WQ0004843_Application (FTSE)_20181119

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. Central Fifes: APS ._ S1NP
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P�r��� � e� VVQ00O4843
- Permit Tracking Slip
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` Program Category
�3 P ro�ect Type Status �. ..>
Non-discharge In review Major modification
Permit Type
. yR version Permit Classification.
.. .Gravity Sewer Extension, Pump Stations,&Pressure Sewer Extensions F: Individual
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Primary Reviewer Permit Contact Affiliation
dean.hunkele
Coastal SWRt6le
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Permitted Flag
900,�288
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FacilityName - F
� Major/Minor Region
Country Haven Pump Station Minor Wilmington
Location Address County =
New Hanover � I
Facility Contact Affiliation -
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• nor _
Owner Name Owner Type �
Cape Fear Public Utility Authority Government-Municipal
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Owner Affiliation
- � - James R.Flechtner
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PE
235 Government Center Dr
Dates/Events Wilmington NC 28403
• Scheduled
Urgg Issue App Received Draft initiated issuance Public Notice - Issue Effective Expiration .
6/14/1991
- Reg"14--t6d.A 6fivitles Requested/ eceived Events
Apartment`complex : - Additional information reqLiested
Comrnercial or industrial,other. _
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Additional information::received.
Grocery
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October 3. 2O18 '
OCT 7018 '
DeanHunk�e - ' �
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Senior Environmental Specialistater Quality Regional
NC. [)EQ.Wilmington Regional Offioe `'
Operations Section
127 Cardinal Drive Extension VVi|mingi[on Regional Office
Wilmington, NC284O5
Re: Country Haven Pump Station Capacity Upgrade
Fast Track Sewer Extension Application
Cape Fear Public Utility Authority
OearDomn.
Please find attached the fast track sewer extension application for the Country Haven Pump Station
Capacity Upgrade project submitted on behalf of the Cape Fear Public Utility Authority. The
following items have been provided with this application:
. w $48O application fee
° Form FTAO4-16
w Site Maps
0 Existing Permit /
|f you have any questions or comments, please contact me at your earliest convenience.
Sincere{y,
of the Carolinas
Jacob— G. '-------' PE
Project Manager
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hunnm oom mm
101 m 3rd Street Suite 201 vmminoton.mC 28+01-4034
(e10)398-e020
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State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 42T.0300—FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
LLlrrllrn of Water Resources FTA 44-16&SUPPORTING DOCUMENTATION
Application Number: to be completed b,DWR
pp � P � )
All items must be completed or the application Will be returned
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I. APPLICANT INFORMATION:
1. Applicant's name: Cape Fear Public Utility Authority(company, municipality,HOA,utility, etc.)
2. Applicant type: El Individual El Corporation ❑ General Partnership ❑ Privately-Owned Public Utility
❑ Federal ❑ State/County N Municipal ❑ Other
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3. Signature authority's name: Carel Vandermeyden,PE per 15A NCAC 02T.O106(b)
Title:Director of Engineering
4. Applicant's mailing address: 23 5 Government Center Drive
City: Wilmni on State:NC Zip: 28403-1670
5. Applicants contact information: }; OCT ► t
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Phone number: (910)3 32-6560 Email Address:carel.vandermeydenCcfpua.org 7
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II. PROJECT INFORMATION:
1. Project name: Countrg Haven Pump Station Capacily Upgrade i
2. Application/Project status: ❑ Proposed(New Permit) Existing Permit/Project
If a modification,provide the existing permit nlunber: WQ0004843 and issued date: 11/j--_`'i2013
If new construction but part of a master plan,provide the existing permit number: WQ00
3. County where project is located: New Hanover
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4. Approximate Coordinates(Decimal Degrees): Latitude: 34.17' Longitude: -77.47'
5. Parcel ID (if applicable): R03600-005-016-001
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Jacob VandenBosch,PE License Number: 037990
Finn:HDR Engineering,Inc. of the Carolinas
Mailing address: 101 N. 31 Street, Suite 201
City: Wilmington State:NC Zip: 28401-4034
Phone number: [phone] Email Address:jacob.vandenbosch(andrinc.com
IV. WASTEWATER TREATMENT FACILITY(WWTF)INFORMATION:
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1. Facility Name: Northside WWTP Pen-nit Number: WQ23965A03
Owner Name: Cape Fear Public Utility Authority
V. RECEIVING DOWNSTREAM SEWER INFORMATION if different than WWTF):
1. Permit Number(s): WQ0004843 Downstream(Receiving)Sewer Size: 12 inch
System Wide Collection System Permit Number(s)(if applicable): WQCS00012
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Owner Names): Cape Fear Public Utility Authority
FORM: FTA 04-16 Page 1 of 5

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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 EN/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 EN/A
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. If the Applicant is a Home/Property Owners Association,has an Operational Agreement(FORM:HOA)been attached?
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❑Yes ❑Na EN/A
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4. Origin of wastewater: (check all that apply):-
E Residential Owned E Retail(stores,centers,malls) ❑ Car wash �
E Residential Leased E Retail with food preparation/service ❑ Hotel and/or Motels
❑ School/preschool/day care E Medical/dental/veterinary facilities E Swimming Pool/Clubhouse
❑ Food and drink facilities E Church ❑ Swimming Pool/Filter Backwash
E Businesses/offices/factories El Nursing Home ❑ Other(Explain in Attachment)
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5. Nature of wastewater: 100%Domestic/Commercial %Commercial
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%Industrial(See 15A NCAC 02T.0103(20))
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
7. Summarize wastewater generated by project:
Establishment Type(see 02T.0114(f}) Daily Design Flow No. of Units Flow
gal GPD
gal/ GPD
gal/ GPD
g
al/ GPD
gal/ GPD
gal GPD
Total 0 GPD
a See 15A NCAC 02T.0114(b), (d), (e)(1)and(e)(2)for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling;proposed unknown non-residential development uses;public access facilities located near high public use areas; �
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S.42A-4).
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b Per 15A NCAC 02T.0114(c),design flow rates for establishments not identified[in table 15A NCAC 02T.01141 shall be
determined usingavailable flow data,water using fixtures,occupancy or operation patterns,and other measured data.
g
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S. Wastewater generated by project: 0 GPD (per 15A NCAC 02T.0114)
➢ 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 lisle
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❑ Flow has already been allocated in Permit Number:
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❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other(Explain):
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FORM:FTA 04-16 Page 2 of 5

VH. 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
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➢ 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
VIII. PUMP STATION DESIGN CRITERIA(If Applicable)—02T.0305&MDC (Pump Stations/Force Mains): i
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COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or naive: Country Haven
2. Approximate Coordinates(Decimal Degrees): Latitude: 34.17' Longitude: -77.47'
3. Design flow of the pump station: 1.21 millions gallons per day(firm capacity) A-CA
4. Operational point(s)of the pump( 2098 gal ns per minute at 122 feet total dynamic head(TDH)
5. Summarize the force main to be permitted(for this Pump Station): Q.✓
Size{inches} Length{feet} Material
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6. Power reliability in accordance with 15A NCAC 02T.0305(h)(1):
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Standby power source or pump with automatic activation and telemetry- 15A NCAC 02T.0305(h)(1)(B)_
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation,quick-connection receptacle and telemetry- 15A NCAC 02T
.0 305(h)(1)(C)
or
El Portable pumping unit with plugged emergency pump connection and telemetry- 15A NCAC 02T.0305(h)(1)(C): �
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant(draft agreement)
and is compatible with the station.
➢ If the portable power source or pump is dedicated to multiple pump stations,an evaluation of all the pump stations'storage
capacities and the rotation schedule of the portable power source or pump,including travel timeframes, shall be provided
in the case of a multiple station power outage. �
FORM: FTA 04-16 Page_ of 5

Ix. SETBACKS& SEPARATIONS—(02B.0200 & 15A NCAC 02T.0305(f)):
1. Does the project comply with all separations 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 severs and other-utilities not listed below(vertical) 24 inches
Water mains(vertical-water over sever including in benched trenches) 18 inches
Water mains(horizontal) 10 feet
Reclaimed water lines(vertical-reclaimed over sewer) 18 inches
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Reclaimed water lines(horizontal-reclaimed over sewer) 2 feet
"Any,private or public water supply source, including any wells,WS-I waters of Class I or
Class II impounded reservoirs used as a source of drinking water 100 feet
**Waters classified WS(except WS-I or WS-V),B, SA,ORW,HQW, or SB from normal
high water(or tide elevation)and wetlands(see item IX.2) 50 feet
**Any other stream,lake,impoundment,or ground water lowering and surface drainage
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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
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Drainage systems and interceptor drains 5 feet
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Any swimming pools 10 feet
Final earth grade(vertical) 36 inches
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➢ 15A NCAC 02T.0305(gg)contains alternatives where separations in 02T.0305(f)cannot be achieved.
➢ `*Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
➢ If noncompliance with 02T.0305(f)or(g),see Section X of this application
2. Does the project comply with separation requirements for wetlands?(50 feet of separation) Yes ❑ No ❑ N/A
➢ See the Division's draft separation requirements for situations where separation cannot be meet
➢ No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
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3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? Yes ❑ No ❑ NIA
➢ This would include Trout Buffered Streams per 15A NCAC 2B.0202 j
4. Does the project require coverage/authorization under a 404 Nationwide or ❑ Yes No
individual pen-nits or 401 Water Quality Certifications?
➢ Information can be obtained from the 401 &Buffer Permitting Branch
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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?" j
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 [I No ❑ N/A
➢ If yes, include an attachment with details for each line,including type(aerial line, size,material,and location).
High priority lines shall be inspected by the permittee or its representative at least once every six-months and inspections
documented per 15A NCAC 02T.0403(a)(5)or the permitee's individual System-Wide Collection permit.
FORM:FTA 04-16 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,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 Q.C.oL VC4.0n C�R—on F�o attest that this application for
(Professional Engineer's name from Application Item III.1.)
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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 doctunnentation to the best of my knowledge. I.fiu-ther 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 j
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 14 3-215.6B, 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.
..................................... ..............................................
North Carolina Professional Engineers seal,signature,and date: `�� ,�tA CA�
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3. Applicant's Certification per 15A NCAC 02T.0106(b):
I �- - attest that this application for
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(Signature Authority' 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 -Mll 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:
FORM:FTA 04-16 Page 5 of 5