WQ0040324_Application (FTSE)_20180815

Strickland, Bev
From: 1 [e-mail]
Sent: Friday, October 05, 2018 11:36 AM
To: Dunn, Barbara M
Subject: USE Permit - WQ0040324
Attachments: USE Permit - WQ0040324.pdf
See attached document
Attachment File Type: pdf, Multi -Page
Multifunction Printer Location: machine location not set
Device Name: Xerox 5955 2nd Floor
Multifunction Printer IP Address: 10.251.193.234

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T.0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: WI 0l]42)dM (to be competed by ❑WR)
All items must be completed or the anplication will be returned
1. APPLICANT INFORMATION:
1. Applicant's name: City_ of Rocky Mount (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State/County ® Municipal
3. Signature authority's name: William B. Kerr. PE per 15A '14CAU U2T _01.06 b
Title: Director of Engineerine
4. Applicant's mailing address: PO Box 1180
City: Rocky Mount State: NC Zip: 27802-
5. Applicant's contact information:
Phone number:2(_52) 972-1120 Email Address: brad.kerrQrockymountnc.go_v
II. PROJECT INFORMATION:
❑ Privately -Owned Public Utility
❑ Other
NC Dept Of Fnviron,11en1,11 ptt�llity
A01i 1 " 2018
Raleigh Regionai office
1. Project name: Stonewall Villas- Phase 1
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: Nash
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.962185 Longitude: -77.8I0042
5. Parcel ID (if applicable): 316039
(or Parcel 1D to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: J. Michael Stocks License Number: 19843
Firm: Stocks_ Engineering, P.A.
Mailing address: PO Box 1108
City: Nashville State: NC Zip: 27856 -
Phone number:j2) 459-8196 Email Address: mstocks(a-)stocksengineerine com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Tar River Regional Wastewater Treatment Plant Permit Number: NC030317
Owner Name: Ci1y of Rocky Mount.
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 5

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 Developer's Operational Agreement (FO}tM: UEV} been attached?
❑ Yes [:]No ®N'A
3. If the Applicant is a Home[Proaerty.Owners' Association, has an Operational Agreement fl, HOA) been attached?
❑ Yes ❑No [ON. -: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 f 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: 100 % Domestic/Commercial % Commercial
% Industrial ( 1 SA NCAC 0?'I' ,0103(203)
4 Is there a Pretreatment Program in effect? ❑ Yes [:]No
6. Has a flow reduction been approved under 15ANCAC_02T _01 14f 1l? ® Yes ❑ No
D If yes, provide a cony of flow reduction annroval letter
7. Summarize wastewater generated by project:
Establishment Type (see 021.0114ff}1
Daily Design Flow' b
No. of Units
Flow
Residential Lots
360 gal/day
14
5,040 GPD
gall
GPD
gall
GPD
gall
GPD
gal/
GPD
gal/
GPD
Total
5,040 GPD
a See S N &C 02T .0I 14[h), WL (e)(1) and fel(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. 42A4).
b Per 15A NCAC 02T.01 14(c), design flow rates for establishments not identified [in table 15A 1tiCAC 02T_01 14] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 5,040 GPD (per 15A.NCAC 02T,0 1 14)
D Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this Iine
❑ FIow 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

Vll. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T.0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 670 SDR -26 PVC
➢ Section 11 &III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section Ill 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
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) - 02T.0305 & MDC (Puma Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: - _
3. Design flow of the pump station: millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): _ gallons per minute at feet total dynamic head (TDH)
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 .0305(h)(11.
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(13).,
➢ 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 - I5A NCAC 02T .0305(h)(1)(C):
D 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.
FORM: FTA 04-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B.0200 & 15A NCAC 02T .0305(f)):
I. Does the project comply with all separations found in 15A NCAC 02T _0305Ct & f¢l
➢ 15A NCAC 02T.030541) contains minimum seuarations that shall be nrovided far 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
IS 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 -1 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
Any building foundation
10 feet
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 grade vertical
36 inches
15A NCAC 02T_0305(g) contains alternatives where separations in 02T.0305[fw cannot be achieved.
D **Stream classifications can be identified using the Division's 14C Surface Water Classifications webpaec
If noncompliance with 02T.0305(f) or f, see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes ❑ No
See the Division's draft separation requirements for situations where separation cannot be meet
D 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 all setbacks found in the river basin rules per 15A NCAC 02B.0200? ® Yes ❑ No
D This would include Trout Buffered Streams per 15A NCAC 213.0202
4. Does the project comply with an individual 404 Permit or any 401 Certifications? ® Yes ❑ No
D 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 Permitting Branch
5. 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 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 ® No
D 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 onceevery 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 NC AC 02T, the Minimum Design C ritcria liar the Permitting of Pump Stations
and Farce Mains tlatest version, and the Gravity 5cwer Minimum Desien Criteria (latest vcrsian) as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. ARRroval of the request is required prior to submittal of the Fast Track Application and supporting documents
2. Professional Engineer's Certification:
I, 11
CkACA&A S4crAc _ _ attest that this application for
(Professional Engineer's name from Application Item Ill. 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, 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 (Iatest 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 143-215.66, 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.
........................_ .-._._....._..._ _...... ....
.
��tit�et�trtii
North Carolina Professional Engineer's seal, signature, and date: ♦♦�`,H CgRO''►.,�
�.`�� .•'FESS/p'.; Ly�
L
a SEAL
'!9843 s
Applicant's Certification per 15A NCAC 02T .0106(b):
f
1, _ VV ! �! t Q_e-A J� rr _ attest that this application for
(Signature Authority's name & title from Application Item I.3.)
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 143-2I5.6B, 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: / • g,
�t
FORM: FTA 04-16 Page 5 of 5

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: City of Rocky Mount
Project Name for which flow is being requested:
Stonewall Villas - Phase I
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewater flow.
1. Complete this section only if you are the owner of the wastewater treatment plant.
0
a. WWTP Facility Name: Tar River Regional WWFP
(A)
(B)
b. WWTP Facility Permit #: NC 0030317
(D)=(B+C)
E �
All flows are in MCDi U-)
c. WWTP facility's permitted flow
21.00
Lo
d. Estimated obligated flow not yet tributary to the WWTP
0.531
�-
e. WWTP facility's actual avg. flow
10.83
Q
f. Total flow for this specific request
0.00504
A
g. Total actual and obligated flows to the facility
11.366
Flow**
h. Percent of permitted flow used
54.124%
Flow Plus
Il. Complete this section for each pump station you are responsible for along the route of this
proposed wastewater flow.
List pump stations located between the project connection point and the WWTP:
(A)
(B)
(C)
(D)=(B+C)
(E)=(A-D)
Design
Obligated,
Pump
Average Daily
Approx.
Not Yet
Total Current
Station
Firm
Flow**
Current Avg.
Tributary
Flow Plus
(Name or
Capacity, *
(Firm / pf),
Daily Flow,
Daily Flow,
Obligated
Available
Number)
MGD
MGD
MGD
MGD
Flow
Capacity***
97 Lift St.
30.0
12.0
6.5
0.2
6.7
5.3
* The Firm Capacity 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 (pi) not less than 2.5.
*** 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): Tar River Regional
Downstream Permit Number: NC 0030317
Page 1 of
FTSE 04-16

Ill. Certification Statement:
I William B. Kerr 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 11 plus all
attached planning assessment addendums for which I am the responsible party. Signature of this
form indicates acceptance of this wastewater flow.
Signingial Sig lure Date
Page a of 6
FTSE 04-16

�
`§ �
� �% ` �
�s
@ �
■
»
is
@®
ƒ
2
m � �
�
7
u.
.22
« �
� �
E
I
�
�
�
7
E
o
&
En
�
g
A
.Xf
|
� k
k
�
`§ �
� �% ` �
@ �
■
»
is
@®
E
�
« �
� �
�
a
�
}
E
o
&
�
� k
k
S
f
rL
£ �
�
/
5 'aA
|@ 4

'MICHAEL SCDfT.OR r
BELL DR
tAHfC
kq
a C
MALlru RD si 4 i
� C �
{ ,
r� I WFATHERSTbNFD
STONY
ELSEA OR MANSFIELD DR
f G ` � l 'I3t��oiaa�— p •� ` y
�� .) DDBURN DT
s :1, Ba x3381 NDLS�
N / o TYSDH AYE (� JOAFS•RD
TIMBERLME" O
FNGLFWOOD
3AY 3TYDHDAYSH�'M AND
'
RNFS4f
5 wQWBLVa
Y _
L4
1N8W03td
�o TDRx sr x�� — 1 ZY Al -
OR-
� � � tcl.
S 5 ^ 1
?I NlP
ntcFRysT �,. � rj � jSr
Sr as N MYfST
SRL ST Y Y51 p H R'FtL ST �+� i• u �ai ' =',�� r i' ? .... �' �� �
RCS ST r I 1 %'t

Sewer Project Narrative
For
Stonewall Villas
Stonewall Villas is a subdivision in Rocky Mount, NC that will consist of 71 residential
lots. Phase One of sewer design will serve 14 lots. Stonewall Villas subdivision, is
located off Falling River Walk, just south of US 64 in Rocky Mount. It will consist of
100% domestic flow. The sewer system will be constructed of approximately 670 LF of
8 -inch SDR -26 PVC sewer pipe. Each residential lot served by this sewer service will
require 360ga1?day. Phase One includes 14 lots which makes the total projected flow for
this facility 5,040 GPD. The wastewater treatment plant facility that will be handling this
flow is the Tar River WWTF (Permit # NC 0030317). The permitted flow for the
WWTF is 21.0 MGD (NPDES).

LE717ER OF TRANSMIYFAL
Stocks Engineering, PA
PO Box 1108
J. Michael Stocks, PE Nashville, NC 27856 J. Kevin Varnell
252.903.6891 252.459.8196 252.382.0012
To:
Ted Cashion
NCDEQ-DWQ
3800 Barrett Drive, Suite 101
Raleigh, NC 27609
Phone:
919-791-4252 Overnight No
Yes
Job No.
2018-004 -
0
Job Name:
Stonewall Villas
....
y
Ctd
A
E
N
d
Date:
7/23118
c
W
CM
fy
Sent By:
Ethan Averette
o
We are sendingA
you the following
U
0 EC Plans ❑ Prints/Plans ❑ Construction Plat ❑ Site Plan Drawings ❑ Computer Disk
❑ Contracts x Permit Applications ❑ Site Work Calculations ❑
These are transmitted as checked below:
x For Approval Cl As Discussed ❑ For Your File ❑ As Requested O For Your Use
❑ For Review and Comment ❑ For Your Signature, then return to
Copies Date Description
2 8-13-18 Fast Track Sewer Application
2 8-13-18 Flow Tracking/Acceptance for Sewer Extension Applications
2 8-13-18 USGS Map with location of site shown
2 1 8-13-18 1 Street Map of Surrounding Area
2 1 8-13-18 1 Sewer Narrative
1 1 8-13-18 1 Permit Fee Check
Copies To: