WQ0039978_Application (FTSE)_20190204

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
IV
Application Number: �A lJ U&A be completed by PwR)
All Items must be completed or the application will be returned
I. APPLICANT INFORMATION: JW
1. Applicant's name; Old North State Water Company. LLC (company, municipality, HOA, utilit ,etc.) 4
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
El Federal ❑ State.. -County❑ Municipal ❑ Other �4
3. Signature authority's name: Michael J. Myers per 15A NCAC 02T .0106(b)
Title: Pre i e
4. Applicant's mailing address: 4700 Homewood Court_ Suite 108
City: Raleigh State: NC Zip: 276�0
5. Applicant's contact information:
Phone number: Q& ] 1-jam Email Address. mmeyers@enyirolinkinc_com
IL PROJECT INFORMATION:
1. Project name:Bxiar-Chapel Phase 16 North
2. Application/Project status: ❑ Proposed (New Permit) ® Existing Permit/Project
If a modification, provide the existing permit number: WQ0039978 and issued date: 24 8.01.05
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Chalharn
4. Approximate Coordinates (Decimal Degrees): Latitude: 35,8301
5. Parcel ID (if applicable): $2829. 1154, 2177
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Gareth Avant License Number: 036348
Longitude:-79,1265'
NC Dept of Environtnental QuOity
Firm: McKim & Creed. Inc.
Mailing address: 1730 Varsity Drive. Suite 500 Raleigh Regional Office
City: Raleigh State: NC Zip: 27606-
Phone number: (2 ) 233- 091 Email Address: gavantQmckimcreed.coM
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: -Hriar Chapel Utilities Wastewater Treatment Facili1y Phases A and B Permit Number: WQ0028552
Owner Name: Old North State Water Company.
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ0038118 - Briar -Chapel Phase 16 South
System Wide Collection System Permit Numbcr(s) (if applicable): WQCS deb 5 P
Owner Name(s): I North t Water m n L �1
FORM: FTA 04-16 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 ❑NIA
2. If the Applicant is a Developer of lots to be sold, has a R+weioper's 0=91iowl As=cnt fFORM: DEVt been attached?
[--]Yes ®No ❑NIA
3. If the Applicant is a Amdation. has WLCWwJj2nvl A U FORM, HQW 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 / preschool / day care ❑ Medical / dental / veterinary facilities ❑ Swimming Pool iClubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: ISQI % Domestic/Commercial % Commercial
% Industrial ($Vg 1 SA NCAC 42T _JkX20))
bIs there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A )NCAC 02T .0114(fl? ® Yes ❑ No
D If yes, provide a cony of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see OZT.01140
Daily Design Flow
No. of Units
Flow
62
190 gal/day
11,780 GAD
gall
GPD
gal/
GPD
gall
GPD
gall
GPD
gal/
GPD
Total
11,780 GPD
a See 15A NCAC 02T .0114(b). )(g)(l) and (e)f21 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-41.
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.01141 shall
be determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 11,780 GPD (per 15A NCAC 02T .0114) �{
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 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

VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers).
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
I693
PVC
8
707
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) — 02T .0305 & MDC(Pump Stations/Force Mains
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: Briar h gel Please 16N Pump Station
2. Approximate Coordinates (Decimal Degrees): Latitude: 35,8292 Longitude:-79,1266
3. Design flow of the pump station: 0.223 millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 1,K gallons per minute at 615 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
4
1,2I0
DIP
6. Power reliability in accordance with 15A NCAC 02T .03051h1(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)(l)(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-I6 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) & (e)
➢ I5A 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)
I0 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 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
Anv 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
➢ I SA NCACO2T.0305(e) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications weboage
➢ if noncompliance with 02T.03Q5(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
➢ 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 all setbacks found in the river basin rules per ® 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
➢ Information can be obtained from the 401 & BuffetPermitting Branch
5. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 1 SA NCAC 02T.0I05(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
➢ 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:
I. Does the submitted system comply with �, the %l1i1H%V" I)Qio VlFiWlia li)f rf►c Nernritlirm ni•l'Iuulti tirrli++ng
nut v,rcr_i4 aigs j l � �timkkni. and the Qravi y ScwC- •H,1 M-r ti veminnl as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Altemativc Design Request application (VADC 10-14) and supporting documents
for review. Approval of the regual is retsuired arfor to %ubutittal of the Fast Track Application and su oriln 1
JllZtd Meats.
2. Professional Engineer's Certification:
1, ; 6na(M�ner's
_ _attest that this application for
(Professname from Application Item Ill.1.)
Briar Chapel Phase 16 North -» odification
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 ( 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 143-215.6B, any person who knowingly snakes 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 S 10,000. as well as civil penalties up to S25,000 per violation.
North Carolina Professional Engineer's seal, signature, and date:Ak
: `�0 . FESSip • /?i':
0363�tF3
G.
"11114114+++"
3. Applicant's Certification per l5A NCAC 02T ,0106(b).
I, _Michael J. Myers,:l?trsident _attest that this application for
(Signature Authority's name & lisle frorn Application Itcrn 1.3.
Briar Chapel Phase 16 Noah -- Modification
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 ofwastcwalcr 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 arc 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 uccordance with General Statutes 143•.6A and .I43i15.6B, any person who knowingly makes any Pulse
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed S 10.000 as well as civil penalties up to $25,000 per violation.
5ignaiurcw-'-A-kt
� _ We.
FORM: FTA 04-16 page 5 or

State of North Carolina
Department of Environmental Quality
)-WRDivision of Water Resources
Division of Water Res Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Old North State Water Company, LLC
Project Name for which flow is being requested: Briar Chapel - Phase 16 North
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,flotiv.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Briar Chapel Utilities Wastewater Facility Phases A and B
b. WWTP Facility Permit #: WQ0028552
All flows are in MGD
c. WWTP facility's permitted flow 0.330
d. Estimated obligated flow not yet tributary to the WWTP 0.123
e. WWTP facility's actual avg. flow 0,151
f. Total flow for this specific request 0.012 ca
g. Total actual and obligated flows to the facility 0.286
h. Percent of permitted flow used 86.67% 7d
11. Complete this section for each pump station you are responsible for along the route of ets NJ
proposed wastewater flow.
a
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 / pl),
Daily Flow, Daily Flow, Obligated
Available
Number) MGD MGD
MGD MGD Flow
Capacity***
Ph. 15 LS 0.374 0.101
0 0.055 0.055
0.046
* 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 (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 < 0.
Downstream Facility Name (Sewer): Briar Chapel Phase 16 South
Downstream Permit Number: WQ0038118
;z
v
Page I of 6
FTSE 04-16

III. Certification Statement:
I _Michael Myers (President) 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 wastewater flow.
Signing
S �S4y
Date
Page 2 of 6
FTS E 04-16

44��MCKIM&CREED
*° Division of Water Resources
Raleigh Regional Office
3800 Barrett Drive
Raleigh, N.C. 27609
rAM11M07N. Mr. Danny Smith
WE ARE SENDING: ® Originals
❑ Specifications
LETTER OF TRANSMITTAL
DATE. January 30, 2019
FROJECf NO; 2735_0206
TASK NO: REIMB
RE; Briar Chapel — Phase 16 North (Modification)
TRANSMITTAL NO:
PAGE 1 OF 1
❑ Prints
❑ CalcuIations
❑ Shop Drawings ❑ Samples
® Other - Fee
Quantity Drawing No. Rev Description Status
2
Fast Track Application for Gravity Sewers, Pump Stations and
Force Mains
G
2
Copy of previously provided FTSE Form
G
2
Project Narrative & USGS Map
C
1
Permit Application Fee ($480.00)
C
1
Certificate of Public Convenience and Necessity and Franchise
Document
C
1
Briar Chapel Flow Reduction Approval
C
1
Copy of Original Approval Letter (WQ0039978)
C
Issue Status Code: A. Preliminary B. Fabrication Only C. For Information D. Bid
E. Construction F. For Review & Comments G. For Approval H. See
Remarks
Action Status Code: 1. No Exceptions Taken 2. Make Corrections Noted 3. Other
4. Amend & Resubmit 5. Rejected -See Remarks
1730 Varsity Drive, Sidle SM, Raleigh, NC 27G06 91912336091 Fax 919r233.11MI
Cc: File McKIM & CREED, INC.
VC Dept of Environmental Quality
FEB U 4 2019 �/ 44
Signed .
Gareth Avant, PE
Raleigh Regional Office Project Engineer