WQ0040721_Application (FTSE)_20190204

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
I5A NCAC 02T .0300-- FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: wr UV 40 (to be completed by DWR)
All items must be completed or the application will be returned
1. APPLICANT INFORMATION:
1. Applicant's name: CITY OF SANFORD (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: PAUL WEEKS PE per 15A NCAC: 02T .OIOab)
Title: CITY ENGINEER
4. Applicant's mailing address: PO Box 3729 NC Dept of Environmental Quality
City: SANFORD State: NC Zip: 27331-3729
5. Applicant's contact information: FEB O 4 2019
Phone number: L9) 777-1 I 19 Email Address: paul.weeks sanfordnc.net
II. PROJECT INFORMATION: Raleigh Regional Office
I. Project name: FOREST HILLS SEWER EXTENSION
2. Application/Project status: ® Proposed (New Permit) ❑ Existing PermitlProject
If a modification, provide the existing permit number: WQOQ_ and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ0016086
3. County where project is located: LEE
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.4986' Longitude:-79.1953`
5. Parcel ID (if applicable): Lee Coun1y Pin # : 9643-16-7692-00
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: KEN W BRIGHT License Number: 17585
Firm: KEN BRIGHT ASSOCIATES PLLC
Mailing address: PO BOX 553
City: SANFORD State: NC Zip: 27331-0553
Phone number: 919 776-3444 Email Address: KWBRIGHT KENBRIGHTENGINEERING.COM
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: BIG BUFFALO WASTEWATER TREATMENT PLANT Permit Number: 0024147
Owner Name: CITY OF SANFORD
i
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ `� 1 tqO . Downstream (Receiving) Sewer Size: inch
System Wide Collection System PermitNumbg(s) ifa licable : WQCS
Owner Name(s):
S
FORM: FTA 04-16 Page 1 of 5

Vl. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑No ®NIA
2. If the Applicant is a Developer of lots to be sold, has a Developer's operational Agreement (FORM:.DEV) been attached?
[]Yes [:]No ®NIA
3. If the Applicant is a Home-Troperry Owners' Association. has an Operational Agreement (FORM: HOA} been attached?
❑ Yes ❑No ®NIA
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 / preschooI / day care ❑ MedicaI / 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 (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 .01 14f 11? ❑ Yes ®No
➢ If Yes, provide a copy, of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 021.0114tf)}
Daily Design Flow
No. of Units
Flow
RESIDENTIAL
480 ga"IT
7
3,360 GPD
gall
GPD
gaV
GPD
gall
GPD
gall
GAD
gal/
GPD
Total
3,360 GPD
a See 15A NCAC 02T ,0114(h), 10 {ej l.) and le)(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).
b Per 15A NCAC 02T .0l 14(c), design flow rates for establishments not identified [in table 15A NCAC O2T.0114] shall be
determined using available flow data, water using fixtures, occupancy or ope tion patterns, and other measured data
Wastewater generated by project: 3,360 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 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- l6 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers)t
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
716
PVC
8
144
DIP
�0
➢ Section It & 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 StalionslForce Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: F
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 .Q305(h)(I ):
❑ 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)(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 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(f) i. (r_)
➢ 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for 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
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
l00 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 ?
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
AnX swimming pools
10 feet
Final earth grade vertical
36 inches
➢ 15A NCAC 02T.030 contains alternatives where separations in 02T.0305if) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water C. lass ificatio_n_s_webna,;e
➢ if noncompliance with 02T.0305(f) or (e), 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
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑ Yes ❑ No ® N.-'A
➢ This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project require coverage/authorization under a 404 Nationwide or ❑ Yes ® No
individual permits or 401 Water Quality Certifications?
➢ Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02T.0I05(c)(6) (additional permits/certifications)? ® Yes [:]No
Per 15A N AG 02T.0(05(c)(& 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 ❑ NIA
➢ 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

IL CERTIFICATIONS:
1. Does the submitted rystam comply with l5A NCAC 02T'. the ffMinwm De4n Criteria for the Pertaining of Puma St;sd=
and Force Main& flatest version), and the W! jty Sewer Minimum lksian Critffja (latest version) as applicable?
® Yes ❑ No
KNo, complete and submit the Varlance/Alternative Design Request application (VADC 10-14) and supporting documents for
review.
2. Professional Engineer's Certification:
1. - Kea W. Bright == that this application for
(Professional Engineer's name from Application Item M.1.)
Forest Hills Sewer Extension
has been reviewed by me and is accurate, complete and consistent with the le formation supplied in the pleas, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. I further aunt drat tD 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 fire Minimum Design Criteria for the Fast Track Permitting
of Pump Stations and Forte Maims (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 143-215AB, any person who imowingly mak" any false
statemem, 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 Roglmeer's seal, signature, and date: .•`-O� '�O(
SEAL
10
. 13�
3. Applicant's Certification per 15A NCAC MT .0106(b):
1, Paul Weeks, PE attest that this application for
(Signature Authority's imams, & title from Application Item 1.3.)
Forest Hills Sewer Extension
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 am not completed and drat if all required supporting documentation and attachments are not included, this
application package is abject to being returned as incomplete. I understand that any discharge of wastewater from this non -
discharge system to surface waters or the Ind will result inns 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 rationed to me as
Incomplete.
NOTE - In accordance with General Statutes 143-215.6A and JAU=. any person wbo 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 mot to exceed $10.000 as wall trs civil penalties uy%-AW per violation.
FORM: FPA 04-16 Page 5 of 5

State of North Carolina
Department of Environmental Quality
DD
Division of Water Resources
Divislon of Water Resources Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: City of Sanford
Project Name for which flow is being requested: Forest Hills Sewer Extension
More than one FTSE may be required far a single project if the owner of the WWTP is not responsible for all pump
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: Big Buffalo WWTP
b. WWTP Facility Permit #: NC0024147
All flows are in MGD
c. WWTP facility's permitted flow 12.0
d. Estimated obligated flow not yet tributary to the VVWTP 1.17887
e. WWTP facility's actual avg. flow 4.616
f. Total flow for this speck request 0.0036
g. Total actual and obligated flows to the facility 5.79823
h. Percent of permitted flow used 48.32%
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) (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 l P0, Daily Flow, Daily Flow, Obligated Available
Number) MOD MOD MOD MOD Flow Capacity***
* 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 pealdng
factor (pf) 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 g 0.
Downstream Facility Name (Sewer):
Downstream Permit Number:
Page 1 of 6
FTSE 04-16

III. Certification Statement:
I Paul M Weeks JR., P.E. 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 indicates acceptance of this waspe ater o
Signing Official Signature
Date
Page 2 of 6
FfSE 04-16

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KEN BRIGHT ASSOCIATES, PLLC
January 31, 2019
Mr. Ted Cashion
North Carolina Division of Environmental Quality
1628 Mail Service Center
Raleigh, NC 27699-1628
Re: Forest Hills Sewer Extension
Lee County
Dear Mr. Cashion:
Enclosed please find the following documents:
1. The fast track sewer application.
2. Form FTSE 04-16
3. A check for the amount of $ 480.00.
4. A Color copy of a USGS Topographic map.
5. A Street level map.
The project consists of the extension of approximately 860 LF of 8" PVC and DIP pipe
to serve 7 residential lots. The receiving sewer is an 8" line.
If you have any questions please feel free to contact me.
1 would appreciate your reviewing these as soon as possible. If you have any questions
please feel free to contact me.
Sincerely,
Ken W. Bright, PE
Ffle.project2017�The Parkl$ewer:`Letter sewer appl. doc
P.O Box 553
2305 Carthage Street
Sanford, NC 27330
Phone, [phone]
e-mail: kwbright@ken brig htengineering. com

Cashion, Ted
From: Paul Weeks <[e-mail]>
Sent: Tuesday, March 19, 2019 12:51 PM
To: Cashion, Ted; 'Ken Bright'
Cc: Robinson, Jason; Deck, Erin M
Subject: (External] RE: Forest Hills sewer extension fast track application
External errisil. Do not,allek finks or open attachments unless you verify. teni-aff susptclous emall asan attachment to
L.E2W.spam(@nt_aay
Hey Ted,
The line went in 11/5/1990 based on the City inspector's stamp. It is 8" DIP and VCP. The WWTP permit number is
0024147. The system permit number is WQCS 0047
Best regards,
Paul M. Weeks Jr, P.E.
City of Sanford
City Engineer
225 E. Weatherspoon St
PO Box 3729
Sanford, NC 27330
(o ) 919-777-1119
(o)919-777-1122
From: Cashion, Ted [mailto:[e-mail]]
Sent: Tuesday, March 19, 2019 11:36 AM
To: Paul Weeks <[e-mail]>; Ken Bright<[e-mail]>
Cc: Robinson, Jason <[e-mail]>; Deck, Erin M <[e-mail]>
Subject: Forest Hills sewer extension fast track application
Hi Paul and Ken,
We're reviewing the subject application. Can you provide the info in item V of the application — downstream sewer
permit number ( if too old to have been issued a permit, provide the approximate age of the line), downstream sewer
size ( I believe the narrative states it's 8", please confirm), and collection system permit number.
Thx
ted
Ted Cashion
Water Quality Regional Operations