HomeMy WebLinkAboutWQ0040849_Application (FTSE)_20190715April 155 2019
Memorandum of Transmittal
To: NCDEQ
Asheville Regional Office
2090 US Highway 70
Swannanoa, NC 28778
From: Jeffrey T. Brown; PE
President
Cc: David Lutz
City of Brevard — Public Works Director
Re: Lamb Creek Sewer Repair
Transylvania County, NC
The fast -track application attached is for the. City of Brevard in Transylvania County. The
proposed project is to repair/relocate the existing gravity sewer on Lamb Creek due to erosion of
creek bank and exposure of gravity sewer line. This project will consist of repairing/relocating
approximately 255 linear feet of 10 inch PVC gravity sewer line and 1 manhole.
Please fmd the following attached items for the referenced project:
1. Two (2) —Signed &Sealed Fast Track Application
Z. One (1) —Check in the amount of $480
3. Two (2) — Site Map and Location Map
Should there be any questions., please call.
30 Ben Lippen School Road, Suite 202, Asheville, NC 28806 > 828.350.7683 [once] > NC License No.: C-3214 > www.brownpa.net
State of North Carolina
DWR Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION
Th s applicat on is for sewer extensions nvoly ng gravity sewers, pump stations and force mains, or any combination that has been
certified by a professional engineer and the applicant that the project meets the requirements of 15A NCAC 02T and the Division's
Minimum Design Criteria and that plans, specifications and supporting documents have been prepared in accordance with, 15A
NCAC 02T, 15A NCAC 02T .0300, Division policies and good engineering practices.
While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02T .0305(b), design
documents must be prepared prior to submittal of a fast track permit application to the Division. This would include plans, design
calculations; and project specifications referenced in 15A NCAC 02T .0305 and the applicable minimum design criteria. These
documents shall be available upon request by the Division.
Projects that are deemed permitted (do not require a permit from the Division) are explained in I SA NCAC 02T.0303.
Projects not eligible for review via the fast track process (must be submitted for full technical review):
➢ Projects that require an environmental assessment in accordance with 15A NCAC I .0100;
➢ Projects that do not meet any part of the minimum design criteria (MDC) document;
➢ Projects that involve a variance from the requirements of 15A NCAC.2T;
➢ Pressure sewer systems utilizing septic tank -effluent pumps (STEPS) or simplex grinder pumps;
STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mains);
➢ Vacuum sewer systems.
General —When submitting an application, please use the following instructions as a checklist in order to ensrue all required
items are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time
and reduce the amount of requested additional information. Failure to submit all required items will necessitate additional
processing and review time, and may result in return of the application. Unless otherwise noted, the Applicant shall submit
one original and one copy of the application and supporting documentation.
A. One Original and One Copy of Application and Supporting Documents
® Required unless otherwise noted
B. Cover Letter (Required for All Application Packages):
® List all items included in the application package, as well as a brief description of the requested permitting action.
➢ Be specific as to the system type, number of homes served, flow allocation required, etc.
➢ If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Major Modification Application Packages):
® Submit a check or money order in the amount of $480.00 dated within 90 days of application submittal.
➢ Payable to North Carolina Department of Environmental Quality (NCDEQ)
D. Fast Track (Form: FTA 04-16) Application (Required For All Application Packages):
® Submit. the completed and appropriately executed application.
➢ If necessary for clarity or due to space restrictions, attachments to the application may be made.
❑ If the Applicant Type in Item I.2 is a corporation or company, provide documentation it is registered for business with
the North Carolina Secretary of State.
❑ If the Applicant Type in Item L2 is a partnership or d/b/a, enclose a copy of the certificate filed with the Register of
Deeds in the county of business.
® The Project Name in Item II.1 shall be consistent with the project name on the flow acceptance letters, agreements, etc.
® The Professional Engineer's Certification on Page 5 of the application shall be signed, scaled and dated by a North
Carolina licensed Professional Engineer.
® The Applicant's Certification on Pages of the application shall be signed in accordance with 15A NCAC 02T .0106(b).
Per 15A NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation letter is
provided from a person who meets the criteria in 15A NCAC 02T .0106(b).
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page 1 of 3
E. Flow Tracking/Acceptance Form (Form: FTSE 04-16) (If Applicable):
❑ Submit the completed and executed FTSE form from the owners of the downstream sewers and treatmentfacility.
➢ Multiple forms maybe required where the downstream sewer owner and wastewater tteatment facility are different.
➢ The flow acceptance indicated in form FTSE must not expire prior to permit issuance and must be dated less than one
year priorto the application date.
Submittal of this application and form FTSE indicates that owner has adequate capacity and will not violate G.S. 143-
215.67(a).
➢ Intergovernmental agreements or other contracts will not be accepted in lieu of a piaject-specific FTSE.
F. Site Maps (All Application Packages):
® Submit an 8.5-inch x 11-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project
area and closest surface waters.
➢ Location of the project (gravity sewer, pump stations &force main)
➢ Downstream connection points and permit number (if known) for the receiving sewer
❑ Include a street level map (aerial) showing general project area so that Division staff can easily locate it in the field.
G. Existing Permit (All Modificafion Packages):
❑ Submit the most recently issued existing permit.
❑ Provide a list of any items within the permit the Applicant would like the Division to address during the permit
modification (i.e., permit description, flow allocation, treatment facility, etc.).
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
❑ Per 15A NCAC 02T .0305(h)(1), submit documentation of power reliability for pumping stations.
➢ This alternative is only available for average daily flows less than 15,000 gallons per day
It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is
compatible with the station. The Division will accept a letter signed by the applicant(see 15A NCAC 02T .0106(b)) or
proposed contractor, stating that "the portable power generation unit or portable, independently -powered pumping
units, associated appurtenances and personnel are available for distribution and operation of this pump station."
If the portable power source or pump is dedicated to mnitiple 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. (Required at time of certification)
I. Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per 15A NCAC 02T .0115(a)(1) provide the Certificate of Public Convenience and Necessity from the North Carolina
Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by
the sewer extension, or
❑ Provide a letter from the North Carolina Utilities Commission's Water and Sewer Division Public Staff stating an
application for a franchise has been received and that the service area is contiguous to an existing franchised area or
that franchise approval is expected.
J. Operafional Agreements (Applications from HOA/POA and Developers for lots to be sold):
❑ Home/Property Owners'
Associations
❑ Per 15A NCAC
02T .0115(c),
submit the properly executed
Operational Agreement (FORM: HOA).
❑ Per 15A NCAC
02T .0115(c),
submit a copy of the Articles
of Incorporation, Declarations and By-laws.
❑ Developers of lots to be
sold
❑ Per 15A NCAC
02T .0115(b),
submit the properly executed
Operational Agreement (FORM: DEV).
For more information, visit the Division's collection systems website
INSTRUCTIONS. FOR FORM: FTA 04-16 &SUPPORTING DOCUMENTATION Page 2 of 3
THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
2090 US Highway 70
Avery, Buncombe, Burke, Caldwell, Cherokee,
Water Quality Section
Swannanoa, North Carolina 28778
Clay, Graham, Haywood, Henderson, Jackson,
(828) 296-4500
Macon, Madison, McDowell, Mitchell, Polk,
(828) 299-7043 Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quality Section
Fayetteville, North Carolina 28301-5094
Montgomery, Moore, Robeson, Richmond,
(910) 433-3300
Sampson, Scotland
(910) 486-0707 Fax
Mooresville Regional Office
610 E. Center Avenue
Alexander, Cabarrus, Catawba, Cleveland,
Water Quality Section
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
(704) 663-1699
Stanly, Union
(704) 663-6040 Fax
Raleigh Regional Office
1628 Mail Service Center
Chatham, Durham, Edgecombe, Franklin,
Water Quality Section
Raleigh, North Carolina 27699-1628
Granville, Halifax, Johnston, Lee, Nash,
(919) 791-4200
Northampton, Orange, Person, Vance, Wake,
(919) 788-7159 Fax
Warren, Wilson
Washington Regional Office
943 Washington Square Mall
Beaufort, Bertie, Camden, Chowan, Craven,
Water Quality Section
Washington, North Carolina 27889
Currituck, Dare, Gates, Greene, Hertford, Hyde,
(252) 946-6481
Jones, Lenoir, Martin, Pamlico, Pasquotank,
(252) 975-3716 Fax
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wilmington Regional Office
127 Cardinal Drive EMension
Brunswick, Carteret, Columbus, Duplin, New
Water Quality Section
Wilmington, North Carolina 28405
Hanover, Onslow, Pender
(910) 796-7215
(910) 350-2004 Fax
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Alamance, Alleghany, Ashe, Caswell, Davidson,
Davie, Forsyth, Guilford, Rockingham, Randolph,
Water Quality Section
Winston-Salem, North Carolina 27105
Stokes, Surry, Watauga, Wilkes, Yadkin
(336) 776-9800
INSTRUCTIONS FOR FORM: FTA 04-16 &SUPPORTING DOCUMENTATION Page 3 of 3
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T A300 —FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 &SUPPORTING DOCUMENTATION
Application Number:
(to be completed by DWR1
All items must be comnleted or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: City of Brevard (company,municipality,. HOA, utility, etc.}
2. Applicant type: ❑Individual ❑Corporation ❑General Partnership
❑ Federal ❑State/County ®Municipal
3. Signature authority's name: James Fatland per 15A NCAC 02T .0106(b)
Title: Citv Manaeer
4. Applicant's mailing address: 9S West Main Street
City: Brevard State: NC Zip: 28712-
5. Applicant's contact information:
Phone number:) 8$5-5602 Email Address: iim.fatland(c�citvofbrevard.com
❑ Privately -Owned PublioUtility
❑ Other
II. PROJECT INFORMATION:
1. Project name: Lamb Creek Sewer Repair
2. Application/Project status: ®Proposed (New Permit) ❑Existing Permit/Project
If a modification,: provide the existing permit number: W000 and issued date:
If new construction but part of a master plan, provide the existing permit number: W000
3. County where project is located: Transylvania
4. Approximate Coordinates (Decimal Degrees}: Latitude: 35.253385° Longitude:-82.711649°
5. Parce] ID (if applicable}:
(or Parcel ID to closest downstream sewer}
III. CONSULTANT INFORMATION:
1. Professional Engineer: Jeffrey T. Brown License Number: 28289
Firm: Brown Consultants PA
Mailing address: 30 Ben Lippen School Road, Suite 202
City: Asheville State: NC Zip: 28806-
Phone number: (828 350-7683 Email Address: itbrown(a�brownpa.net
IV. WASTEWATER TREATMENT FACILITY (WWTF} INFORMATION:
L Facility Name: Brevard W WTP Permit Number: NC0060534
Owner Name: City of Brevard
V. RECEIVING DOWNSTREAM SEWER INFORMATIQN (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving} Sewer Size: 10 inch
System Wide Collection Svstem Permit Numbers) (if applicable): WQCS00084
Owner Name(s): City of Brevard
FORM: FTA 04-16 Page 1 of 5
VI. GENERAL REQUII2EMENTS
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 fond 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)
S. Nattne of wastewater : 100 %Domestic/Commercial %Commercial
Industrial (See ] SA NCAC 02T .0103(20))
3,Is there a Pretreatment Program in effect? ❑Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .Ol 14(fl? ❑Yes ®No
➢ Ifyes, provide a coov of flow reduction aooroval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(fl)
Daily Design Flow e'b
No. of Units
Flow
gaU
GPD
gaU
GPD
gal/
GPD
gaU
GPD
gaU
GPD
gaU
GPD
Total
0 GPD
a See 15A NCAC 02I' .0114(b), (d) (e)(1) and (e)(2) for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unlmown non-residential development uses; public access facilities located near high public use
azeas; 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 [ih 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: 0 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-] 6 Page 2 of 5
VH. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 &MDC (Gravity Sewersl:
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
10
255
PVC
➢
Section II &III of the MDC for
Permitting
of Gravity Sewers contains informaton related to design criteria
Section III contains information
related to minimum slopes for
gravity sewers)
➢
Oversizing lines to meet. minimum slope
requirement is not
allowed and a violation of the MDC
V I I I. 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:
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: - °
3. Design flow of the pump station: millions gallons per day (firm capacity)
4. Operational points) 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):
❑ Standby power source or pump with autamatie 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 I5,000 gallons per day
➢ Must be permanent to facility
Or ifthe 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)(I)(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(fl & (el
➢ 15A NCAC 02T.0305(f) contains minimum se orations that shall be rovided 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)
SO feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any buildin foundation
5 feet
Any basement
10 feet
To slo e 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(el contains alternatives where separations in 02T.0305(fl cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webnaee
➢ If noncompliance with 02T.0305(fl or (g), see Section X of this application
2. Does the project comply with separation requirements for wetlands? (SO 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?
➢ Infomtation can be obtained from the 401 &Buffer Permittine Branch
5. Doss project comply with 15A NCAC 02T.0105(e)(6) (additional permits/certifications}? ®Yes ❑ No
Per 15A NCAC 02T.0105(c)(6), duectly 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) orthe permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5
X. CERTIFICATIONS:
1. Does the submitted system
comply with
] SA NCAC 02T the Minimum
Design Criteria
for the
Permittin¢ of Pump Stations
and Force Maus (latest version), and the
Gravity Sewer Minimum Desiar
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
I, �,� EJ�(\I` 1 w .�Q1� attest that this application for
(Professional gineer's name from Application Item 1II.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 documentafion to the best of my knowledge. I further attest that to the best
of my knowledge the proposed design has been prepared in accorday� with the applicable regulaticns, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), at 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 7 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 certifiGatiion in any application package shall be
guilty of a Class
2 misderneanor, which may
include a fine not to exceed $1Q000, as well as
civil penalties up to $25,000 per
violation.
Nortih Carolina Professional Engineer's seal, signature, and date:
�Heccs MGM �x�a �,c��at hnaa ,
���
cti, - ��
3. Anolicant's Certi£eatieraner I5�
T����
p���►�.
�AC 02T .0106(b):
.�``�ttN,C+aR
zo .•oF+✓ssi�
;' 2-
r � a SEAL
4 - ig"'i�t
4gr�S/�
rGrT/ryy'r
6 ?�i //Qp/�/�tittest
that this application for
name &title.
from Application
Item 1�/�
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. [understand that any dischazge 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 crimina] 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 $] 0,000 as
well as civil penalties
up to $25,000 per
violation.
Date: ri��
FORM: FTA 04-16 Page 5 of 5
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