WQ0033325_Application (FTSE)_20240607

Burd, Tina J
From: Burd, Tina J
Sent: Monday, June 10, 2024 11:48 AM
To: [e-mail]; [e-mail]; [e-mail]
Cc: Cocanower,Jordan M;Tharrington, Tom
Subject: WQ0045503 - The Proximity at Watermark Public 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 June 7, 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 l
Tyler Benson Brunswick, Columbus, Duplin & Pender tyler.benso,n(c?cl g. tc.goy
Jordan Cocanower Carteret, New Hanover&Onslow iord an.coca noweL deq.nc.g_ov
Bryan Lievre All -ARPA Projects Only bryr�,lievre@decCnc,go�
Tom Tharrington All—Coordinator, Please Copy on All Emails [e-mail]. ov
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 [phone]
New email: tina.burdC)deq.nc.gov
NCDEQ
Wilmington Regional Office
127 Cardinal Drive Ext.
Wilmington, NC 28405
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1

Proximity at Watermark
Sanitary Sewer Narrative-8" Gravity Line (Public)
04/16/2024
Narrative:
The Proximity at Watermark is proposed to be a multi-family project occupying approximately
16.2 acres of land situated across from the River Road/Independence Boulevard intersection.
The property is bordered on the north by existing parcels off River Road, oil the west by the
Cape Fear River, and the south by Barnards Creek. The site topography is generally flat but
exhibits some relief with grades trending from east to west. The sewer system on site shall be a
gravity system utilizing C900 PVC. A minimum slope of 0.4 will be maintained for all 8"
gravity lines and. The project proposes to capture the sanitary sewer flow from Waste
Management Inc. located to the north of the property which will then be conveyed via 8" PVC
gravity line to a proposed regional lift station located on Watermark property (separately
permitted) prior to its conveyance off-site via a 6"force main. The proposed 6" force main will
tie into an existing CFPUA force main to the north of the site at the intersection of Watermark's
access road and River Road. The connection to the existing force main at River Road has been
designed by others and will be permitted under the pump station permit mentioned above.
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Cocanower, Jordan M
From: Brian Ensign <[e-mail]>
Sent: Wednesday, June 19, 2024 10:35 AM
To: Cocanower,Jordan M
Subject: [External] RE:WQ0045503 (The Proximity at Watermark Public Sewer) - Request for
Additional Information
CAUTION:External email.Do not click links or open attachments unless verified. Report suspicious emails with the Report Message
button located on your Outlook menu baron the Home tab.
Jordan-
Please see below in red.
Thanks,
Brian
Brian P. Ensign, P.E.
Partner
TCZ Engineering
201 N.Front St,Suite M-108
Witmington,NC 28401
910-547-5856
[e-mail]
From: Cocanower,Jordan M <[e-mail]>
Sent: Wednesday,June 19, 2024 9:39 AM
To: Brian Ensign <[e-mail]>
Subject: WQ0045503 (The Proximity at Watermark Public Sewer) - Request for Additional Information
Brian/Wesley
I am writing to you regarding the fast-track sewer extension application for The Proximity at Watermark Public
Sewer(WQ0045503) Please receive this message as a formal request for additional information.
I have conducted a preliminary review of the application and supporting documents for the subject application. In
accordance with 15A NCAC 02T.0107, please provide the information requested below:
1. The FTA shows 75000 GPD allocated for"Commercial—Waste Management". Please describe the nature
of these flows and cite the allocation used (flow/unit)from the.02T Rules.—75,000 gpd is based on
operational data from Waste Management; I do not see a refuse collection establishment listed in the
table. These flows are related to the treatment of grease utilizing mechanical processes to separate solids
from liquids. CFPUA is aware of this process as they have been part of the permitting program and have
accepted the flows/volume.
2. The FTA shows 500 GPD allocated for"Commercial—4 Seasons Demolition". Please describe the nature of
these flows and cite the allocation used (flow/unit)from the .02T Rules. 500 GPD flow is related the
"General Business" with minimum 4 employees operating per shift plus additional employees at different
periods (4 X 25gpd = 100 gpd + up to 16 x 25gpd additional employees/laborers during different periods).
3. Please provide the permit number for the downstream sewer this project will connect to-WQ0045503
1

Cocanower, Jordan M
From: Brian Ensign <[e-mail]>
Sent: Wednesday,June 19, 2024 10:35 AM
To: Cocanower,Jordan M
Subject: [External] RE:WQ0045503 (The Proximity at Watermark Public Sewer) - Request for
Additional Information
i
CAUTION ,External:enlall.Do not click links or open a#tachments unless verified.Report suspicious emaiEs with the-Report'
button located on your Outlook menu bar on the Horne tab. ,
Jordan-
Please see below in red.
Thanks,
Brian I
Brian P. Ensign, P.E.
Partner
TV Engineering
201 N.Front St,Suite M-108
Wilmington,NC 28401
910-547-5856
[e-mail]
I
I
From: Cocanower,Jordan M <jordan.coca [e-mail]>
Sent: Wednesday,June 19, 2024 9:39 AM
To: Brian Ensign <[e-mail]>
Subject: WQ0045503 (The Proximity at Watermark Public Sewer) - Request for Additional Information
Brian/Wesley
I am writing to you regarding the fast-track sewer extension application for The Proximity at Watermark Public
Sewer(WQ0045503) Please receive this message as a formal request for additional information.
I have conducted a preliminary review of the application and supporting documents for the subject application. In
accordance with 15A NCAC 02T.0107, please provide the information requested below:
1. The FTA shows 75000 GPD allocated for"Commercial—Waste Management". Please describe the nature
of these flows and cite the allocation used (flow/unit)from the .02T Rules.—75,000 gpd is based on
operational data from Waste Management; I do not see a refuse collection establishment listed in the
table. Theseflows are related to thetreatment of grease utilizing mechanical processes to separate solids
from liquids. CFPUA is aware of this process as they have been part of the permitting program and have
accepted the flows/volume.
2. The FTA shows 500 GPD allocated for"Commercial-4 Seasons Demolition". Please describe the nature of
these flows and cite the allocation used (flow/unit)from the .02T Rules. 500 GPD flow is related the
"General Business" with minimum 4 employees operating per shift plus additional employees at different
periods(4 X 25gpd = 100 gpd + up to 16 x 25gpd additional employees/laborers during different periods).
3. Please provide the permit number for the downstream sewer this project will connect to-WQ0045503
1

wum.
WASTE MANAGEMENT WASTE MANAGEMENT
3920 River Road
Wilmington,NC 28412
8/12/2024
To Whom it may concern,
Waste Management is currently hauling effluent from our pretreatment facility Permit#SDTF
65-01 to CFPUA's James A. Loughlin Water Treatment Plant under permit# N2013A via a 6000-gallon
water tanker.The current average daily flow rate is 16,383 gallons per day(Exhibit A). The facility is
undergoing upgrades which will increase the design flow rate to 40,000 gallons per day. i
I
I
Exhibit A
Average Daily
Flow I
Jul-24 17,100
Jun-24 13,600
May-24 14,700
Apr-24 18,800
Mar-24 17,300
Feb-24 12,900
Jan-24 15,900
Dec-23 15,200
Nov-23 19,200
Oct-23 17,700
Sep-2 3 15,800
Aug-23 18,400
Average 16,383
i
David Greer
I
District Operations Manager
I
Waste Management of Wilmington
i
I
From everyday collection to environmental protection, Think Green?, Think Waste Management.

State of North Carolina
4.j.,.; •. '.: Department of Environmental Quality
Coil "s Division of Water ResourResources)) r�
D10%lon of Vt1mi r Rescpurces Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Cape Fear Development
Project Name for which flow is being requested: The Proximity at Watermark, LLC
More titan one FTSE ntay be required for is single project if the owner of the WNW is not respousihle )r rill punrl),
stations along the rouse of the proposed wastewater fio►v.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: M'Kean Maffitt(Southside)WWTP
b. WWTP Facility Permit#: NPDES NC 0023973
All flows are in MGD
c. WWTP facility's permitted flow 12.000
d. Estimated obligated flow not yet tributary to the WWTP 3.614
e. WWTP facility's actual avg. flow 8.044
f. Total flow for this specific request 0,112400
g. Total actual and obligated flows to the facility 11.771
li. Percent of permitted flow used 98.1
11. 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) (11) (C) (D)=(B+C) ([:-)=(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/pt), Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow,MGD MGD Flow Capacity***
WM N/A 0.395 0.158 0.000 0.112 0.112 0.045
The Firm Capacity(design flow)of any prunp 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
(pi)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 where the Available Capacity is<0.
Downstream Facility Name (Sewer): Cape Fear Public Utility Authority
Downstream Pert-nit Number:
Page I of 6
FTS L 10-18
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111.Certification Statement:
Jeff Theberge,CFPUA Eng. Mgr 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 1
am the responsible party. Signature of this form certifies tizat the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
,7eff hebewe 04/29/2024
Jeff Theberge(Apr 29,202 6:32 EDT)
Signing QIficial Signature Date
Engineering Manager
Title of Signing Official
Page 2 of 6
FTSE 10-18
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i.; A.,
Flow Tracking for Sewer Extension Permit
Application
Final Audit Report 2024-04-29
Created: 2024-04-29
By: Jeff Theberge([e-mail])
status: Signed
Transaction ID: CBJCHBCAABAA1e-wHeCWhDEAWwlSdA3fu5WziUAJwuRB
"Flow Tracking for Sewer Extension Permit Application" History .
Document created by Jeff Theberge(Jeff [e-mail])
2024-04-29-8:31:43 PM GMT
Document emailed to Jeff Theberge([e-mail])for signature
2024-04-29-8:31:47 PM GMT
Document e-signed by Jeff Theberge([e-mail])
E-signature obtained using URIL retrieved through the Adobe Acrobat Sign API
it Signature Date:2024-04-29-8:32:10 PM GMT-Time Source:server
Agreement completed.
2024-04-29-8:32:10 PM GMT
Adobe Acrobat Sign
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Purchase a license to generate PDF files without this notice.

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Dlvlslon of Water Resources INSTRUCTIONS FOR FORM: FTA 10-23&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 02T and the Division's
Minimum Design Criteria(Gravity Sy ewer& Pump Stations/Force Mains) and that plans,specifications and supporting documents
have been prepared in accordance with 15A NCAC 02T,15A NCAC 02T.0300,Division policies,and food euaineerine uractices.
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 plans, design
calculations, and project specifications referenced in 15A NCAC 02T .0305 and the applicable injmmum design criteria. 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 NCAC 02T.0303.
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;
➢ 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;
➢ 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
® 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(downstream/upstream)
Y 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$600.00,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):
® Submit the completed and appropriately executed application.
➢ if necessary for clarity or due to space restrictions,attachments to the application may be made.
® If the Applicant Type in Item 1.2 is a corporation or company, provide documentation it is registered for business with the
North Carolina Secretary of State.
❑ 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 1I.1 shall be consistent with the project name on the flow acceptance letters,agreements,etc.
® The Professional Engineer's Certification on Page 5 of the application shall be signed,sealed and dated by a North Carolina
licensed Professional Enyuleer,
® 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).
INSTRUCTIONS FOR FORM:FTA 10-23 & SUPPORTING DOCUMENTATION Pagel of 3

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.
I
I
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.
is
➢ 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, i
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)
1. 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 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.
J. Operational Agreements(Applications from HOA/POA and Developers for lots to be sold):
® Home/Proyerty Owners' Associations
❑ Per 15A NCAC 02T .01 15(c),submit the properly executed Operational Agreement(FORM: HOA).
❑ Per 15A NCAC 02T.01 15(c),submit a copy of the Articles of Licorporation, Declarations and By-laws.
❑ Developers of lots to be sold
❑ Per 15A NCAC 02T.01 15(b),submit the properly executed Operational Agreement(FORM: DEV).
For more information, visit the Division's collection systems irebsite
INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION Page 2 of 3

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
Fayetteville Regional Office 225 Green Street Suite 714 Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quality Section Fayetteville, North Carolina 28301-5095 Montgomery,Moore,Robeson, Richmond,
[phone] Sampson, Scotland
[phone] Fax
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 Regional Office 3800 Barrett Drive Chatham, Durham, Edgecombe, Franklin,
Water Quality-Section Raleigh, North Carolina 27609 Granville, Halifax,Johnston, Lee, Nash,
[phone] Northampton,Orange, Person,Vance,Wake,
[phone] Fax 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 Quality Section Wilmington, North Carolina 28405 Hanover, Onslow, Pander
[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 10-23& SUPPORTING DOCUMENTATION Page 3 of 3

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 10-23&SUPPORTING DOCUMENTATION
Application Number:0 0 e7 45Ob (to be completed by DWR)
All items must be completed or the application will he returned
I. APPLICANT INFORMATION:
I. Applicant's name: CFPUA(company,municipality,HOA,utility,etc.)
2. Applicant type: ❑ Individual ❑Corporation ❑General Partnership ❑ Privately-Owned Public Utility
❑ Federal ❑ State/County ❑Municipal ®Other CFPUA
3. Signature authority's name:Jeff Theberge per 15A NCAC 02T.0106(b)Title:
Engineering Manager
4. Applicant's mailing address:235 Govenment Center Drive
City: Wilmington State:NC Zip:28403
5. Applicant's contact information:
Phone number:[phone] Email Address: jeff.theberge a,cfpua.org
11. PROJECT INFORMATION- k/ /�
1. Project name: he- PrO�i 1111 a+�- IL Pu btu I L SC'��•-
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:New Hanover
4. Approximate Coordinates(Decimal Degrees):Latitude: 33.56815' Longitude:-85.5683'
5. Parcel ID(if applicable): R07000-002-005-000(or Parcel 1D to closest downstream sewer)
Ill. CONSULTANT INFORMATION:
I. Professional Engineer: Wesley Paul Corder License Number:
Firm:TC2 Engineering PLLC
Mailing address:201 N.Front St.Suite M-108. #?ECEiFFD/NCDENpjDWR
City:Wilmington State:NC Zip:28401-
Phone number:[phone] Email Address:brian tc2 llc.com wescorder mails n JUN ��14
IV. WASTEWATER TREATMENT FACILITY(WWTF)INFORMATION: WaaterQua#traty�f9lcnal
V!m' .,,ions Section
I. Facility Name:Southside WWTP Permit Number:NC 0023973 "gt�OnRe9lonaloflica
Owner Name: Cape Fear Public Utility Authority
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ
2. Downstream(Receiving)Sewer Information: 12 inch ® Gravity O Force Main
3. System Wide Collection System Permit Number(s)(if applicable): WQCS
Owner Name(s):Cape Fear Public Utility
FORM: FTA 10-23 Pagel 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 %Commercial 100%Industrial(See 15A NCAC 02T.0103(20))If
—Tndustrial,is there a Pretreatment Program in effccT. es ❑No
G. Has a flow reduction been approved under 15A NCAC 02T.0114(f)? ❑ 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
Commercial(Waste Management) gal/ 75000 GPD
Commercial(4 Seasons Demolition) gal/ 500 GPD
Total 75,500 GPD
a See 15A NCAC 02T .01 14(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
detennined using available flow data,water using fixtures,occupancy or operation patterns,and other measured data.
8. Wastewater generated by project: 75,000 GPD(per 15A NCAC 02T.01 14 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: S1Q`
�O
❑Rehabilitation or replacement of existing sewers with no new flow expected
❑Other(Explain):
Jv\v c ca`
FORM: FTA 10-23 Page 2 of 5

VI1. GRAVITY SEWER DESIGN CRITERIA(if Applicable)-02T.0305& MDC(Gravity Sewers):
l. Summarize gravity sewer to be permitted:
Size(inches) Length(feet) Material
8 1818 C900 PVC
➢ Section 11& III of the MDC for Pennitting 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
Vill. 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: 0Longitude:- °
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):
RECEIVED/NCDENRfDWR
Size(inches) Length(feet) Material
JUN U 7 i924
Water Oualty Regional
operations section
Wilmington Regional office
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
➢ Must have 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 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 plump 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 10-23 Page 3 of 5

IX. SETBACKS&SEPARATIONS—(02B.0200& 15A NCAC 02T.0305(f)):
I. Does the project comply with all separations/alternatives found in 15A NCAC 02T.0305 t & ? ®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 watersupply source,including any wells,WS-1 waters of Class I or
Class It 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.0305(fl or(.,),see Section X.1 of this application
*15A NCAC 02T.0305(g)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 webnaae
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: Cape Fear ❑No
If yes,does the project comply with setbacks found in the river basin rules per I SA NCAC 02B.0200? ® Yes ❑No
Y 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

I
X. CERTIFICATIONS: I
I. Does the submitted system comply with 15,\ '-:IL the ' Iioti!a,uuj+ t)tw a l,•r the l'eci�;iaiij, r)I ta,w;p')taticias
�irJ I ;rCr lltins Int yl�c'su and the rir;s�Tite,�_rrli_i»fttij; ii':�ig} 'ritcriplate. e'sj_,Ir as applicable?
® Yes ❑No
If no, for projects requiring a single variance, complete and submit the Vatianct Alternative Design Request application
(VADC 10-14) and supporting documents for review 'to the Central Office. Apployal of the Leauest will be issu
c with he approvalol thermit dwo4ects reggirlotri ce apgroval m sublegI lo Wager
review! r e r iHns?two or more vad4qcesorwhcE&JU1HJ&Ue 1sdsqrmIntd bytheDlyiyjun
51201rica.rit DQIIiQll.Qf the orglect, h ull hnI i rovilw 11 reapIred.
2. Professional Engineer's Certification:
I, Wt40L 0L1 Q4J1.- Cv��Ic �� ,attest that this application for The Proximity at Watertttark
(Professional Engineer's name from Application (Project Name from Application Item 11.)1
has been reviewed by me and Is accurate, complete and cansistent 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,
.IiLl ,rut;? f�;�i :�:�itc t Lair( r,?t_i�' g` :is G �rsi ll), and the )',lid?iitl,l {'�esi�„t. rireria li r il, E�'�&t-_ir�t l'e,e ,it
;Af Ii:n,�asa i • s.+rttii )�+rcc ' t.ir;s lof �er 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 143-215,6,A 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 510,000,as well as civil penalties up to 525,000 per violation.Misrepresentation of the application
information,including failure to disclose any design non-cdn)pliance with the applicable Rules and design criteria,may subject
the North Carol ina•licensed Professional [engineer to referral to the licensing.board.(21 NCAC 56.0701)
North Carolina Professional Engineer's seal,signature,and date: i "% CAAO4
� l
SEL
'; .,EfyQl
1...
3. Applicant's Certification per 15A NCAC 02T .0106(b):
Jeff Theberge,P.E.Engineering Manager f
1, attest that this application for1-.,s(!11 r ,.'ht��:k, _
(Signatu y tw
re At from Application IIcra 13.) (project N&rTw from Application Item ti 1)'
attest that this application has been reviewed by me and is accurate and complete to the best of my knowledge.
1 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 lion-discharge system to sorface waters or the land will result in an immediate enforcement
action that may include civil penalties, injunctive relief,an or criminal prosecution. I will make no claim against the Division
of Water Resources should a condition of this permit be vio�atcd. 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 !1 _415.6-N and .I,.; `15.1 ii, any person who knowingly makes any false
statement, representation, or certification in any applicatid 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.
I
Signature; Date:
FORM: FTA 10.23 Page 5 of 5