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WQ0045582_Application (FTSE)_20240620
City of Brevard Pump Station Rehabilitation and Replacement Project - Fish Camp Pump Station Sewer System Extension Permit Application June 2024 CS�DM CDM. Smith® cdmsmith.com State of North Carolina Department of Environmental Quality DWR Division of Water Resources FAST TRACK SEWER SYSTEM EXTENSION APPLICATION Division of Water Resources FTA 10-23 & SUPPORTING DOCUMENTATION Application Number: WQ0045582 (to be completed by DwR) All items must be completed or the application will be returned L APPLICANT INFORMATION: 1. Applicant's name: City of Brevard, NC (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: Wilson Hooper per 15A NCAC 02T .0106(b) Title: City Manager 4. Applicant's mailing address: 95 W Main St City: Brevard State: NC Zip: 28712- 5. Applicant's contact information: Phone number: (828) 885-5602 Email Address: Wilson.Hooper(a)cityofbrevard.com II. PROJECT INFORMATION: 1. Project name: Pump Station Rehabilitation and Replacement - Fish Camp Pump Station 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: Transylvani 4. Approximate Coordinates (Decimal Degrees): Latitude: 35.273376' Longitude:-82.701699' 5. Parcel ID (if applicable): 8597-55-3136 (or Parcel ID to closest downstream sewer) III. CONSULTANT INFORMATION: 1. Professional Engineer: Richard J. Rudin License Number: 042739 Firm: CDM Smith Mailing address: 1430 Commonwealth Dr, Suite 302 City: Wilmington State: NC Zip: 28403- Phone number: (919) 325-3545 Email Address: rudinrj(a,CDMSmith.com IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION: 1. Facility Name: Brevard WWTP Permit Number: NCO060534 Owner Name: City of Brevard V. RECEIVING DOWNSTREAM SEWER INFORMATION: 1. Permit Number(s): WQ 2. Downstream (Receiving) Sewer Information: 6 inch ❑ Gravity © Force Main 3. System Wide Collection System Permit Number(s) (if applicable): WQCS00084 Owner Name(s): City of Brevard FORM: FTA 10-23 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 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: 0 % 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(f)? ❑ Yes ®No ➢ If Yes, provide a copy of flow reduction approval letter with this application 7. Summarize wastewater generated by project: Establishment Type (see 02T.0I14(f)) Daily Design Flow a,b No. of Units Flow N/A - this project does not generate any wastewater 0 gal/day GPD gal/ GPD gal/ GPD gal/ GPD gal/ GPD gal/ GPD Total GPD a See 15A NCAC 02T .0114L1, (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: 0 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): 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 N/A N/A N/A ➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria ➢ Section III contains information related to minimum slopes for gravity sewer(s) ➢ Oversizing lines to meet minimum slope requirements is not allowed and a violation of the MDC VIIL PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Puma Stations/Force Mains): PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED M THIS PROJECT 1. Pump station number or name: Gallimore Pump Station 2. Approximate Coordinates (Decimal Degrees): Latitude: 35.273376' Longitude:-82.701699' 3. Total number of pumps at the pump station: 2 3. Design flow of the pump station: 0.29 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): 200 gallons per minute (GPM) at 38 feet total dynamic head (TDH) 5. Summarize the force main to be permitted (for this Pump Station): Size (inches) Length (feet) Material 4 40 DIP PC350 6 22 DIP PC350 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.l.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 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 10-23 Page 3 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 N/A N/A N/A ➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria ➢ Section III contains information related to minimum slopes for gravity sewer(s) ➢ Oversizing lines to meet minimum slope requirements is not allowed and a violation of the MDC 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: Fish Camp Pump Station 2. Approximate Coordinates (Decimal Degrees): Latitude: 35.273376' Longitude:-82.701699' 3. Total number of pumps at the pump station: 2 3. Design flow of the pump station: 0.29 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): 200 gallons per minute (GPM) at 38 feet total dynamic head (TDH) 5. Summarize the force main to be permitted (for this Pump Station): Size (inches) Length (feet) Material 4 40 DIP PC350 6 22 DIP PC350 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.l.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 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 10-23 Page 3 of 5 IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(t)): 1. Does the project comply with all separations/alternatives found in 15A NCAC 02T.0305(f) & (g)? ® Yes ❑ No 15A NCAC 02T.0305(f) 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 2Water mains (vertical - water over sewer preferred, including in benched trenches) 18 inches 2Water mains (horizontal) 10 feet Reclaimed water lines (vertical - reclaimed over sewer) 18 inches Reclaimed water lines (horizontal - reclaimed over sewer) 2 feet **Any private or public water supply source, including any wells, WS-I waters of Class I or Class II impounded reservoirs used as a source of drinking water, and associated wetlands. 100 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) 10 feet Top slope of embankment or cuts of 2 feet or more vertical height 10 feet Drainage systems and interceptor drains 5 feet Any swimming pools 10 feet Final earth grade (vertical) 36 inches ➢ If noncompliance with 02T.0305(f) or (a), see Section X.1 of this application *15A NCAC 02T.0305(e) contains alternatives where separations in 02T.0305(f) 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 webbaee 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: ® 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.0 105 (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 Gravity 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. Approval of the request will be issued concurrently with the approval of the permit, and projects requiring a variance approval may be subject to longer review times. For projects requiring two or more variances or where the variance is determined by the Division to be a significant portion of the project, the full technical review is required. 2. Professional Engineer's Certification: I, Richard J. Rudin , attest that this application for (Professional Engineer's name from Application Item III.1.) Pump Station Rehabilitation and Replacement - Fish Camp Pump Station (Project Name from Application Item II.1) has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications, engineering calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and have judged it to be consistent with the proposed design. NOTE — In accordance with General Statutes 143-215.6A and 143-215.613, 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: ����� '(N CAROj izl r••�FESS/0''•. -V % Rp�Ju`R...... Applicant's Certification per 15A NCAC 02T .0106(b): Pump Station Rehabilitation and I Wilson Hooper , attest that this application for Replacement - Fish Camp Pump Station (Signature Authority Name from Application Item I.3.) (Project Name from Application Item II.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: 06/14/24 FORM: FTA 10-23 Page 5 of 5 /�� `� R.•t.: ,, Existing Fish Camp10 J _ Pump Station to f. Fish Camp °rR ~'_ be Rehabilitated Ps / . '[f `-wi•. mp. prinrl '� • ' '�. \pith 'i 64 I �'t Fee i m n.wan- 100 200 cl Pi f 1 - - fit_ _, • 5� •, `.- a .,� .1 � ri• i� f rah Ha76' � r •{ � �� •�, ti f. _ "I l ' f - f �r •� :1 t JIA7 - .--�. • • - ' PS O 4- ILLK Gall c - '� '�.�• • -� / Wk .--1 ' . - ,• ivy a f G e y.• :.,� - s u -�' • w -- it •,,� , • � � r 93 •t • ,� % ~ti L., •, • ,� . it '�. �fi�� �1 � r . � � � G.1 RJ!}/�-.�r�' vv .•. __.,�;: ,'fir �� �`�VfJ� UFO ILI . A. PS fry .��+� � • 1� 1- K+ � r .rT l • •%, I�ll �J 1 f � , f HAYWOOD END MBE Legend Figure 1 Fp—sl Pump Station USGS Map N Fish Camp Pump JACKSON CDM Existing Force Main Station Project NSYLVANIA Smith - Existing Gravity Sewer BREVARD, NORTH CAROLINA ea rt Feet 0 750 1,500 3,000 4,500 m Fish Camp Pump Station IVI Aerial Map FRgA ®® JULY 2024 Smith 1430 Commonwealth Dr, Suite 302 Wilmington, NC 28403 tel: 919-325-3548 September 3, 2024 Mr. Cheng Zhang North Carolina Division of Environmental Quality Division of Water Resources - Raleigh Regional Office 3800 Barrett Drive Raleigh, NC 27609 Subject: Address NCDEQ Fast Track questions project number WQ0045582 (Fish Camp Pump Station) from 7/3/2024. Dear Mr. Zhang: Please find updated attachments along with further discussion on the questions provided on 7/1/2024 below. 1. Please include the DWI assigned ARPA project number in your response. • The DWI assigned ARPA project number for this project is SRP-W-ARP-0236. 2. Section VIII 1. Pump station number or name was not correct. Please see attached document. • 1-FTA_Fish Camp 3. Although there is currently zero flow, a Flow Tracking for Sewer Extensions (FTSE) Form is required. Please see attached document. • 2-Fish Camp Pump Station - Flow Tracking 4. According to Section F of the Application Instructions, an 8.5-inch x 11-inch color copy of a USGS Topographic Map and an aerial map should be included with the application. The maps need to clearly identify the project area, including the closest surface waters, general Location of the gravity sewer, pump stations, and force mains, and the downstream WATER+ENVIRONMENT+TRANSPORTATION+ENERGY+FACILITIES , Smith Page 2 connection points for the receiving sewer. For the project, it should clearly detail the existing and proposed modifications with necessary components mentioned in section F. Please provide the required maps according to the application requirements. Please see attached documents: • 3-Figure 1- USGS Map - Gallimore Pump Station Project • 4-Aerial Map -Fish Camp 5. Section IX 6. Will an erosion/Sediment Control Permit be needed for this project? • No. We are below the 1-acre threshold for the whole project, but we have included erosion control measures in our plans. 6. Provide an updated narrative and cover letter including changes made to the application. • Let me know if you need anything more than this letter and associated attachments. If you have any questions or comments, please do not hesitate to contact me. Sincerely, Rick Rudin Project Engineer CDM Smith Inc. 04 State of North Carolina Department of Environmental Quality Division of Water Resources Flow Tracking for Sewer Extension Applications (FTSE 10-18) Entity Requesting Allocation: (No New Flow) City of Brevard Project Name for which flow is being requested: (No New Flow) Fish Camp Pump Station More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for rill pannp stations along the route of the proposed wastewater flow. I. Complete this section only if you are the owner of the wastewater treatment plant. a. WWTP Facility Name: C, hU ft J S (a u apd b. WWTP Facility Permit #: ytL 60 os-Tq All flows are in MGD c. WWTP facility's permitted flow Z. S d. Estimated obligated flow not yet tributary to the WWTP o . Z & S e. WWTP facility's actual avg. flow zo z_ 9 4,lke I. f. Total flow for this specific request g. Total actual and obligated flows to the facility / 7�, h. Percent of permitted flow used 70 • Z. 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) Design Pump Pump Average Station Station Firm Daily Flow** (Name or Permit Capacity, * (Firm / pf), Number) No. MGD MGD -rs� v. ! �5 (B) (C) (D)=(B+C) (E)=(A-D) Obligated, Approx. Not Yet Total Current Current Tributary Flow Plus Avg. Daily Daily Flow, Obligated Available Flow, MGD MGD Flow Capacity*** o EDtI (, v - 010� * The Firm Capacity (design flow) of any pump station is defined as the maximum pumped flow that can be achieved with the largest pump taken out of service. ** Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor (pf) not less than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Criteria. *** A Planning Assessment Addendum shall be attached for each pump station located between the project connection point and the WWTP where the Available Capacity is < 0. Downstream Facility Name (Sewer): Downstream Permit Number: Page 1 of 6 FTSE 10-18 III. Certification Statement: I JJaf! rr—L\ ()J- S kO 6 IC 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. Signing Of Signature Date C CA.. -)or -lc Q. VC'4c Title of Signing Official 0 Page 2 of 6 FTSE 10-18 PLANNING ASSESSMENT ADDENDUM (PAA) Submit a planning assessment addendum for each pump station listed in Section 11 where Available Capacity is < 0. Pump Station (Name or Number): Given that: a. The proportion and amount of Obligated, Not Yet Tributary Daily Flow (C) accounts for % and MGD of the Available Capacity (E) in Pump Station ; and that b. The rate of activation of this obligated, not yet tributary capacity is currently approximately MGD per year; and that c. A funded Capital Project that will provide the required planned capacity, namely is in design or under construction with planned completion in ; and/or d. The following applies: Therefore: Given reasonably expected conditions and planning information, there is sufficient justification to allow this flow to be permitted, without a significant likelihood of over -allocating capacity in the system infrastructure. I understand that this does not relieve the collection system owner from complying with G.S. 143- 215.67(a) which prohibits the introduction of any waste in excess of the capacity of the waste disposal system. '/�. , , , A/" /' Signing Official Signature � -a7—cl Date Page 3 of 6 FTSE 10-18 Instructions for Flow Tracking form (FTSE) and Planning Assessment Addendum (PAA) Section 1 a. WWTP Facility Name: Enter the name of the WWTP that will receive the wastewater flow. b. WWTP Facility Permit #: Enter the NPDES or Non -Discharge number for the WWTP receiving the wastewater flow. c. WWTP facility's permitted flow, MGD: From WWTP owner's NPDES or Non -Discharge permit. d. Estimated obligated flow not vet tributary to the WWTP, MGD: This includes flows allocated to other construction projects not yet contributing flow to the collection system. Flows allocated through interlocal agreements or other contracts not yet contributing flow to the collection system are also included. For POTWs that implement a pretreatment program, include flows allocated to industrial users who may not be using all of their flow allocation. Please contact your Pretreatment Coordinator for information on industrial flow tributary to your WWTP. As of January 15, 2008 the POTW should have reviewed flow allocations made over the last two years and reconciled their flow records, to the best of their ability, so it is known how much flow has been obligated and is not yet been made tributary to the WWTP, in accordance with local policies and procedures employed by the reporting entity. e. WWTP facility's actual avg. flow, MGD: Previous 12 month average. f. Total flow for this specific request MGD: Enter the requested flow volume. g. Total actual and obligated flows to the facility, MGD Equals [d + e + f] h. Percent of permitted flow used: Equals [(g / c)* 100] For example: On January 15 a POTW with a permitted flow of 6.0 MGD, reported to the Regional Office that there is 0.5 MGD of flow that is obligated but not yet tributary. The annual average flow for 2007 is 2.7 MGD. There is a proposed flow expansion of 0.015 MGD. The first Form FTSE submitted after January 15, 2008 may have numbers like this: c. = 6.0 MGD d. = 0.5 MGD e. = 2.7 MGD f. = 0.015 MGD g. = 3.215 MGD h. = 53.6 % The next Form FTSE may be updated like this with a proposed flow expansion of 0.102 MGD: c. = 6.0 MGD d. = 0.515 MGD e. = 2.73 MGD f. = 0.102 MGD g. = 3.349 MGD h. = 55.8 % Each subsequent FTSE form will be updated in the same manner. Page 4 of 6 FTSE 10-18 Section II List the pump station name or number and approximate pump station firm capacity, approximate design average daily flow (A) approximate current average daily flow (B), and the obligated, not yet tributary flow through the pump station (C) for each pump station that will be impacted by the proposed sewer extension project. Calculate the total current flow plus obligated flow (D=B+C) and the available capacity (E=A-D). Include the proposed flow for this project with other obligated flows that have been approved for the pump station but are not yet tributary (C). Firm capacity is the maximum pumped flow that can be achieved with the largest pump out of service as per the Minimum Design Criteria. Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor (pf) of not less than 2.5. If the available capacity (E) for any pump station is < 0, then prepare a planning assessment for that pump station if the system has future specific plans related to capacity that should be considered in the permitting process. (A) (B) (C) (D)=(B+C) (E)=(A-D) Obligated, Design Approx. Not Yet Total Current Firm Average Current Avg. Tributary Flow Plus Pump Station Capacity Daily Flow Daily Flow, Daily Flow, Obligated Available (Name or Number) MGD (Firm / pf) MGD MGD Flow Capacity* Kaw Creek PS 0.800 0.320 0.252 0.080 0.332 -0.012 Valley Road PS 1.895 0.758 0.472 0.135 0.607 0.151 Page 5 of 6 FTSE 10-18 Planning Assessment Addendum Instructions Submit a planning assessment addendum for each pump station listed in Section I1 where available capacity is < 0. A planning assessment for Kaw Creek PS (see example data above) may be performed to evaluate whether there is significant likelihood that needed improvements or reductions in obligated flows will be in place prior to activating the flows from the proposed sewer extension project. If the system decides to accept the flow based on a planning assessment addendum, it is responsible to manage the flow without capacity related sanitary overflows and must take all steps necessary to complete the project or control the rate of flow to prevent sanitary sewer overflows. The planning assessment may identify a funded project currently in design or construction, or a planned project in the future not yet funded but in a formal plan adopted by the system. The system should carefully weigh the certainty of successful timely project completion for any expansion, flow management diversion or infiltration and inflow elimination projects that are the foundation of a planned solution to capacity tracking and acceptance compliance. For example: Given that: a. The proportion and amount of obligated, not yet tributary flow accounts for 24 % and 0.080 MGD of the committed flow in Pump Station Kaw Creek; and that b. The rate of activation of this obligated, not yet tributary capacity is currently approximately 0.01 MGD per year; and that c. A funded capital project that will provide the required planned capacity, namely is in design or under construction with planned completion in ; and/or d. The following applies: The master plan and ten year plan contain recommended scope and funding for a capital project entitled Kaw Creek Pump Station upgrade with funding_ planned in July 2014 This project is planned to add 0.100 MGD to the firm capacity of the pump station by October 2015 Inclusion of this proposed capital project as a condition of this Flow Tracking/Acceptance for Sewer Extension Permit Application elevates this project's priority for funding and construction to be implemented ahead of the activation of obligated not yet tributary flows in amounts that exceed the firm pump station capacities identified in Section II above Therefore: Given reasonably expected conditions and planning information, there is sufficient justification to allow this flow to be permitted, without a significant likelihood of over -allocating capacity in the system infrastructure. Page 6 of 6 FTSE 10-18