WQ0029358_Application (FTSE)_20180910 (2)

u , Odom
Engineeringi3ac
August 31, 2018
Tim Heim
NCDEQ —Asheville Regional Office
2090 US Highway 70
Swannanoa, North Carolina 28778
Subject: Fast Track Sewer System Extension Application
Henderson County —White Oak Phase V Project
Dear Mr. Heim:
169 Oak Street • Forest City, NC 28043
office 828.247.4495 • fax [phone]
SEP - 4 2018
,p r?o^rations
We are submitting a Fast Track Sewer System Extension Application for the White Oak Phase V project
located in Henderson County. This submittal will include one original and one copy of the following
items:
■ Fast Track Sewer Application
■ Check for application fee
■ USGS Topographic Map
Please note that this project is part of the White Oak Village project, Permit No. WQ0029358 and dated
9/25/05. Flow allocation/acceptance has not been included with this application because the existing
permit allocated flow for 120 homes. The total number of homes existing and proposed in White Oak
Village is 115.
If you have any questions or need additional information, please contact me at 828-247-4495 or
[e-mail].
Sincerely,
David Odom, P.E.

State of North Carolina
j r � Department of Environmental Quality
� x1 (, Division of Water Resources
42 ;41 15A NCAC 02T.0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: (to be completed by DWR)
All items must be: completed or the application will be returned
1. APPLICANT INFORMATION:
1. Applicant's name: A&D Water Service, Inc (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership 0 Privately -Owned Public Utility
❑ Federal ❑ State/County ❑ Municipal ❑ Other
3. Signature authority's name: AUBREY D.EAVER per 15A NC1C 02T .0106{b)
Title: PRESIDENT
4. Applicant's mailing address: PO Box 1407
City: PISGAH FOREST State: NC Zip: 28768-
5. Applicant's contact information:
Phone number:[phone] Email Address: [e-mail]
II. PROJECT INFORMATION:
1. Project name: WHITE OAK PH V
Gas
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SEP - 4 2018
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2. Application/Project status: ❑ Proposed (New Permit) `� Existing Permit/Project
If a modification, provide the existing permit number: WQ00915SSnd issued date: _ Ct
If new construction but part of a master plan, provide the existing permit number: WQ00 Vg35t
3. County where project is located: HENDERSON
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.826388° Longitude: -80.873611°
5. Parcel ID (if applicable):
(or Parcel ID to closest downstream sewer)
ill. CONSULTANT INFORMATION:
1. Professional Engineer: DAVID W. ODOM, PE License Number` NC 21130
Firm: ODOM ENGINEERING, PLLC
Mailing address:, 169 OAK ST.
City: FOREST CITY State: NC Zip: 28043
Phone number: [phone] Email Address: davidodom@odoinengineering:com
1V. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
Fiet4eu5ortittlle Wastewater
1 FaeilityName:t0ya4 Faulity Permit Number:.N0002553'1
Owner Name: tA"F HQ(1( M1%Vft
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than'WWTF):
1. Permit Number(s) WQ Downstream (Receiving) Sewer Size: inch
System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner. Name(s):
FORM: FTA 04-16 Page 1 of

V1. 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 Develol7cc' (-- rational A rccm4;nt:_(1�t�1�_M;-1­1-1--
[]Yes
.)i V been attached?
❑ Yes ❑No MN/A
3. If the Applicant is a Home/Property Owners' Association_has an C7perational_ f4reenient (FORM: HOA) been attached?
[-]Yes ❑No NN/A
4. Origin of wastewater: (check all that apply):
0 Residential Owned ❑ Retail (stores, centers, malls)
❑ Residential Leased ❑ Retail with food preparation/service
❑ School / preschool / day care ❑ Medical / dental /veterinary facilities
❑ Food and drink facilities ❑ Church
❑ Businesses / offices / factories ❑ Nursing Home
5. Nature of wastewater : 100 % Domestic/Commercial % Commercial
❑ Car Wash
❑ Hotel and/or Motels
❑ Swimming Pool /Clubhouse
❑ Swirpming Pool/Filter Backwash
❑ Other (Explai`n`in Attachment).
l No SEP - Q M8
% Industrial (Seep 15A NCAC 02T.0 103(20))
:Is there a Pretreatment Program in effect? ❑ Yes
6. Has a flow reduction been approved under ;I5A NCAC 02T .0114(i)? ❑ Yes ❑ No
r If Yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment.Type (see 0 T.0114W)
Daily Design Flow a,n
No. of Units
Flow
gal/
GPD
gal/
GPD
gay
GPD
gal/
GPD
gal/
GPD
�C`L 4 I �i�_0&w �tL t7�►FtCP t' ' 1 c et'tl t, > W'
Tdtul
- -,P"PD�
21,
a See 15A NCAC 02T.01 14(b), (d). (e)(I) a0c 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`1 42A4),
b Per 15A.NCAC '02T .0114(c), design flow rates for establishments not identified. [in table 15A NCAC 02T.ti l X41;shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other, measured data.
8. Wastewater generated by. project: 1=1520'GPD (per 15A NCAC 02'L.01 14'1
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
F] Pump Station.or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been; allocated in Permit.Number:
❑Rehabilitation or replacement of existing sewer with no new flow expected.
❑ Other (Explain):
FORM: FTA 04-16 Page 2 of 5

V1I.
VIII.
GRAVITY SEWER DESIGN CRITERIA (If Applicable) - fit.1ti 30 & nALK", (t: Cavi€;.,Sewers .:
Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material j
i
SEF - Q 2018
i
➢ 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 requirement is not allowed and a violation of the MDC
PUMP STATION DESIGN CRITERIA (If.Applicable) —_02T .0305-& MDt. Pun►gr.,.8lations/Farce fqa us):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station nurnber or.name:
2. Approximate Coordinates (Decimal Degrees): Latitude 0 Longitude: - °
3. Design flow of the pump station: millions gallons perday(firm capacity)
4. Operational point(s) of the pump(s): gallons per minute at feet total dynamic head (TDI -1)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15A NCAC 02T .030`i(h]L),:
Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(B)
Y 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 - MA NCAC 02T
0305(h)(1)(C)
or
El Portable pumping,unit with plugged emergency pump connection and telemetry- -15A NCAC 02T .0305(h)(I)(C):-
It shall be demonstrate dto 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 timefiatnes, shall be provided
in the case of a multiple station power .outage:
FORM: FTA 04-16 Page 3 of 5

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SEP - 4 2018
IX. SETBACKS & SEPARATIONS — (0213.0200 & 15A NCAC 02T.0305(f)):
1. Does the project comply with all separations found in 1 A N A Q?"['_.O.i{)S{ fl is C }' l ® Yes ❑ Nd
Y 15A NCAC 02T.0305(f) contains minnnum separations that shall be provided for sewers stems:
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 11 impounded reservoirs used as a source of drinking water
100 feet
**Waters classified WS (except WS -I or WSN), 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
Any swimming pools
10 feet
Final earth rade vertical
36 inches
15A NCAC 02T.0305(a) 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_(gl see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) 0 Yes [:]No
➢ See the Division's draft separation requirements for situations where separation cannot be meet
> No variance is requited if the alternative designcriteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with all setbacks found in the river basin rules per 15A NCAC 02B .0200? 0 Yes ❑ No
➢ This would include Trout Buffered Streams per 15A NCAC 26.0202
4. Does the project comply with an individual 404 Permit or any 401 Certifications?
0 Yes. ❑ No
r Wetland -related permits shall be requested, obtained, and adhered to for projects that, impact wetlands or surface waters.
�? Information can be obtained from the 401 & Buffer F'ermilting,Branch
Does project comply with 15A NCAC 02 T.0I05 c 6 (additional. permits/certifications)? 9 Yes ❑ No
Per 15A NCAC 02T:0:105(c)(6), 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.0402„ "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 .N No
): If yes, include an attaclimcmt 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; FTA 04-16 Page 4: of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A N( AC;,02_I', the Niulinafni i usiQnCriloria forth fuiniittin o E'urnp � ,anon;
l,nd i ��ac tviair�s,(I�ttikt v� r5icrrt), and the Gr�avilv,SCNVOt, Nlif)*WlUni D ; ign � toi is crest version) as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the request is required prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
I, Dai i dy'. attest that this application for
(Professional Engineer's name from Application Item 11.I.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 preparedin accordance with the applicable regulations, Gravity Sewer
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 GeneralStatutes 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.
North Carolina Professional Engineer's seal, signature, and date: ,(�`A�O��,,�/�''�
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3. Applicant's Certification per 15A NCAC 02T .0106(b):
L`Oyt- , "l� L � Zattest that this application for
's name z title fiom Application Item 13.)
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 appli cation. 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 143-215.613, 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;
Date: 4r'.
SEP - 4 2018
FORM: FTA 04-16; Page 5 of 5

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