WQ0040775_Application (FTSE)_20190517

Central Files- APS SVVP
4/8/2019
rer_nnirt- NrUrnber VV00040775 Permit Tracking Slip
Program Category Status Project Type
Non -discharge In review New Project
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
Primary Reviewer
dean-.hunkele
Coastal SWRLde
Permitted Flow
Version Permit Classification
A Individual
Permit Contact Affiliation
Facility Name Major/Minor Region
Peace Baptist Church Private Sewer Minor Wilmington
Location Address County
New Hanover
Facility Contact Affiliation
Owner Name Owner Type
Peace Baptist Church Inc of Wilmington NC Non -Government
Owner Affiliation
Rudy Shepard
320 Military Cutoff Rd
Da4_es/Events Wilmington NC 28403
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
4/5/2019
Regulated Acltivffies oquested X — R/Received Pvents
Additional information requested
Additional information received
0 419
U'Llall
Waterbody Name Streamindex Number Current Class. SUbbasin

0
Intracoastal Engineering PLLC
April 5th, 2019
NCDEQ
Division of Water Quality
127 Cardinal Drive Extension
Wilmington, NC 28405
Re: Peace Baptist Church
PN 2017-019
Dear To Whom It May Concern,
JE
APR 9 S 2019 ' f
Please find enclosed (1) original and (1) copy of Fast -Track Application for
Private SS Main Extensions, (1) FTSE Form, (1) fee check ($480.00), and (1) USGS
Topographic Maps.
Please review for approval and contact us with any questions, comments or additional
information needed.
Sincerely,
Intracoastal Engineering PLLC
5725 Oleander Dr. Unit E-7 Wilmington, NC 28403 (91o)859-8983

my State of North Carolina
Department of Environmental Quality
Division of Water Resources
DWR
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
DIvisiun of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number:
(to be completed by DVVR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Peace Baptist Church, Inc. of Wilmington, North Carolina (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual Corporation ❑ General Partnership ❑ Privately-Ovin.ed Public Utility
❑ Federal ❑ State/County ❑ Municipal ❑ Other
3. Signature authority's name: Dr. Rudy Shepard per 15A NCAC 02T .0106(b)
Title: President
4. Applicant's mailing address: 320 Military Cutoff Rd.
City: Wilmington State: NC Zip: 28403-
5. Applicant's contact information:
Phone number: [phone] Email Address: gi:[e-mail]
II. PROJECT INFORMATION:
1. Project name: Peace Baptist Church (iiW
2. Application/Project status: Z Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ003 and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: New Hanover
4. Approximate Coordinates (Decimal Degrees): Latitude: 34.257' Longitude:-77.827'
5. Parcel ID (if applicable): R04400-006-001-000
(or Parcel ID to closest downstream sewer)
IIT. CONSULTANT INFORMATION:
1. Professional Engineer: Charles CazierLicense Number: P-0662
Firm:. Intracoastal En •neeringPLLC
Mailing address: 5725 Oleander Dr.
City: Wilmington State: NC Zip: 288403-�,
Phone number: [phone] Email Address: Charlie i ,intracoastalengineering com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
l . Facility Name: James A. Loughlin(NSWWTP) Permit Number: NCO023965
Owner Name: Cape Fear Public Utility Authority
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ `1k2b Downstream (Receiving) Sewer Size: inch
System Wide Collection System Permit Numbers) (if applica_ ble): WQCS-
Owner N ame(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: DEy) been attached?
[:]Yes ❑No ®N/A
3. If the Applicant is a Home/PropeM Owners' Association has an Operational Agreement (FORM: HOA) been attached?
�r
El Yes E]No ®N/A
4. Origin of wastewater: (check all that apply):
❑ Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wash
El Residential Leased ❑ Retail with food preparation/service El Hotel and/or Motels
El School / preschool / day care D Medical / dental / veterinary facilities ❑ Swimming Pool /Clubhouse
El Food and drink facilities Church
❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home n Other (Explain in Attachment)
5. Nature of wastewater: % Domestic/Commercial 100 N Commercial
%,Industrial (See 15A NCAC 02T .0103(20))
Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .011 M7, ❑ Yes ® No
➢ If yes, Rrovide a com of flow reduction #Mrov I letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(fd)
Daily Design Flow a,b
No. of Units
Flow
Church (312 Seats)
5 gal/seat
312
17560 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
17560 GPD
a See 15A NCAC 02T . 011 (b), (d), (e)(1)and ( 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.0114] shall
be determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured'data.
8. Wastewater generated by project: 1, 5 60 GPD (per 15A NCAC 02T. 0114)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
El 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:
El 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 15 SCH-40 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 AMC
VHI. PUMP STATION DESIGN CRITERIA (If Applicable) -- 02T .0305 & MDC (Pump S__ tatio„ns�o ce
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 15A NCAC 02T .0305(h_)(1):
[: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 . 03 05 (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) & (g) Z Yes ❑ No
➢ +Un+ CUnll U'M *,rntr.AeA Vi%r ^­^4,.,.,, --
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 hei ht
10 feet
Drains e systems and interce for drains
5 feet
Any swimming pools
10 feet
Final earth grade vertical
36 inches
➢ 15A NCAC 02T.0305� contains alternatives where separations in 02T.0345(f} cannot be achieved.
➢ "Stream Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
➢ If noncompliance with 02T.0305 fl or (g), see Section x of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ZYes []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 [:1 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 El Yes 9 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 0210105(c)(6) (additional permits/certifications)? 0 Yes [:]No
Per 15A NCAC 02T.0105(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 [:] 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 the Permitting of Pump Stations
and Force Mains (latest version, and the Gravity Sewer Minimum Design Criteria(latest version) as applicable?
El Yes ❑ No
If No, complete and submit the variance/Alternative Design Request application (VADC 10-14) and supporting documents
for review. Ajaproval of the reguest is required prior to submittal of the Fast Track ApRileation and suppordng
documents.
2. Professional Engineer's Certification:
I,CA A 0 "29! 0^ CA -2 t r, t9
Laocomma pp 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. 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.
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I,
(Signature Authori s name & title from Application Item I.3.)
4 0
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SEAL
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032555
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attest that this a cation for
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 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.
Signature:A�7 Date: �/007—bl 142,01�7
�T
FORM: FTA 04-16 Page 5 of 5

State of North Carolina
Department of Environmental Quality
Division of Water Resources
ti
b
55
Division of Watet Resources Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Peace Baptist Church, Inc
Project Name for which flow is being requested: Peace Baptist Church
More than one FTSE may be required for a singleproject if the owner of the WWTP is not responsible for allpump
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: James A. Loughlin (Northside) WWTP-
b. WWTP Facility Permit #: NPDES NC 0023965
Allflowsare inMGD
c. WWTP facility's permitted flow 16.000
d. Estimated obligated flow not yet tributary to the WWTP 3.245
e. WWTP facility's actual avg. flow 10.661
f. Total flow for this specific request 0.001560
g. Total actual and obligated flows to the facility 13.907
h. Percent of permitted flow used 86.9%
II. Complete this section for each pump station you ate 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
Pump
Average
Approx.
Not Yet
Total Current
Station
Station
Firm
Daily Flow* *
Current
Tributary
Flow Plus
(Name or
Permit
Capacity, *
(Firm / p fl,
Avg. Daily
Daily Flow,
Obligated
Available
Number)
No.
MGD
MGD
Flow, MGD
MGD
Flow
Capacity* * *
77
N/A
3.312
1.325
0.498
0.283
0.781
0.543
89
N/A
14.583
5.833
4.493
1.613
6.105
-0.272
i ne r irm capacity kaesign iiow) of any pump station is aeiinea as the maximum pumpea ziow
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, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
*** 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): Cape Fear Public Utility Authority
Downstream Permit Number: WQ0001135
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I Matthew Tribett, CFPUA Eng. Mgr 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 certifies that the receiving collection system or treatment
works has. adequate capacity to transport and treat the proposed new wastewater.
✓Signing Official Signature
CE&�- ����G-
Title of Signing Official
1e%
Date
Page 2 of 6
FTSE 10-18

PLANNING ASSESSMENT ADDENDUM (PAA)
Submit a planning assessment addendum for each pump station listed in Section II where Available Capacity is <
0.
Pump Station (Name or Number):
Given that:
a. The proportion and amount of Obligated, Not Yet Tributary Daily Flow (C) accounts for
26% total flow % and 1.613 MGD of the Available Capacity (E) in Pump Station
and that
b. The rate of activation of this obligated, not yet tributary capacity is currently approximately
MGD per year; and that
c. A funded Capital Project that will provide the required planned capacity, namely
Blue Clay Road Force Main is in design or under construction with
planned completion in complete ; and/or
d. The following applies:
The Blue Clay Road Force Main is able to provide additional capacity at PS 89 by
diverting existing flow that is currently tributary to PS 89 directly to NSWWTP.
Construction of the force main is complete and was certified 4/5/18. The force main is
available for event. management. Administrative procedures are. required for full activation.
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification to allow
this flow to be permitted, without a significant likelihood of over -allocating capacity in the system
infrastructure.
I understand that this does not relieve the collection system owner from complying with G.S. 143-
215.67(a) which prohibits the introduction of any waste in excess of the capacity of the waste disposal
system.
Signing��cial Signature
w
P
f
Date
Page 3 of 6
FTSE 10-18

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Non -Profit Corporation
Legal Name
Peace Baptist Church, Inc. of Wilmington, North Carolina
Information
Sosld: 0111207
Status: Current -Active
Annual Report Status: Not Applicable
Citizenship: Domestic
Date Formed: 11/15/1976
Registered Agent: Shepard, Rudy
Addresses
Reg Office
113 South Branch Rd
Wilmington, NC 27411
Principal Office
320 Military Cutoff Rd
Wilmington, NC 28405
Reg Mailing
113 South Branch Rd
Wilmington, NC 27411
Mailing
320 Military Cutoff. Rd
Wilmington, NC 28405

4/5/2019
SewerNarrative
Peace Baptist Church
Wilmington, NC
PN 2017-019
Peace Baptist church occupies and existing 3.18 acre tract located in Wilmington,
NC. We are proposing an additional church sanctuary building with 112 seats for a total
Of 312 seats between the two sanctuaries at a daily flow of 5 gallons per seat for a total of
1,56o gallons per day proposed. This sewer flow will be conveyed via 6" private gravity
sewer main which will tie into a proposed 6" public sanitary sewer service. The public
line will tie in at an existing manhole located across Military Cuttoff Rd. within the
right-of-way. The receiving downstream sewer size is a 16" line. The flow will ultimately
reach the James A. Loughlin Wastewater Treatment Plant (NSWVVTP) Permit No.
NCo023965•

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