WQ0040511_Application (FTSE)_20181026

h State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T.0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources15A
04-16 & SUPPORTING DOCUMENTATION
Application Number: ��0� 1 Ito be completed by oWR>
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name- City of Durham (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: Robert N. Joyner, Jr., PE per 15A NCAC 02T .0106(b)
Title. Development Review Group Manager O'
4. Applicant's mailing address: 101 -City Plaza i
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City: Durham State: IVC Zip: 27701- C=� N c
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5. AppIicant's contact information: Uc••i
Phone number: (9j.2) 560-4326 Email Address. robertJovnerAMurhamnc.gov t y V
II. PROJECT INFORMATION: Z6 �
1. Project name, Ellis Road - Connector Road A P4
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project Z+
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: Durham
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.56- Longitude: -78.51
5. Parcel ID (if applicable): 222525.163385
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
I. Professional Engineer: Z. Nathan Bales, P.E. License Number: 044862
Firm: The John R. Mcadams Comnanv. Inc.
Mailing address: 2905 Meridian Parkway
City: Durham State: NC Zip: 27713 -
Phone number: [phone] Email Address: bales a,,mcadamsco.com
IV. WASTEWATER TREATMENT FACILITY (-,VWTF) INFORMATION:
1. Facility Name: Durham County Triangle WWTP Permit Number: NC 0026051
Owner Name: Durham County
V. RECEIVING DOWNSTREAM SEWER INFORiMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Number(s) (if applicable): WQCS00038
Owner Name(s): Durham Count_v
FORM: FTA 04-I6 Page 1 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 Ooerational Agreement (FORM: DEV) been attached?
❑ Yes ❑No ❑NIA
3. If the Applicant is a Home:,Property Owners' Association, has an Qperational Appeem.ent ORM: HOAbeen attached?
❑ Yes []No ❑N?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 1 day care ❑ Medical dental I veterinary facilities ❑ Swimming Pool /Clubhouse
® Food and drink facilities ❑ Church
El Businesses.." offices /factories El Swimming Poo[/Filter Backwash
❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: % Domestic.:Comrnercial l00 °ln Commercial
% Industrial (See 15A NCAC 02T.0103 {?0))
f--2,Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T _0114if)? ❑ Yes ® No
If vesprovide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 021.0114 Daily Design Flow'-' No. of Units Flow
N/A - Infrastructure only at this time gal{ 0
GPD
gall GPD
gal! GPD
gaL' GPD
gall GPD
gap GPD
Total 0 GPD
a See ISA NCAC 021 .0114b, (d), fe)[ ] ]and. �e)(21 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 Iocated south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in S. 42A -J4.
b Per 15A NCAC 02T.01 14(c), design flow rates for establishments not identified [in table 1,5. N AC 2T.0114] 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 (perSQA NQAC 01T .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 line
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
® Other (Explain): Infrastructure only. Flow will be permitted once parcels are developed.
FORM. FTA 04-16 Page 2 of5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC jGravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
S" 1746 PVC/DIP
➢ 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) —_22T.0305 & MDC (PumI2 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 15_A NCAC_ 02T .0305( le){ 1):
❑ 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
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(f)(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 3 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. 8&
15A NCAC 02T-03 05M contains minimum %enararinnc rhnt chall hA nr i,1 .A r-
® 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
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
CIass II impounded reservoirs used as a source of drinking water
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 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
AnX 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 vols
10 feet
Final earth grade vertical
36 inches
D 1 MA A -C 02T.0305( contains alternatives where separations in 02T.0305(f) cannot be achieved.
D **Stream classifications can be identified using the Division'sC Surface W_ atgr Classifications weboage
➢ If noncompliance with 02T. 305 or}t 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
I No variance is required if the alternative design criteria specified is utilized in design and construction
i 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 I5A NCAC 02B .0.200? ® Yes ❑ No
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
Wetland -related permits shall be requested, obtained, and adhered to for projects that impact wetlands or surface waters
1W Information can be obtained from the 401 & Bu er Permitting Branch
5. Does project comply with 15A NCAC_ 02T.0.105tc1(6) (additional permiWcertifications)?
® Yes [-]No
Per 15A NCAC 02T.OI&cJ(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
-01 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 Minimunt Design Criteria for the Ferntittin of Pum,s Stations
and Force Mains (latest version), and the Gravis Sewer Minimum Design griteria ilatest version l 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 Tracie Application and supporting documents.
2. Professional Engineer's Certification:
I, `-�J.&M C' _&!tE S attest that this application for
(Professional Engineer's name from Application Item Ill. —I.)
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 (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.
North Carolina Professional Engineer's seal, signature, and date:
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3. Applicant's Certification per 15A NCAC 02T.0106(b):
[,Robert N. _Joyner, Jr. 1PE,_Developtnent Review Group Manager 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 and4l 3-215.613, 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 n��xceed $10,000 as well as civil penalties up to 525,000 per violation.
Signature: _ — late: P 11 4
FORM: FTA 04-16 Page 5 of 5

PUBLIC WORKS
CITY OF DURHAM
October 11, 2018
N.C. Department of Environmental Quality
Division of Water Resources
Raleigh Regional Office
1628 Mail Service Center
Raleigh, NC 27699-1628
July 31, 2014
Dear Sirs:
Subject: Sewer Permit Application - Public
ELLIS ROAD - CONNECTOR ROAD
ATC Dept
lrtc
OCT Z 61018
-Raleigh Rcgional Olrl"
Please find enclosed the subject application package, which includes the original and one copy of both
the public completed application form, the appropriate topographic maps, and the $480.00 fee for
each APPLICATION
Should you have questions or comments, please do not hesitate to contact me at [phone], ext
30229.
Robert N. Joyner, Jr.,`F.E., I
Development Review Group Manager
City of Durham
Dept. of Public Works
101 City Hall Plaza, Third Floor, Durham, NC 27701 919.560.4326 DurhamNC.gov Follow Us @C© o/ DurhamNNCC

'J MCADAMs
October 2, 2018
Maurice Smith
City of Durham
Department of Public Works — Engineering Division
101 City Hall Plaza
Durham, North Carolina 27701
Re: Ellis Road — Connector Road
Fast Track Application for Gravity Sewer — Cover Letter
HLE-17000
Mr. Maurice Smith,
FAST TRACK APPLICATION > HLE-17000
NC DeptafCm,ironmenf,-11 pit,1Iity
OCT 2 6 2618
Raleigh Regional 01'1irL
We are proposing a public gravity sewer system as part of the Ellis Road — Connector Road infrastructure plans which
will serve a future commercial development. This application consists of 1,746 LF of 8 -inch gravity sewer which ties
into an existing Durham County public gravity sewer system located beneath Ellis Road at the southwest corner of the
development in addition to road, water line, and storm sewer improvements. Flows generated from the future
development will be permitted at a later date.
Estimated Flow (Infrastructure Only) = 0 GPD
Thank you for taking the time to review our application. A list of the items included in the application package is
provided on the Letter of Transmittal. If you have any questions please feel free to contact me at 919-361-5000 and
[e-mail].
Sincerely,
MCADAMS
. Nathan Bales, PE
Technical Manager, Private Engineering Services
creating experiences through experience 2905 Meridian Parkway, Durham, NC 27713 / 919. 361.s000

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