection System Permit Number(s): Owner Name(s): Cape Fear Public Utility Authority
FORM: ASEA 04-16 Pagel of 5

VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been submitted?
[:]Yes [:]No ®N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement FORM: DEV i been submitted?
[:]Yes [-]No ®N/A
3. If the Applicant is a Home/Property Owncrs' Association, has an 01,erational A,-.reement(FORM: HOA been submitted?
❑ Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply):
® Residential 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)
S. Is/was an Environmental Assessment required under 15A NCAC 01C? ❑ Yes ® No
If yes, submit the appropriate final environmental document (FONSI, ROD, etc.)
6. Nature of wastewater: 100 % Domestic/Commercial % Other waste — specify:
% Industrial � See 15A NCAC 02T .0103(201)
7. Wastewater generated by project: 12,600 GPD (per 15A NCAC 02T .0114)
Has a flow reduction been approved under 15A NCAC 02T .0I 14(f)? ❑ Yes ® No
If yes, provide a cony of approval
8. Summarize wastewater generated by project:
Establishment Type Daily Design Flow
Single Family Home 360 gal/Home
gal/
gal/
gal/
gal/
gal/
No. of Units
Flow
35
12,600 GPD
GPD
GPD
GPD
GPD
GPD
Total
12,600 GPD
a See 15A NCAC 02T .0114(b), (d), (e)(1) 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 .0I 14(c), design flow rates for establishments not identified below shall be determined using available
flow data, water using fixtures, occupancy or operation patterns, and other measured data.
FORM: ASEA 04-16 Page 2 of 5

VII. PRESSURE SEWER DESIGN CRITERIA —15A NCAC 02T .0305:
1. Number of simplex pump stations (STEP tanks/effluent pumps, vacuum pits, etc.) provided: 35
2. What is the nearest 100-year flood elevation to the facility? 17 feet mean sea level.
Is any of the proposed project located within the 100-year flood plain? ® Yes ❑ No
3. If Yes, are the following items provided per 15A NCAC 02T .0305 e :
Water -tight seals on all station hatches and manholes; and
Control panels vents extend two feet above the 100-year flood plain elevation? ❑ Yes ® No ❑ N/A
If No, what measures are being taken to protect them against flooding? All sites minimum 2' above elev. 17
4. Volume of storage in wet well above pump on elevation: 431 = 1.75x1.75x3.14x6x7.481 Gallons include calculations)
5. How power reliability will be provided in accordance with 15A NCAC 02T .0305 h D :
® Wet well storage provides 24 hours worth of wastewater storage; or
❑ Wet well storage provides wastewater storage based on power reliability and response times
(See "Polio• for Meeting Reliability Requirements")
➢ Provide 3 years of power history date in the area.
➢ Provide response time to replace a failed pump. This would include travel time, time, to replace pump, etc.
➢ Wet well storage would be based on whichever is greater.
All other pump stations meet the reliability requirements of 15A NCAC 02T .0305(h)(1): ❑ Yes ❑ No ® N/A
6. Summarize simplex pump station design elements:
Design Element Plan Sheet Specification
Reference Reference
Emergency Contact Placard or Sticker
_
33.32.17
2.2.H.I I
Screened Wet Well Vent
-
_
-
33.32.17
Restricted Access Details
3.3.E
Control Panel
C9
33.32.17
2.2.H
High Water Alarms (Audible & Visual)
C9
33.32.17
2.2.H.9
Valves (Check, Gate, etc)
C9
33.32.17 3.3.
Air Relief Valves
C9
-
7. Summarize the pipe length by diameter to be permitted. Lines from a building to the septic or pump tank should be excluded.
(provide attachments if necessary)
Zone
From Node
To Node
Diameter (in)
Length (feet)
# Pumps in Zone
Pump Model
S ecified for Zone
See
attached
calculations
8. Air release valve station locations per 15A NCAC 02T .0305(i) (provide attachments if necessary)
Air Release Valve # I Station j Plan Sheet Reference
1 1 0+73 1 CS
FORM: ASEA 04-16 Page 3 of 5

VHL SETBACKS & SEPARATIONS— (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T.0305(f) & (s1
15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems_
® Yes ❑ No
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below {vertical)
24 inches
Water mains (vertical -water over sewer 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 II impounded reservoirs used as a source of drinking water
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 see item IX.2
50 feet
"Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
An swimming pools
10 feet
Final earth grade (vertical)
36 inches
15A NCAC 02T.0305f et contains alternatives where separations in 02T.0305(f) cannot be achieved.
**Stream classifications can be identified using the Division's NC Surface Water Classifications web age
If noncompliance with 02T.0305(f) or (&I see Section IX of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes ❑ No ❑ N/A
See the Division's draft separation requirements for situations where separation cannot be meet
No variance is required if the alternative design criteria specified is utilized in design and construction
As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ®Yes ❑ No ❑ N/A
This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project require coverage/authorization under a 404 Nationwide or ® Yes ❑ No
individual permits or 401 Water Quality Certifications?
Information can be obtained from the 401 & Buffer PermittiM Branch
5. Does project comply with 15A NCAC 02T.0105 c 6) (additional permits/certifications)? ® Yes [:]No
Per 15A NCAC 02T.0105(c)E6), directly related environmental permits or certification applications are 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.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NCAC 02T.04021 "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ® No
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 permitee's individual System -Wide Collection permit.
FORM: ASEA 04-16 Page 4 of 5

R. CERTIFICATIONS:
1. Does the Submitted system comply with 15A NCAC 02T. the MiDnIlUill I)CSILrn C cri I'or Ilhc 'ertnittul g o'fuel, Stations
and Force Mains ilatest version,. and the Gravitv Server Mininium Design Criteria (latest version,), as applicable?
® Yes ❑ No
If No. complete and submit the VariancelAltcrnative Design Request application (VADC' 10-14) and supporting documents lbr
review. Approval of the request is required rla• to submittal of the Fast Track Application amd-s-u,ortin documents.
2. 1'rol'essional Engincer's Certification:
Phillip G. Tripp, PE _ _ _ _ _ attest that this application for
(Professional Engineer's name from Application Item 111.1.)
Castle HMe Habitat for Humanity _
(Facility name 4rom Application Item II.1.)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plains. specilications.
engineering calculations, and all other supporting documentation to the hest of my knowledge. I litrlher attest that to the hest
of my knowledge the proposed design has been prepared in accordance with this application package and its instructions, as
well as all applicable regulations and statutes. Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials ender my signature and seal signifies that I have reviewed this material and
have judged it to he consistent with the proposed design.
?VOTE — In accordance with General Statutes 143-215.6A and 143 215.GI3, any person who knowingly makes any false
statement, representation, or certification in arty application package shall be guilty of a Class 2 misden,canor, which may
include a tine not to exceed S 10,000, as well as civil penalties up to $25,000 per violation.
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T-0106lbl:
DNA CAR
�, •4 SEA
I�
r
I
�i REGU t�
i, Jeff The erae,Fngineem* g Manager arrest that this application Ibi
(Signature Authority's nal»c & title from Application heat 1.3.)
_ Castle Ha ne Habitat for Humani
(facility nanrc liom Application item 11.1.)
hi.s been reviewed by ale and is accurate and complete to the hest of my knowledge, 1 understand [hit[ any discharge ul'
wastewater Irom Ibis 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. 1 will Snake no claim against the Division of Water
I%sources should a condition of this permit be violated. I also understand that i I all required parts nl this application package
are not completed and that if all required supporting information and attachments are not included, this altllhcation package
will he returned to ntc as incomplete. As the lcrmittce for the lressum sewer system. i understand 1 will be required to
own. maintain. and operate all individual puml) stations.
DOTE - In accordance with (.ieneral Statutes 143-215.6A and I43-215.6f3, any person who knowincly makes any false
statement, representation, or ceriilication in any application package shall be guilty of a (_'lass 2 misdemeanor, which may
include a line not to exceed S I0.000 as well -is civil penalties up to S25,000 per violation.
Signature: 1 Date. Z
1`01IM: ASEA 04-16 Page 5 ol'5

0
K"
GRAVITY SEWER DESIGN CRITERIA - 15A NCAC 02T .0305:
1. Summarize Gravity Sewer to be permitted:
Size (inches) Length (feet) Material
8
1,112
C-900 PVC
8
115
DIP
PUMP STATION DESIGN CRITERIA — 02T .0305 & MDC (Puma) Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: - °
3. What is the nearest 100-year flood elevation to the facility? feet mean sea level. Source:
Is any of the proposed project located within the 100-year flood plain? ❑ Yes [:)No
4. If Yes, are the following items provided per 15A NCAC 02T .0305(e) :
Water -tight seals on all station hatches and manholes; and
Control panels vents extend two feet above the100-year flood plain elevation?
❑ Yes ❑ No ❑ N/A
If No, what measures are being taken to protect them against flooding?
5. Finish grade elevation of the pump station:
6. Design flow of the pump station: millions gallons per day (firm capacity)
7. Operational point(s) of the pump(s): gallons per minute at feet total dynamic head (TDH)
8. Number of pumps provided:
9. Number of pump cycles at average daily flow: cycles per hour
10. Power reliability in accordance with 15A NCAC 02T .0305(h)f 1 :
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(B)_
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(1)(C):
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
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 in the case of a multiple station power outage.
Section X & XI Attachment
Page 1 of 2

XI. PUMP STATION DESIGN CRITERIA (continued)
11. Summarize the pump station design elements:
Design Element
Plan Sheet F Specification
Reference Reference
Power Reliability Source and Associated Elements
Screened Wet Well Vent
Check Valves, Gate Valves, etc.
Control Panel
Restricted Access Elements (Fence, Wet Well Lock, etc)
Audible and Visual Alarms
Telemetry/SCADA
Level Controls
Weatherproof Sign with Required Information
Air Relief Valves
12. Summarize the force main to be permitted:
Size (inches)
Length (feet)
Material
High
Elevation (feet)
Discharge
Elevation (feet)
Pump -Off
Elevation (feet)
13. Air release valve station locations per 15A NCAC 02T .0305t il:
Air Release Valve # Station Plan Sheet Reference
Section X & XI Attachment Page 2 of 2