WQ0040986_Application (FTSE)_20190808

Central Files: APS SWID
7/3/2019
Permit Number WQ0040986 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
A &�( I �M 1 171
Version Permit Classification
A Individual
Permit Contact Affiliation
Facility Name Major/Minor Region
Trinity Landing Senior Apartments DRY Private Sewer Minor Wilmington
Location Address County
New Hanover
Owner Name
Lutheran Retirement Center - Wilmington Inc
0101912�1�
Owner Type
Non -Government
Owner ,affiliation
Ted W. Goins Jr.
PO Box 947
Dates/Events Salisbury NC 28145094
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
7/2/2019
Regulated Activities Requested /Received Events
Additional information requested
Additional information received

R I AL-11L,
1900 Eastwood Road, Suite 11
Wilmington, NC 28403
[phone]
[phone] Fax
John S. TunstaH, P.E.
T. Jason Clark, P.E.
1429 Ash -Little River Road
Ash, NC 28420
[phone]
[phone] Fax
J. Phillip Norris, P.E.
Thomas J. Scheetz, E.T.
Trinity Landing
4915 Masonboro Loop Road
Wilmington, NC
N&T Project No. 18055 , ' �
Dear Sir or Madam:
Enclosed is one (1) original application form with one (1) copy, two (2) copies of the Sewer
Narrative, one (1) original Flow Tracking /Acceptance Form (FTC E 10-18) from the Cape Fear
Public Utility Authority with one (1) copy, two (2) 8 Y2x 11 color USGS Topographic as, two
(2) site plans (ledger size) and a $480.00 check for the processing fee.
Please review this information for approval and contact us with any questions or comments you
may have. Thank you for your assistance on this project. VM W— — , ,
Is=
NORRIS & TUNSTALL
CONSULTING ENGINEERS, P.C.
f QV
T. Jason lark, P.E.
TJC/asn
18055 06-21-19-s-swr-itr (Private)
NCBELS License C-3641

Department of Environmental Quality
R Division of Water Resources
15A NCAC 02T.0300 - FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
q
6 (to be completed by DWR)
Application Number : 6-0 -1 J
All items must be completed or the application will be returned
1. Applicant's name: Lutheran Retirement Center - Wilmingion, Inc. (company, municipality, HOA, utility, etc.)
2. Applicant type: El Individual 0 Corporation General Partnership E] Privately -Owned Public Utility
El Federal E] State/County Municipal EJ Other
3. Signature authority's name: Ted. W. (loins , Jr. per C'
Title: President
4. Applicant's mailing address: P.O. Box 947
City: Salisbury State: NC Zip: 28145
5. Applicant's contact information:
Phone number: [phone] Email Address: jfrye@trini1yIqqd net
1. Project name: Trinity Landing
1 Application/Project status: Proposed (New Permit) Existing Permit/Project
If a modification, provide the existing permit number: WQOO 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: IN' Longitude: -30-TW'
ILA
5. Parcel ID (if applicable): R07600-003-001-000 "t
(or Parcel ID to closest downstream sewer)
1. Professional Engineer: T. Jason Clark. P.E. License Number: 030869 NC
Firm: Norris & Tunstall Consulting En2meers, P.C.
Mailing address: 1900 Eastwood Road, Suite 11
City: Wilmingto State: NC Zip: 28403
Phone number: (9_10) 343-9653 Email Address: jclarkgntengineers.com cc: anorris(&,mengineers.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: M'Kean Maffitt (Southside WWTP) Permit Number: NC 0023973
Owner Name: Cape Fear Public Utility Authority
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream Sewer is Currently Being Permitted Concurrently w/ this App - Trinity (Public)
System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s):
FORM: FTA 04-16 Page 1 of 5

V1. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
7000�4'��
1 If the Applicant is a Developer of lots to be sold, has been attached?
FN_ Z �0 �19=
R_ A: __ C�A) been attached?
1 If the Applicant is al.o-me/Pr" 0
FN_1119001=1
4. Origin of wastewater: (check all that apply):
El Residential Owned El Retail (stores, centers, malls) 0 Car Wash
ED Residential Leased El Retail with food preparation/service 0 Hotel and/or Motels
El School / preschool / day care El Medical / dental / veterinary facilities Swimming Pool /Clubhouse
0 Food and drink facilities ED Church Swimming Pool/Filter Backwash
El Businesses / offices / factories El Nursing Home Other (Explain in Attachment)
5. Nature of wastewater: 100% % Domestic/Commercial _% Commercial
% Industrial (See, 15 "s
L ------- >Is there a Pretreatment Program in effect? E] Yes E] No
i. Has a flow reduction been approved under I 5A TKICAC 02— -' If ves, nrovide a corw of flow reduction aDnroval letter i
7. Summarize wastewater generated by project:
Establishment Type (see t,12T.0,1_111-
Daily Design Flow a,b
No. of Units
Flow
Residential I & 2 Bedroom (Apt. Units)
240 gal/Unit
124
29,760 GPD
Restaurant
40 gal/
265
10,600 GPD_
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
=40,3%-,9PD
a See I NCAC 02T J1 4-th, ilandicM for caveats to wastewater design �
flow rates minimum w per
:
dwelling; proposed unknown non-residential development uses; public access facilities located larhigh public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in f S 2 A - 4).
b Per 15A NCAC 02T .0 1 14(c), design flow rates for establishments not identified [in table J -5AI-! AC 01 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
J
8. Wastewater generated by project: 40,360 GPD (per 5,-'-'� `,"CA'C' 0 - 2 J,­ ",Q) i 1
> 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
0 Flow has already been allocated in Permit Number: Currently Being Permitted. (Public w/ CFPUA_)
El Rehabilitation or replacement of existing sewer with no new flow expected
E] Other (Explain):
FORM: FTA 04-16 Page 2 of 5

I
im
1
2
3
4
NOW i �11 11IIH ii F III 1 01 111 1 11! 11 1' 1, 111��i 11 1 11;11 111
Summarize gravity sewer to be permitted:
Size (inches) Lein Material
8" 332 PVC & DIP
> 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 MDC
PUMP STATION DESIGN CRITERIA if Applicable).iceo r_e
Pump station number or name: -
Approximate Coordinates (Decimal Degrees). Latitude: 0 Longitude: -
Design flow of the pump station., millions gallons per day (firm capacity)
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
` C 0 2 T � 3 0 ,,( 6. Power reliability in accordance with "'5l �_A
F] 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:
El Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)(1)(C)
Ki
E] Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(I)(Q:
> 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 i `Vk N-,­A-,C 0
> 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems:
021mrs-0
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-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, 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
To slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drams
5 feet
I Any swimming pools
10 feet
F
L Final earth ade (vertical)
36 inches
5A NCA"-- 02T,03-05" contains alternatives where separations in 0,22T. cannot be achieved,
**Stream classifications can be identified using the Division's N-C Surflace _'�X.fater
If noncompliance withsee Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ED Yes El No
> 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
0
3. Does the project comply with all setbacks found in the river basin rules per '."A ' Yes El NoA," (12�6
> This would include Trout Buffered Streams per -A _`_`P',Q`,GG­,
4. Does the project comply with an individual 404 Permit or any 401 Certifications? ED Yes [—]No
Wetland -related permits shall be requested, obtained, and adhered to for projects that impact wetlands or surface waters
> Information can be obtained from the 40 1 37Bulfer
5. Does project comply with 6
5A _`,K!Q�AC Q­,`,01,,M,(c (additional permits/certifications)?
FIRIMM-00
Per 5.ANQ'A-­1 �,,_Y_T�Q 1 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?"
I A,'�
Per 5AT-,,!,C­A�1­__,02 Q-A , "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.
El Yes 0 No
> If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
FORM: FTA 04-16 Page 4 of 5

CERTIFICATIONS:
Does the submitted system comply with 4 'r tla t931[ [ nit ..l P a 6° 11tE 13�t, !i pt , 31 _{;. 3 ..I. ;. �a�� . w.
j nd the
h' ii,! fliT'2 t7 c,c. it ,t ti4' f des„ mIe'9i ri as applicable?
Yes I] No
If No, complete and submit the ari nce/A1tcmative Design Request application (VADC 10-14 and supporting documents for
review. A2gMyal of the °� nest is aalr riot taI submittal €�f t # Traek ticattaan and sn ortin documents,
2. ' ProfessionalEngineer'sCertification:
K
attest that this application for
{Professional Engineers name from Application Item tlLl
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all either supporting documentation to the best of arty knowledge, f 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 ;ewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force wins (latest version), Although other proNssionals may have developed certain portions of this
submittal package, inclusion of these materials under trry 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 1 3a215.6A and l 3-215,6tl, arty 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, tlf1, as well as civil penalties up to $25,000 per violation.
North Carolina Professional Engineer's seal, signature, and date:
H7Q SEAL
VJZ
e 0308,69 ra � W
'me
. Applicants Certification per I5A U2T.0l0 (b)-
I, that this application for
(Signature Authority's name & title from application Item 1..)
has been reviewed by rate 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. 1 understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will resent in are immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. I will make area claim against the Division of Water R"ources should a condition
of this permit be violated. I also understand that if all required parts of this application package are; not completed area 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 µ and any person who knowingly stakes any false
statement, representation, or certificsation in any application package shall be guilty of a Class 2 misdemeanor, which may
includes a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation,
u _
Signature
Lute:
FORM: FTA 04-1 Page 5 of 5

11111 11111 111 Ip III PININ
2MEMM
LegaL Name
Lutheran Retirement Center - Wilmington, Inc.
9171��
Principal Office
1416 S. Martin Luther King, Jr. Ave
Reg Office Reg MaRing
1416 S. Martin Luther King, Jr. Ave. PO Box 947
Salisbury, NC 28144 Salisbury, NC 28145

01vision of Water Resourcei,
Flow Tracking ifor Sewer Extension Applications
(FT 10®1 )
,1st pump stations located between the project connection point and the TP:
Design
Obligated,
Pump
Pump
Average
Approx.
Not Yet
Total Current
Station
Station
Finn
Daily low"
Current
Tributary
Flow Plus
(Name or
Permit
Capacity,
(F° / p ,
Avg. Daily
Daily Flow,
Obligated
Available
Number)
No.
MGD
MGD
Flow, I+ GD
MGD
Flow
Capacity***
T
/A
0.446
00140
0.000
0.040
0.040
0.099
— 69
N/A
4.065
1.506
0.900
0.764
1.665
-0.159
Downstream Facility Name (Sewer): apq FeqrPub.IicUfi.IityAutho
Downstream Permit Number: Not Available
TS E l 88

Title of Signing Official
Page 2 of 6
FTSE 10-18

Planning Assessment
60K III �, M'Ik f � 11 � � "'I"'
IM
M
Lutheran Retirement Center — Wilmington, NC
P.O. Box 947
Salisbury, NC 28145

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7/3/2019

Hunkele, Dean
From: John Frye <[e-mail]>
Sent: Tuesday, July 2, 2019 4:23 PM
To: Hunkele, Dean; '[e-mail]'
Cc: '[e-mail]'; 'John Tunstall'; Amy Norris; Matt Tribett
Subject: [External] FW: Trinity Landing PS
Lutheran Retirement Center - Wilmington, Inc. dba Trinity Landing also concurs. Both
systems should be dry.
Thank vou.
John C. Frye, Jr.
Executive Director
Trinity Landing
5215 Junction Park Circle, Suite 102
Wilmington, N. C. 28412-2287
From: Bernice Johnson <Bern ice.Joh nson @cf pua org>
Date: Friday, June 28, 2019 at 11:50 AM
To: Dean Hunkele <Dean. h u n kgle@ ncden rgoy>, Jason Clark <jLlarkenten �ineers�.com>, John Tunstall
<[e-mail]>
Cc: Amy Norris Matt Tribett <Matthew.Tritett@cfpuaorg>
Subject: RE: Trinity Landing PS
CFPUA concurs. Both systems should be dry.
Thanks
Bernice S. Johnson, Senior Project Manager
235 Government Center Drive
Wilmington, NC 28403
Office: 910.332.6620
Mobile: [phone]
Fax: [phone]
From: Hunkele, Dean <dean.hunke1e@ncdenr,gov>
Sent: Friday, June 28, 2019 9:31 AM
To: Jason Clark <jL1arkffntengineerscorn>; John Tunstall <[e-mail]>
Cc: Amy Norris <[e-mail]>; Matthew Tribett <Matthew.Tribett2cfpuaorg>; Bernice Johnson