WQ0040781_Application (FTSE)_20190228

State of North Carolina
DW
Department of Environmental Quality
Division of Water Resources
ISA NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Dlvislon of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: _ a R%a& 0o be completed by dwtt)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
I. Applicant's name: Town of Fu ua -Varina NC (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ GeneraI Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
3. Signature authority's name: Jay T. Movers, PE per 15A NCAC 02T .0106 b
Title: Public Utilities Director
4. Applicant's mailing address: 401 Old Honeycutt Road 2!
City: Fu ua -Varina State: N& Zip: 27526- d
5. Applicant's contact information: m
Phone number: (9� 753-1028 Email Address: 'me ers a fu ua-varina,or
CD 0
, � e
11. PROJECT INFORMATION: o
1. Project name: Lane Dental Plaza Phase I �
tv �
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ00 and issued date: A
If new construction but part of a master plan, provide the existing permit number: WQ00 �
3. County where project is located: Wake
4. Approximate Coordinates (Decimal DcLrces). Latitude: .607= Longitude:-78.806'.
5. Parcel ID (if applicable): 0657-76-7890, 0657-77-5163
(or Parcel ID to closest downstream sewer)
Ill. CONSULTANT INFORMATION:
I. Professional Engineer: Jim Chandler, PE License Number: 026466
Firm: Timmons Groun
Mailing address: 5410 Trinity Road Suite 102
City: Raleigh State: NC Zip: 27607-
Phone number: [phone] Email Address: iim.chandler a timmons.com
1V. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
t. Facility Name: Terrible Creek WWTP Permit Number: N1100 ]h
Owner Name: Town of Fuquay-Varina
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than 11'1VTF):
1. Permit Number(s): WQ0037633 Downstream (Receiving) Sewer Size: 6 inch
System Wide Collection System Permit Numbers if a nheable : WQCS00193
Owner Name(s): Town of Fu as -Varina
FORM: FTA 04-16 Page 1 01'5

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 )C❑NIA
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: D1= V) been attached?
❑ Yes ❑No ®NiA
3. If the Applicant is a Home/Pro er Owners' Association has an Operational Agreement FORM: HOA been attached?
❑ Yes ❑No ❑NSA
4. Origin of wastewater: (check all that apply):
❑ Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential Leased ❑ Retail with food prcparationlservice ❑ Hotel and/or Motels
❑ School / preschool / day care ❑ Medical / dental I veterinary facilities ❑ Swimming Pool /Clubhouse
❑ Food and drink facilities ❑ Church
® offices /factories ❑Swimming Pool/Filter Backwash
Businesses /o
❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: % Domestic/Commercial 100 % Commercial
% Industrial Sec 15A NCAC 02T .0103 20 )
�, Is there a Pretreatment Program in effect? [--]Yes ❑ No
6. Hasa flow reduction been approved under 15_. A NCAC 02T .01 Imo? ❑ Yes ®No
If provide a copy of now reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 112T.0114 1)
Bank (9 max team)
Daily Design Flow ", No. of Units Flow
25 gallemploycel shift 1 9 1 225 GPD
ga F
GPD
gall
GPD
gall
GPD
gall
GPD
gall
GPD
Tolcrl
225 GPD
a Sec 15A NCAC 02T .01 14(b). (d). (c)(1) and (c)(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 cast of the Atlantic Intracoastal Watenvay 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 NCAC 02T.01 141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 225 GPD (per 15A NCAC 02T 01 14)
> 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 now expected
❑ Other (Explain):
ORM: FTA 04-16
Page 2 ol'5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
S 593 PVC
r> Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
D 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
VI11. 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:
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: - u
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 (TDI-I)
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 ! :
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(!)(B)_
v Required far all purnp 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.
fthe portable power source or pump is dedicated to multiple pump stations, an evaluation of all the punlp stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel tinteframcs, shall be provided
in the case of a multiple station power outage.
FORM: (:TA 04-16 Page 3 of5

IX. SETBACKS & SEPARATIONS -- (02B .0200 & 15A NCAC 02T .0305(()):
1. Does the project comply with all separations found in 15A NCAC 02T .0305(I) & (g)
® Yes ❑ No
15A NCAC 02T.0305 contains alternatives where separations in 02T.0305(f) cannot be achieved.
**Stream classifications can be identified using the Division's NC Surface Water Classifications webriage
If noncompliance with 02T.0305(f) or (gl, see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes ❑ No ❑ NIA
Sec 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 0213 .0200? 2 Yes ❑ No ❑ N/A
This would include Trout Buffered Streams per 15A NCAC 28.0202
4. Does the project require coveragclautltorization 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.0105 C 6) (additional perinitslccrtifications)? ® Yes ❑ No
Per 15A NCAC 02T.0105 c fi , 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, e1c.)-
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
ll'yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall he 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 S}stem-Wide Collection permit.
FORM: FTA 04-16 Page 4 o1'5

X. CERTIFICATIONS:
Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pumn Stations
and Farce Mains latest version and the Gravit Sewer Minimum Design Criteria (latest version) as applicable?
® Yes ❑ No
If No, complete and submit the VariancerAlternative Design bequest application (VADC 10-14) and supporting documents for
review. Approval of the request is re uired prior to submittal of the Fast Track Application and supporting documents.
2. Professional En tincer's Ccrtifi
I, —
(Professional
s name trom Application Item III. I.)
attest that this application for
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 143-2I5.6A 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.... hp
North Carolina Professional Engineer's seal, signature, and date: f'`•'" F�S8�0'•�����
i ,J•J ff
I
.......... ...... ._ _.. .- ... .... .........
3. Applicant's Ccrt9catioon r ] 5A NCAC 02T .0106(b):
2
Authority's name & titld from
1.3.)
1'r
that this application for
has bden revowed by mefffiind 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, ariftr 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 ifall 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 143-215.6f3, 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 _ _ _ � J e i /
Date:
FORM; FTA 04-16 Page 5 of 5

�OF WArEgp State of North Carolina
'O G Department of Environment and Natural Resources
jDivision of Water Quality
t] Y Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE 06-13)
Project Applicant Name: Town of Fu ua-Varina
Project Name for which flow is being requested: Lane Dental Plaza, 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 wasteivater jlo►v.
Complete this section only if you are the owner of the wastewater treatment plant.
a.
b.
C.
d.
e.
WWTP Facility Name: Terrible Creek WWTP
WWTP Facility Permit #: NC0066516
All flows are in MGD
WWTP facility's permitted flow 3.000
Estimated obligated flow not yet tributary to the WWTP
WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
0.910
1.150
0.001
2.061
h. Percent of permitted flow used
68. 7%
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 Pius
(Name or Capacity,* (Firm / po,
Daily Flow, Daily Flow, Obligated
Available
Number) MGD MGD
MGD MGD Flow
Capacity***
NW
_D--M-13-1 1.274 0.510
0.243 0.040 0.284
0.226
* The Firm Capacity of any pump station is dei ned 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.
Page I of 6
FTSE 06-13

Certification Statement:
Jay T. Meyers, P.E., Public Utilities certify to the best of my knowledge that the addition of
Director
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.
25
Date
Page 2 of 6
FTSE 06-13

PROJECT NARRATIVE
Project Name: Lane Dental - Phase I
Location: Fuquay Varina, Wake County, NC
Owner: 1830 N Broad Street c/o Perry Truelove
15 Rawls Road, Suite 100
Angier, NC 27501
Developer: 1830 N Broad Street c/o Perry Truelove
15 RawIs Road, Suite 100
Angier, NC 27501
Consultant: Timmons Group
Jim Chandler, PE
5410 Trinity Road, Suite 102
Raleigh, NC 27607
Phone: [phone]
PROJECT DESCRIPTION AND NARRATIVE:
a
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A
The proposed project is inside Fuquay Varina jurisdictional limits and is located along N Broad
Street, north of the intersection of SR 1 110 (Wilbon Road/ Judd PKWY) and NC HWY 55. The scope
of this project will include the construction of a bank and associated roads.
The proposed public sewer extension will provide domestic service to the bank on a 8.22-acre tract of
land in Fuquay Varina, NC.
Development Flow Rate: 225 gpd
9 employees@ 25 gal/ employee! shift

USGS Map
Fuquay Varina Quadrangle
North Carolina
7.5-minute series
-46r U%J I UPU Pv av
4720
I —

VICINITY MAP - 1" 400'

TIMMONS GROUP
YOUR VISION ACHIEVED THROUGH OURS.
TRANSMITTAL
TO: NCDENR-Raleigh Regional Office
Division of Water Resources
3800 Barrett Drive
Raleigh, NC 27609
❑ ENCLOSED PLEASE FIND:
❑ WE ARE SENDING UNDER SEPARATE COVER:
Date:02/27/19 Job #:41157
Project: Lane Dental
Reference:
Copies Sent To:
NC Dept ofEnvironmental Quality
FES 2 8 2019
COPIES
DATE
NUMBER
DESCRIPTION
1
1
Fast Track Sewer Application Regional Offic
1
2
Project Narrative
USGS ma
1
3
1
4
Vicinity Ma
1
5
Flow Acceptance Form/ Certification Statement
1
6
Check for $480
THESE ITEMS ARE TRANSMITTED:
If enclosures are not as noted, please notify us at once.
COMMENTS:
Feel free to contact me with any questions at 919-866-4944 or dexter.howell timmons.com.
Thank you,
Dexter Howell
Project Manager
SIGNED'
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