WQ0040960_Application (FTSE)_20190506

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: �� 0 �� r (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: GRACE CHAPEL CHRISTIAN CHURCH (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: Jonathan Bullard per 15A NCAC 02T .0106 NC Dept of Environmental Quality
Title: Operations & Business Manager
4. Applicant's mailing address: 2605 Jefferson Davis Highway i_Y 0 6 2019
City: SANFORD State: NC Zip: 27330-
5. Applicant's contact information: Raleigh Regional Office
Phone number: (9l9) 270-5281 Email Address: iohnathanbullard -gracechapelsanford.com
IL PROJECT INFORMATION:
1. Project name: GRACE CHRISTIAN SCHOOL LIFT STATION AND FORCE MAIN
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Pernit/Project
If a modification, provide the existing permit number: WQ00 and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: LEE
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.427T Longitude:-79.2212
5. Parcel ID (if applicable): Lee Courtly Pin 9 : 963140-1218-00 9631-30-9911-00 963141-0018-00 9631-40-1920-00
(or Parcel 1D to closest downstream sewer)
111. CONSULTANT INFORMATION:
I. 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: 9l9 776-3444 Email Address: KWBRIGHT rr,KENBRIGHTENGINEERING.COM
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: BIG BUFFALO WASTEWATER TREATMENT PLANT Permit Number: 0024147
Owner Name: CITY OF SANFORD
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Number(s) (if applicable): WQCS 7_
Owner Name(s): City of Sanford
FORM: FTA 04-16 Page i 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 Oeratiogi; A_grecment_{FORM: DEV been attached?
[:]Yes [-]No ®NIA
3. If the Applicant is a Home-Troperty Owners' Association, has an Oiperation_al Agreement (FORM: HOA) been attached?
[]Yes []No SMA
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 /Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: % Domestic/Commercial 100 % Commercial
% Industrial (Lee.. i 5A NCAC 02T .0103(20 )
Its there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .01 14(f)? ❑ Yes ® No
➢ If yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(11]
Daily Design Flow'-'
No. of Units
Flow
Daycare students
25 gal/student
508
12,700 GPD
Daycare employees
25 gal/person
25
625 GPD
School age (K-12)
15 gal/student
600
9,000 GPD
gall
GPD
gall
GPD
gall
GPD
Total
22,325 GPD
a See 15A NCAC 02T .01 l d e I and-LeK2) 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 G5.42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified (in table 15A _NCAC 02T.01 14) shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 22.325 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: T
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-16 Page 2 of 5

V11. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
➢ 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 or Applicable) — 02T.0305 & MDC (Pump Stations/Force—Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: # I
2. Approximate Coordinates (Decimal Degrees): Latitude: 35.4277` Longitude:-79.2212'
3. Design flow of the pump station: 0.0223 millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 48 gallons per minute at 78.6 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
3
1 3,410
PVC-SDR 21
3
900
DIP CLASS 50
3
500
HDPE
10
6. Power reliability in accordance with 15A NCAC 02T .0305(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 .030,;(n Lg)
➢ 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 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 slo a of embankment or cuts of 2 feet or more vertical hei t
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade(vertical),36
inches
➢ 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 webnuge
➢ If noncompliance with 02T.0305(J) or (c)_ see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ❑ Yes ❑ No ® NIA
➢ 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 ISA NCAC 0213.0200? ❑ Yes ❑ No ® NIA
➢ This would include Trout Buffered Streams per l3A.NCAC 213.0202
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 Permittinc Branch
5. Does project comply with 15A NCAC. 02T.0105&)(0) (additional permits.'certifications)? ® Yes [:]No
Per 15A 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 ❑ 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

X. CERTIFICATIONS:
I. 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?
® Yes ❑ No
If No, complete and submit the Varian ce?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:
I, KEN W. BRIGHT attest that this application for
(Professional Engineer's name from Application Item II1.1.)
GRACE CHAPEL CHRISTIAN CHURCH - LIFT STATION AND FORCE MAIN
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.
.C.ARo
North Carolina Professional Engineer's seal, signature, and date: �`�OQ� .; SSI 4.1
= oY o 'L ;
3. Applicant's Certification per 15A NCAC 02T .0106(b):
1, JOHNATHAN BULLARD - GRACE CHAPEL CHRISTIAN CHURCH attest that this application for
(Signature Authority's name & title from Application Item I.3.)
GRACE CHAPEL CHRISTIAN CHURCH - LIFT STATION AND FORCE MAIN
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. 1 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 143-215.613, 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.
Signature: ---- -- — - #late-
FORM: FTA 04-16 Page 5 of 5

NC Dept of Environmental Quality State of North Carolina
Department of Environmental Quality
DWK MAY 0 6; It, Qiq Division of Water Resources
Division of Water Resources Raleigh Regional IDCI Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: City of Sanford
Project Name for which flow is being requested: Grace Christian School Force Main
More than one FTSE may be required for a single project 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: Big Buffalo WWTP
b. WWTP Facility Permit M NC0024147
All flows are in MGD
c. WVVTP facility's permitted flow 12.0
d. Estimated obligated flow not yet tributary to the WWTP 1.21843
e. WWTP facility's actual avg. flow 4.616
f. Total flow for this specific request 0.0223
g. Total actual and obligated flows to the facility 5.85673
h. Percent of permitted flow used 48.81 %
H. 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
Pump
Average
Approx.
Not Yet
Total Current
Station
Station
Firm Daily Flow**
Current
Tributary
Flow Plus
(Name or
Permit
Capacity, * (Firm / pf),
Avg. Daily
Daily Flow,
Obligated Available
Number)
No.
MGD MGD
Flow, MGD
MGD
Flow Capacity***
* The Firm Capacity (design flow) 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, 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 t 0.
Downstream Facility Name (Sewer):
Downstream Permit Number:
Page 1 of 6
FTSE 10-18

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 H plus all attached planning assessment addendums for which I
am the responsible party. Signature of this fo q3 lies that the receiving collection system or treatment
works has adequate capacity to transport treat the osed new wastewater.
Signing Official Signature
Title of
1
Date
Page 2 of 6
FTSE 10-18

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KEN BRIGHT ASSOCIATES, PLLC
Consulting Engineers
anion
May 6, 2019
INC Dept of Environmental Quality
Mr. Ted Cashion MAY 0 6 2019
North Carolina Division of Environmental Quality
1628 Mail Service Center Regional Of Re tRaleigh Office
Raleigh, NC 27699-1628 g g�
Re: Grace Christian School Lift Station & Force Main
2605 Jefferson Davis Highway, Sanford, NC
Dear Mr. Cashion:
Grace Christian School is getting ready to build a new building and is going to tie to the
City of Sanford sewer system.
Prooect Description
This facility is currently served by septic tanks with drain field lines and sewer lines
connecting various buildings. There is a 10,000 gallon pump tank with duplex pumps, a
valve tank and a control panel. This was permitted by the State — Project No. 200-29-2
(Permit is attached). Because of the expansion and the construction of the new
building, most of the onsite sewer systems will be abandoned.
The proposed project consists of a lift station with:
• A 10,000 gallon pump tank (we will be reusing the existing pump tank and valve tank)
• Two new 5-HP pumps
• There will be a new onsite generator for the school with a capacity of 60 KW.
• Wireless auto dialer
• Control panel wl indicators
• Alarms panel
• Floats
• Trash rack
• Site light fixture
• Electrical panels
• Manual throw switch
• Yard hydrant
• RPZ
• Approximately 4,900 LF of 3" PVC SDR 21. DIP and HDPE force main which will tie
into a City's existing manhole
Ken Bright Associates, PLLC 1
PO Box 553, 2305 Carthage Street Phone: [phone]
Sanford, NC 27330 e-mail: [e-mail]

Enclosed please find the following:
Fast Track Sewer Application Instructions/Checklist
Fast Track Sewer Application, (FTA 04-16)
Flow Tracking 1 Acceptance Form, (FTSE 04-16)
Site, and Vicinity Maps
Check for the amount of $ 480.00
If you have any questions please feel free to contact me.
Sincerely,
)6""- V
Ken W. Bright, P.E.
Ken Bright Associates, PLLC 2
PO Box 553, 2305 Carthage Street Phone: [phone]
Sanford, NC 27330 e-mail: [e-mail]

Cashion, Ted
From: Ken Bright <[e-mail]>
Sent: Friday, June 21, 20191:22 PM
To: Cashion, Ted; [e-mail]
Cc: Robinson, Jason
Subject: [External] RE: Grace Christian School Lift Station and Force Main fast track sewer extension
application
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an
attachment to [e-mail]<mailto:repo [e-mail]>
Ted,
We don't have a permit number of the downstream sewer. I estimate that it was done in 1997.
The pump station will have grinder pumps and has a 10,000 gallon pump tank.
There are no high priority lines.
If you need something else, please let me know.
Thank you,
Ken W. Bright, PE, PLS
Ken Bright Associates, PLLC
2305 Carthage St.
P.O. Box 553
Sanford, NC 27331
[phone]
[e-mail]
-----Original Message -----
From: Cashion, Ted <[e-mail]>
Sent: Wednesday, June 19, 2019 4:23 PM
To: Ken Bright <[e-mail]>;
[e-mail]
Cc: Robinson, Jason <[e-mail]>
Subject: Grace Christian School Lift Station and Force Main fast track sewer extension application
Hi Ken,
We are reviewing the subject application and just need some clarification on some things.
Can you provide the downstream sewer permit number as noted in item V of the application? if the downstream sewer
is an old one, it may not have a permit number; if so, can you approximate the age of the line?
Will the pump station have grinder pumps?
Is there a high priority line with this project?

Thanks Ken, we'll keep working on the draft permit while you provide this info.
Thx
ted
Ted Cashion
Water Quality Regional Operations
Division of Water Resources
NC Department of Environmental Quality
Raleigh Regional Office
919-791-4254
[e-mail]<mailto:[e-mail]>
1628 Mail Service Center
Raleigh, NC 27699-1628
3800 Barrett Drive
Raleigh, NC 27609
[cid:image001.png@O1D40E3E.A54D3A10j
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v
Cashion, Ted
From:
Sent:
Cc:
Subject:
Hi Ken,
Cashion, Ted C, �, y cvI e— r-
Wednesday, June 19, 2019 4:23 PM A
Ken Bright,'[e-mail]' -c"I�I
Robinson, Jason
Grace Christian School Lift Station and Force Main fast track sews exte �Ica4on
V i �I( ✓c err
We are reviewing the subject application and just need some clarification on some things.
Can you provide the downstream sewer permit number as noted in item V of the application? If the downstream sewer
is an old one, it may not have a permit number; if so, can you approximate the age of the line?
Will the pump station have grinder pumps?
Is there a high priority line with this project?
Thanks Ken, we'll keep working on the draft permit while you provide this info.
Thx
ted
Ted Cashion
Water Quality Regional Operations
Division of Water Resources
NC Department of Environmental Quality
Raleigh Regional Office
919-791-4254
[e-mail]
1628 Mail Service Center
Raleigh, NC 27699-1628
3800 Barrett Drive
Raleigh, NC 27609
ID
.E
f7cpartmenl of Environmental Qwa]ity
Subscribe to Collection System & Sewer Permittinci Updates
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disclosed to third parties unless the content is exempt by statute or other regulation.