WQ0039314_Application_20170728

State of North Carolina
Department of Environmental Quality
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: 63Q 314 (to be completed by DWR)
All items must be completed or the application will be returned
1. APPLICANT INFORMATION:
1. Applicant's name: City of Shelby (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: Rick Howell per 15A NCAC 02T .0106(b)
Title: City Manager RECEIVED/NCDENR1DWR
4. Applicant's mailing address: 824 West Grover Street
City: Shelbv State: NC Zip: 28150- J U N 2 8 2017
5. Applicant's contact information: VVQROS
:
Phone number: 828) 484-6840 Email Address: rick,[e-mail] f nC OREST1,1..F4 t'=.GIONIAL OFFICE
11. PROJECT INFORMATION:
1. Project name: 2017 Westside Sewer System Improvements
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/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: Cleveland
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.27443' Longitude:-81.61633'
5. Parcel ID (if applicable): See plans
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Michael J. Waresak
Firm: McGill Associates
Mailing address: 55 Broad Street
City: Asheville State: NC
Phone number: (T?Sj-ot f
License Number: 019950
Zip: 28801-
EmailAddress:+���-•v✓�r��,r/c�;,neri!/c�?�nc�tt'.
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: First Broad River WWTP Permit Number: NCO024538
Owner Name: City of Shelby
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ n/a Downstream (Receiving) Sewer Size: n/a inch
System Wide Collection System Permit Number(s) if applicable): WQCS00037
Owner Name(s): City of Shelby
FORM: FTA 04-16 Page 1 of 5

V.I. 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: DEV) been attached?
❑ Yes ®No ❑N/A
3. If the Applicant is a Home/Property Owners' Association, has an Operational Agreement (FORM: HOA) been attached?
[:]Yes ®No ❑N/A
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 % Commercial
100 % Industrial (See 15A NCAC 02T .0103(20))
1Is there a Pretreatment Program in effect? ® Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(fl? [:]Yes ®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
Industrial
1.0 M gal/day
1
1.0 M GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gall
GPD
Total
1.0 M GPD
See 15A NCAC 02T .0114(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.01141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 1.0 M GPD (per 15A NCAC 02T .0114)
➢ 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 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
24
14,137
PVC
24
4822
DIP
➢ 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 Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: Westside Pump Station .— ,,�. �C `ts 1
2. Approximate Coordinates (Decimal Degrees): Latitude: 35.27443' Longituu e:-81.61633'
3. Design flow of the pump station: 4.896 millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 3400 gallons per minute at 230 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
16
9150
DIP
20
450
HDPE
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(l ):
® 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(t)):
1. Does the project comply with all separations found in 15A NCAC 02T .0305(t) & (g)
➢ 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-1 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 sloe of embankment or cuts of 2 feet or more vertical height
10 feet
Drainages stems and interce for 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(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webpaae
➢ If noncompliance with 02T.0305( or (g), see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) [:]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 ❑ 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 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?
® 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:
I W Irg-sXk, attest that this application for
(Professional Engineer's name from Application Item Ill. 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,.i111�
North Carolina Professional Engineer's seal, signature, and date: �\�',��►1�Ei®�
1
r 01 950 a
40
3. Applicant's Certificatinper 15A NCAC 02T .0106(b
1, rl / L.,rG %`/OG1oC/ o c ,1 f it 1r1 a11 Cl qc—K attest that this application for
(Signature Authority's nam & title froth Applicatio tem 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 143-215.6A 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 W,900 as well as civil penalties up to $25,000 per violation.
Signature:
Dater
FORM: FTA 04-16 Page 5 of 5

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: City of Shelby
Project Name for which flow is being requested: 2017 Westside Sewer System Improve.
More than one FTSE may be requiredfor a single project if the owner of the WWTP is not responsible for all pump
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: First Broad WWTP
b. WWTP Facility Permit #: NCO024538
All flows are in MGD
c. WWTP facility's permitted flow 6.0
d. Estimated obligated flow not yet tributary to the WWTP 0.27
e. WWTP facility's actual avg. flow 3.02
f. Total flow for this specific request 1.0
g. Total actual and obligated flows to the facility 4.29
h. Percent of permitted flow used 71%
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 Plus
(Name or
Capacity, * (Firm / pf),
Daily Flow,
Daily Flow,
Obligated Available
Number)
MGD MGD
MGD
MGD
Flow Capacity***
Westside 4.896 1.958 0.8 1.0 1.8 0.158
* The Firm Capacity 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 (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.
Downstream Facility Name (Sewer): N/A
Downstream Permit Number: N/A
Page 1 of 6
FTSE 04-16

III. Certification Statement:
I V—' ( C (L -`'� W 611111 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 indicates/, ceptance oj this wastewater flow.
Signing Official Signature
Date
Page 2 of 6
FTSE 04-16

Love, Barry F
From: Mike Waresak <[e-mail]>
Sent: Tuesday, July 11, 2017 2:46 PM
To: Love, Barry F
Cc: Vann Waters
Subject: RE: 2017 Westside Sewer System Improvements
Ba rry,
As a follow-up to our phone conversation today, this email is to provide documentation regarding the 1.0 MGD of
industrial wastewater flow listed in the above referenced City of Shelby's NCDEQ Fast -Track application. The new
industrial facility being served by this project (Clearwater Paper) has indicated to the City of Shelby that 1.00 MGD of
wastewater will be generated by the new facility beginning in January 2019. This information came directly from
Clearwater Paper.
I hope this information is sufficient to document the 1.0 MGD wastewater discharge. If you need additional information,
please let me know.
Mike
Mike Waresak, PE
Senior Project Manager
ON mcGM
A S S 0 C IA T'E
55 Broad Street I Asheville, NC 28801
Phone: [phone] ( Cell: 828.231.06511 Fax: [phone]
[e-mail] I www.mcgillengineers.com
From: Love, Barry F [mailto:[e-mail]]
Sent: Friday, July 07, 2017 2:21 PM
To: Mike Waresak <[e-mail]>
Subject: 2017 Westside Sewer System Improvements
Mr. Waresak,
I'm reviewing the fast track application for 2017 Westside Sewer System Improvements. In the application 1 million
gallons per day of industrial flow is being requested. There was no information in the application as to how this was
determined. Please provide an explanation and calculations as to how this volume was determined and what it is based
on. Also, I have some questions about exactly what is being requested in the application. Are all the requested
lines(gravity and force main) new with the old line also remaining in service, or the old line taken out? Are some
changes being made to the pump station or is it essentially being replaced? Maybe we can discuss these items over the
phone. I will try to reach you by phone on Monday if I don't hear from you sooner. Thanks for your help.
Barry Love
Environmental Specialist
Water Quality Regional Operations Section

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C SEWER SYSTEM IMPROVEMENTS McG
24" GRAVITY SEWER AND 16" FORCE MAIN
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State of North Carolina
Division of Water Resources
Department of Environment
Divis
Watershed Classification f
Along with this form, submit a color copy of a USGS Topographic Map to identify the pi
Each map or maps must show the location of the sewer system and include location i
traverses over or near waterbodies. The map should have location ID's for eac
corresponding classifications should be recorded.
Include the completed form and map portions with the permit application for submittal to the appropriate review
agency. A list of the Division's regional offices, their county coverage, and contact information can be obtained from:
http://Portal.ncdenr.org/web/`"wq/home/ro
Location ID
Name of Waterbody'
River
Basin
Waterbody
Index No.
Waterbody
Classification
Stream
Crossing 1
UT Beaverdam Creek
Broad
unknown
C
Stream
Crossinq 2
UT Beaverdam Creek
Broad
unknown
C
River
Crossin
First Broad River
Broad
9-50-(28)
C
1 If unnamed, indicate "unnamed tributary to V, where X is the named waterbody to which the unnamed tributary joins.

I certify that as a Registered Professional Engineer in the State of
North Carolina that I have diligently followed the Division's instructions
for classifying waterbodies and that the above classifications areDSi`3f
inclusive of the stated project, complete and correct to the best of my OA'�
knowledge and belief.
PE Seal, Signature and Date -- o SEA 0
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