WQ0039896_Application (FTSE)_20190429

Central Files, APS SVVP
3/27/2019
Permit.- Nwnnber W00039896
Permit Tracking Slip
Program category
Status Project Type
Non -discharge
In review Major modification
Permit Type
Version Permit Classification
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions.
B Individual
Primary Reviewer
Permit Contact Affiliation
.dean.hunkele
Coastal SWRu(e
Permitted Flow
1,800
Facifity
Facility Name
453-457 Airlie Road Private Sewer
Location Address
Owner
Major/Minor Region
Minor Wilmington
County
New Hanover
Facility Contact Affiliation
Owner Name Owner Type
Airlie Three HOA Inc Non -Government
Owner Affiliation
Charlotte Noel Fox
701 Market St
Dates/Events Wilmington NC 28401
Scheduled
Orig Issue App.Received Draft Initiated issuance Public Notice Issue Effective Expiration
4/25/2018 3/26/2019
-Regulated Activities Requested /Received Events
Subdivision Additional information requested
Wastewater collection Additional information received
Outfall
Waterbody Name Streamindex Number Current Class Subbasin

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Mr. Dean Hunkele
Senior Environmental Specialist
NC DENR - Division of Water Quality
127 Cardinal Drive Ext.
Wilmington, NC 28405
RE: Airlie Road —Sewer Extension Modification
Existing Permit #WQ0039896 (issued 4/25/18)
RSC Project # 17092292
Please find enclosed a Fast -Track Sewer System Extension Modification Application for Airlie Road.
The site is currently permitted under the referenced extension number. The modification is being
requested as the manhole tie-in location is changing and thus the length of gravity sewer line has
been increased. The total requested flow is not changing (3,residential homes, 5 bedrooms each,
1800 gpd total flow). The wastewater generated by the project (#8 on the application) is noted as
0 gpd per suggestion of CFPUA as this flow has already been allocated under the original permit
(WQ0039896). In addition, the downstream receiving sewer is not changing. For these reasons,
the Flow Tracking/Acceptance Form from the original submittal shall remain applicable. The
project proposes to install a 6" Sch 40 PVC gravity line extension to connect into an existing
manhole along Airlie Road. The permit modification is being requested in order to modify the
manhole tie-in and length of 6" gravity sewer line.
Please see below for a list of what is included in this packet. If you need additional information,
feel free to call or email. Please feel free to contact me with any questions regarding this
submittal.
Included in this submittal:
• Fast -Track Application Form (FTA 04-16)
• Application Fee ($480 made payable to NCDEQ)
• Airlie Three HOA, Inc. Articles of Incorporation
• USGS Topo Map
• Street Level Map
• Operational Agreement
Thanks so much.
Sonya B. Edens, El
sonya @rscengineerinR.com
910-619-1737
EI0/NfCn'F N P�,/p'R
MAR 24 6 2019
�Alater Quality Re ion aI
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State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 —FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
v iv to of Water . . . . . . . . . .
[r Resource- FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number:
(to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: AIRLIE THREE HOA, INC. (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual Z Corporation El General Partnership [:] Privately -Owned Public Utility
El Federal ❑ State/County ❑ Municipal El Other
3. Signature authority's name: Charlotte Noel Fox per 15A NCA.0 02T .01.06(b)
Title: Incorporator
4. Applicant's mailing address: 701 Market Street
City: Wilmington State: NC Zip: 28401-
5. Applicant's contact information:
Phone number: [phone] Email Address: [e-mail]
II. PROJECT INFORMATION:
1. Project name: Airlie Road Sewer Extension
2. Application/Project status: ❑ Proposed (New Permit) Z Existing Permit/Project
If a modification, provide the existing permit numb : WQ0039896 d issued date: 4/25/18
If new construction but part of a master plan, provid fisting permit number: WQ00
3. County where project is located: New Hanover
4. Approximate Coordinates (Decimal Degrees): Latitude: 34.210 Longitude:-77.820
5. Parcel ID (if applicable) : R05700-006-03 6-001
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: W. Randall Edens- License Number: 24906
Firm: RSC Engineering, PLLC
Mailing address: 15226 US Hwy 17
City: Hampstead State: NC Zip: 28443-
Phone number: [phone] Email Address: sonya@rscen�,rineering.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Permit Number:
Owner Name: CFPUA
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size: 6 inch
System Wide Collection System Permit Number(s if a licable : WQCS
Owner Name(s):
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 ®N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DE V� been attached?
El Yes E]No ®N/A
3. If the Applicant is a Hone/Property Owners' Association, has an Operational Agreement (FORM: HOA) been attached?
ZYes ❑No ❑N/A
4. Origin of wastewater: (check all that apply):
Z Residential Owned EJ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential Leased ❑ Retail with food preparation/service El Hotel and/or Motels
❑ School / preschool / day care ❑ Medical / dental / veterinary facilities El Swimming Pool /Clubhouse
❑ Food and drink facilities El Church EJ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home [:] Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic/Commercial % Commercial
% Industrial (Sep; .15A NCAC 02T .0103(20))
Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 1.5A .NCAC 02T .0114(l )? El Yes N 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 a,b
No. of Units
Flow
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
GPD
a See _15A NCAC 02T .01.14(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).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.0.114] 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 (per 1..5A NCAC 02T .0 * 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: WWQ0039896
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain) :
FORM: FTA 04-16 Page 2 of 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
6 543 Sch40 PVC
➢ 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 Maims):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: 0Longitude: - °
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) I Length (feet) I Material
6. Power reliability in accordance with 15A NCAC 02T .03C)5(h)(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)(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) & (,) ® Yes ❑ No
➢ 15A NCAC 02T_0305(f) contains minimum .qenarntinnc that chnll he nrnvided fnr sewer cvctemc-
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 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
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
Any swimming pools
10 feet
Final earth grade (vertical)
36 inches
➢ 15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(1) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surt'ace Water Classifications wcbpa� c;
➢ If noncompliance with 02T.0305 (f) or (,()-)_,_see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) E]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 Z 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.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 1.5A NCAC 02T.0:105(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.
El Yes ® 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 thy; Permitting o Pump Stations
and Farce Mains (Latest version, and the Gravity Sever Mininium Design Criteria (latest versiaas 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:
1 Ti�1 thf,
attest that this application for
(Professional Engineer's name from Application Item III.1.)
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: till
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3. Applicant's Certification per 15A NCA 2 .�i -�a�gjjloae, pp p C 0 T .0106(b).
19 (Ikt 169t WA. 6, RA 161 (AiAt
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 143-21.5.6A and 1.43-215.6B, 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: V IvVyl J Date: 3
FORM: FTA 04-16 Page 5 of 5

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