WQ0039567_Application (FTSE)_20190626

n Nunpber !VQ0039567
Program Category
Non -discharge
Permit Type
Gravity Sewer Extension, Pump Stations: & Pressure Sewer Extensions
Primary gReviewei
dean hunkele
Coastal SWR ale
Ppnmitted Flow
2,520
E .xvifity
Facility same
Han Dee Hugo #109 Private Pump Station
Location Address
Owner Name
Sampson Bladen Oil Company Inc
Central Files APS — SWP
6/3/201 a
Status
Project type
In review
Major modification
Version
Permit Ctass€fica5rion
B
Individual
Permit Contact Affi iat on
U,mjor/RPIinor region
Minor Wilmington
County
Brunswick
Facilit�, Contact Affiliation
Owner Type
Non -Government
Owner Affiliation
Haddon M_ Clark III
PO Box 469
Clinton NC 28329046
Scheduled
C.ig Issue Opp Received Drafts Initiated assuance Public Notice issue Effective Expiration
11/16/2017 5/31/2019
satecs Events
Restaurant Additional information received
Retail
Additional information requested
Wastewater collection
;PC

.... �..... ...... . ..

STROUD ENGINEERING, P.A.
102-D Cinema Drive
Wilmington, NC 28403
[phone]
TO
VVEARE SENDING YOU O Attached O Under separate cover via
�
O Shop drawings O Prints O Plans
O Copy ofletter O Change order O
�
following items:
O Samples O Specifications
COPIES
DATE
NO.
DESCRIPTION
THESE ARE TRANSMITTED aochecked below:
O For approval
O For your use
U As requested
U For review and comment
O FORBIDS DUE
�R TO 611�
O Approved assubmitted
O Approved as noted
O Returned for corrections
O
O Resubmit -copies for approval
O Submit _______' copies for distribution
O Return -corrected prints
O PRINTS RETURNED AFTER LOAN TDUS

S\L ® ENGINEERING, PA.
CONSULTING ENGINEERS
102D CINEMA DRIVE
WILMINGTON, NORTH CAROLINA 28403
WWW,STROUDENGINEER,COM
LICENSE NO. C-0647
May 28, 2019
_LNTCDEQ
Attn: Mr. Dean Hunkele
127 Cardinal Drive Extension
Wilmington, NC 28405
Re: Han -Dee Hugo's #109 Flow Modification
WQ0039567
Mr. Hunkele,
Please find the attached application and supporting documents to increase the permitted flow at
this facility to enable a self-service car wash.
The average daily flow for this feature was taken as 1,200 GPD based on 02T rules. The
calculated ADF was rounded up to the next residential equivalent to arrive at the requested
permitted flow of 1,440 GPD. No additional infrastructure is proposed by this modification and
the total permitted flow will stand at 3,960 GPD once this modification is complete.
Thank you for your attention to this matter. Please let me know if you have any questions or
concerns. I may be reached at [phone] or via email at Imeniusoa stroudengineencom.
Respectfully,
David L. Menius, P.E.
Stroud Engineering, P.A.
107B COMMERCE STREET 102D CINEMA DRIVE 3302C BRIDGES STREET
GREENVILLE, NORTH CAROLINA 27858 WILMINGTON, NORTH CAROLINA 28403 MOREHEAD CITY, NORTH CAROLINA 28557
252.756,9352 910.815,0775 252.2473479

State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T.0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
DIASIon of 1A.1i Resources FTA 04-16 & SUPPORTING DOCUMENTATION
(to be completed by DWR)
W 4
I. Applicanfs name: Sampson-Bladen Oil Company, Inc. (company, municipality, HOA, utility, etc.)
2, Applicant type: 0 Individual M Corporation EJ General Partnership ❑ Privately -Owned Public Utility
0 Federal El State/County Municipal Other
3. Signature authority's name: Haddon M. Clark, III per _r
Title: President
4. Applicant's mailing address: PO Box 469
City: Clinton State: NC Zip: 28329-0469
5, Applicant's contact information:
Phone number: [phone] Email Address: haddon.clarkasarnosonbladen.com
2. Application/Project status: El Proposed (New Permit) ED Existing Permit/Project
If a modification, provide the existing permit number: WQ0039567 and issued date: 11/16/2017
If new construction but part of a master plan, provide the existing permit number: WQOO
3. County where project is located: Brunswick
4. Approximate Coordinates (Decimal Degrees): Latitude: 33.9856' Longitude: -78.1894'
5. Parcel ID (if applicable): - 1860000903
(or Parcel ID to closest downstream sewer)
Firm: Stroud Eneineerina. P.A.
Mailing address: 102-D Cinema Drive
City: md1mingIgn State: NC Zip: 28403-
Phone number: [phone] Email Address: [e-mail]
IV, WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: West Brunswick Regional Water Reclaimgjgg_Eggj!fty Permit Number: M�236�93
Owner Name: Brunswick County
1! 11 1
11111 11 1 i I IIII 1 11 111 1, !1 !1 11111 1 11111 1 1 ­ 111 1111
L Permit Number(s): WQ0030274 Downstream (Receiving) Sewer Size: force main -- 8 inch
':WQCS00284
Owner Nani Brunswick County
FORM: FTA 04-16 Page 1 of 5

a i ORRAIRLINKMIARIN M,
III Fill 11;111 1111111111111111111111111 1111i Fill IIIII•
3. If the Applicant is a been attached?
- — ------ ------- �
lv�fflmn=
4. Origin of wastewater: (check all that apply):
F-1 Residential Owned El Retail (stores, centers, malls) 0 Car Wash
F� Residential Leased F-1 Retail with food preparation/service n Hotel and/or Motels
School / preschool / day care El Medical / dental / veterinary facilities F] Swimming Pool /Clubhouse
Food and drink facilities D Church E] Swimming Pool/Filter Backwasb
F] Businesses / offices / factories F] Nursing Home El Other (Explain in Attachment)
5. Nature of wastewater: % Domestic/Commercial 100 % Commercial
% Industrial ge'
L------> Is there a Pretreatment Program in effect? n Yes E] No
6. Has a flow reduction been approved under Yes ONO
> If yes, Drovide a cony of flow reducti roval letter
7. Summarize wastewater generated by project:
Establishment Type (see
Daily Design Flow
No. of Units
Flow
Car Wash
1200 gal/bay
1
1200 GPD
gal/
GPD
gal/
GPD
Round up to next REU
gal/
240 GPD
gal/
GPD
gal/
GPD
Total
1440 GPD
a See J15A Ni", A! 2T d'� f•o do r caveats t•wastewater esign flw rates (i.e., minimum flow per
LULL ag L 0
dwelling-, proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east ofthe Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G,S. 42 A -Al
b Per 15A NCAC 02T.01 14(c), design flow rates for establishments not identified [in table! ��('-"AC 0ZE01 14] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
I
If permitted flow is zero, indicate why:
F 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:
FORM: FTA 04-16 Page 2 of 5

1. Summarize gravity sewer to be permitted:
> Section 11 & 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 MIDC
2. Approximate Coordinates (Decimal Degrees); Latitude: 0 Longitude: - 0
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
> 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:
E] Portable power source with manual activation, quick -connection receptacle and telemetry ® 15A NCAC 02T
.0305(h)(1)(C)
or
D 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

1 11 , � 11 6101, 5.110 EWE I �11 �
1. Does the project comply withal I separations found in (,2 Yes [] No
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
24inches
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-1 waters of Class I or
Class 11 impounded reservoirs used as a source of drinking water
100 feet
"Waters classified WS (except WS-1 or WS-V), B, SA, ORW, HOW, 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
DrainMe systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade (vertical)
36 inches
> 1 5A N,[7 At- T_P,03, contains alternatives where separations in 021 05(f i cannot be achieved.
> "Stream classifications can be identified using the Division's N" Sur,",, -ge �ass
> If noncompliance with 02T see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) M Yes El No E] 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 loeq.tion of areas effect .
3. Does the project comply with setbacks found in the river basin rules per
®Yes [:]No n N/A
> This would include TroutBuffered Streams per
4. Does the project require coverage/authorization under a 404 Nationwide or 12 Yes El No
individual permits or 401 Water Quality Certifications?
> Information can be obtained from the
8101
Per 'A N(_,AC 02-1i'A" 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,
Per u "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.
[I Yes [-I No 0 N/A
> If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
RMAMPER-M
FORM: PTA 04-16 Page 4 of 5

1. Does the submitted system comply with the
as applicable?
andthe-,_�
�M
1, David L. Memus, P.E. attest that this application for
(Professional Engineer's name from Application Item 111. L)
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
*JrIA4,l
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. ', wHIII/1"
h 0
North Carolina Professional Engineer's seal, signature, and date:
/0
7
98'E'A'L '
35677
0 GINS
7D _1A
lip-
............. -1 F
3. Applicant's Certification per 15A NCAC 02T.0106(b): gy
i, Haddon M. Clark, III, President, Sampson-Bladen Oil Company, Inc. -attest that this application for
(Signature Authority's name & title from Application Item 1.3.)
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-
' outit 9 U-41-4.
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,
.1 5 NOTE - In accordance with General Statutes ' 4_, -2 ",6 A and 113-21,Z.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 Date:
FORM: FTA 04-16 Page 5 of 5

State f': North Carolina
Division ICof Water Resources
"low ' Tae " a for Sewer Extension Applications
(FTSE 10-1 )
Entity requesting Allocation; Sampson-1 laden Oil Company, Inc
Project Name for which flew is being requested: HanDee Hugo (Sunset Harbor) car wash
More than one FTSE may be requ redfor ca single,project rf the owner of the WTP is not respons ble for all pump
stations along the route of theproposed wastewaterf ow.
I Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility
b. 'WWTP Facility
C.
d.
e.
f,
WWTP facility';
Estimated oblige
WWTP facility';
Total flour for tf
Total actual and
Percent of p rm
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:
Pump Pump
Station Station
(Name or Permit
Number) No.
()
()
Design
Average
Approx.
Firm Daily Flaw**
Current
Capacity, # (Firm ,/p,
Avg. Daily
MGD MGD
Flaw; MGD
()
()=( +C) (F,)=(A-D)
Obligated,
Not Yet
Total Current
Tributary
Flaw Plus
Daily :Flaw,
Obligated Available
MGD
Flow Capacity***
Tile Film i t, d. 'a; eEl;' ofanypump defined as themaximum pumpedflow
that can be achieved I with the "g= out of -e
Design Averao Daily .i :!`, •ti capagity of the i1 divided 3 peaking factor
not ,e 2.5, per Section0i of theMinimum
't psi �� t ;ili ,.5� ��_ '.Ii f�� �:• .S�EI, !�.
Downstream Facility Maine (Sewer);
Downstream Permit Number:
Page 1 of 6
FT'SE 10-18

111. Certification Statement:
I William L. Pinnix, P.E. certify to the best of my knowledge that the addition of
the volume ofwastewater 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 circunnstances; given the implementation of the planned improvements
ents
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 11 plus all attached planning assessment a dendums for which I
am the responsible party. Signature oft is form certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
Approved as to Form.
Hiss , eun A me
of 4 '
Page 2 of 6
1*TSE 10-1

33°59 08.2 78°11 21.8 W
6/3/2019