WQ0041078_Application (FTSE)_20190911

Permit Number W00041078
Program Category
Non -discharge
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
Primary Reviewer
dean.hunkele
Coastal SWRule
Permitted Flow
Facility
Facility Name
Island Creek Fire Station Public Force Main
Location Address
Owner
Central Files: APS _ SWP
8/6/2019
Permit Tracking Slip
Status
Project Type
In review
New Project
Version
Permit Classification
A
Individual
Permit Contact Affiliation
Major/Minor Region
Minor Wilmington
County
Ponder
Facility Contact Affiliation
Owner Name Owner Type
Pluris Hampstead LLC Non -Government
Owner Affiliation
Randy R. Hoffer
DateslEvents
1095 NC Hwy 210
Sneads Ferry
NC 28460
Scheduled
O rig Issue App Received Draft Initiated Issuance
Public Notice Issue
Effective
Expiration
8/6/2019
Regulated Activities
Requested /Received Events
Additional information requested
,���--

PARAMOUNTE
E N G I N E E R I N G. I N C.
1 2 2 CINEMA DRIVE
W I L M I N G T O N, N C 2 8 4 0 3
9 1 0- 7 9 1- 6 7 0 7( O) 9 1 0- 7 9 1- 6 7 6 0 ( F;
I. F. T T F. R n F T R A N C M i T T A 1.
To:
NCDEQ
Date
1 08.05.19
127 N. Cardinal Drive
Wilmington, NC 28405
Re:
Island Creek Fire Station
910 796-7215
Fast Track Sewer UBLIC
Attn:
Dean Hunkele
Project No.
I 18466.PE
e axe sendin :
® Originals
® Prints
❑ Shop Drawings
❑ Calculations
❑ Correspondence
❑ Plans
❑ Specifications
❑ Other as listed below
he following items:
Quantity
Date
Dwg. No.
Description
2
Fast Track Sewer Permit FTA 04-16
on 'nal and 1 co ,
2
Flow Tracking/Acceptance Sewer Extension Application FTSE 04-16
oxi al and 1 co
1
Sanitary Sewer Narrative (Cover Letter)
1
USGS Map
1
Site Map
1
$480 check
slue Status: ® For Approval ❑ As Requested ❑ Construction ❑ Bid
❑ For Your Use ® For Review and Comment ❑ Approved as Noted ❑ See Remarks
ction Taken: ❑ No Exceptions Taken ❑ Make Corrections Noted ❑ Amend & Resubmit
❑ Rejected - See Remarks ❑ Approved as Submitted ❑ Other
emarke:
Feel free to contact me with any questions or if you need additional information. Thank you.
jblair akparamounte-eng.com
Cc:
Signed:
Jeremy R. %aj, PE
,ECE#VL
AUG 0 6 2019

State of North Carolina
D1 R Department i ionv fWaerR Quality
Division of Water Resources
I5A NCAC 02T .0300 — FAST TRACT( SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources P"1'A 04.16 & SUPPORTING DOCUMENTATION
Application Number:_V��+"N1v tp (tobecon.plded by DWR)
All items must he conoleted or the annlication will be returned
1. APPLICANT INFORM ATION:
1. Applicant's name: Pluris Hampstead, LLC (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: Randy Hoffer per) 5A NCAC 02T .0106(bl
Title: Regional Manaeer
4. Applicant's mailing address: 1095 Hwy 210
City: Sneads Ferry State: NC Zip: 28460
5. Applicant's contact information:
Phone number: 910) 327-2880 Email Address: rhofferoolurisusa.cont
H. PROJECT INFORMATION:
L Project name: Island Creek Fire Station 'Q�i�L �uvee. 1�se+h
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permil/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: Pender
4. Approximate Coordinates (Decinnal Degrees): Latitude: 34.374" Longitude:-77.784°
5. PareellD(if applicable): 3262-69-4150
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
I. Professional Engineer: Jeremy Blair License Number: 28852
Firm: Paramount; Engineering, Inc
Mailing address: 122 Cinema Drive
City: Wilmineton State: NC Zip: 28403
Phone number: [phone] Email Address: iblair(aparannounte-ene.com
IV. WASTEWATER TREATMENT FACILITY(WWTr) INFORMATION:
1. Facility Name: Pluris Hampstead LLC Permit Number: W 00037287
Owner Name: Pluris Hampstead, LLC
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than W WTF):
I. Permit Number(s): WQOO qi3 Ly Downstream (Receiving) Sewer Size: /X inch
System Wide Collection System Permit Number(s) (if applicable): WQCS_
Owner Name(s): Pluris Hampstead, LLC
17ORM: FTA 04-16 Page I of 5

VI. GENERAL REQUIREMENTS
I. 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', Operational 1gr
eenlent (FORM DFV I been attached?
❑ Yes ❑No ®N/A
3. If the Applicant is a Home/Properly Owneri Assuci•ltion 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
❑ School / preschool / day care ❑ Medical / dental / veterinary facilities
❑ Hotel and/or Motels
❑ Swimming Pool /Clubhouse
❑ Food and drink facilities ❑ Church
❑ Businesses / offices / factories ❑ Nursing Home
❑ Swimming Pool/Filter Backwash
® Other (Explain in Attachment)
5. Nature of wastewater: ,100 % Domestic/Commercial _% Commercial
_I %r Industrial (See I SA NCAC' 02T 0103(20))
`--GIs there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 021'01 14t l)? ❑ Yes ® No
➢ If yes, provide a cony of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02'r.o114(f))
Daily Design Flow 0
No. of Units
Flow
Fire Station with on -site staff
50 gal/person/shift
7
350 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
GPD
a See 15A NCAC 02I' 0114(hl (d), tell1) and (e)(2i for caveats to wastewater design flow rates (i.e., minimum now 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 .01 14(c), design flow rates for establishments not identified [in table I A NCAC 02 F.01 141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 350 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:
❑ 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):
I. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
➢ Section 11 &III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section Ill contains information related to minimum slopes for gravity sewer(s)
Y Oversizing lines to meet mininmm slope requirement is not allowed and a violation of the MDC
Vill. PUMP STATION DESIGN CRITERIA (if Applicable) — 02T.0305 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
I. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: 34.3520° Longitude:-77.7319°
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
2
1060
SDR-91IDPE
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)(D)_
➢ 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)(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.
Y 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 mpump, including travel timeframes, shall be provided
in the case of multiple station power outage.
FORM: PTA 04-I6 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B.0200 & 15A NCAC 02T.0305(f)):
I. Does the project comply with all separations found in 15A NCAC 02T .0305(fl & W M Yes ❑ No
➢ 15A NCAC 02T.0305(f) contains minimum senarations that shall be provided for sewer systems:
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below vertical
24 inches
Water mains vertical -water over sewer including in benched benches
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, W S-1 waters of Class I or
ChISS 11 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 dent 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
Drainage systems and interceptor drains
5 feet
Any swimming cools
10 feet
Final earth grade vertical
36 inches
D 15A NCAC 02T.030S(g) contains alternatives where separations in 02T.0305(fl cannot be achieved,
D **Stream classifications can be identified using the Division's NC Surface Water Classifications weboage
D If noncompliance with 02T.0305(f) or (g). see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes [:]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
D As built documents should reference the location of areas effected
3. Does the project comply with all setbacks found in the river basin rules per 15A NCAC 02B 0200? M Yes ❑ No
➢ This would include Trout Buffered Streams per I SA NCAC 20,0202
4. Does the project comply with an individual 404 Permit or any 401 Certifications? M Yes ❑ No
➢ Welland -related permits shall be requested, obtained, and adhered to for projects that impact wetlands or surface waters
D Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02T.0105(e)(6) (additional pent its/cerlifications)? M 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 M No
➢ If yes, include an altachment with details for each line, including type (aerial line, size, material, and location).
High priority lines slmll 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:
Does the submitted system comply with I SA 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/Atternativc Ucsign Bequest application (VADC 10-14) and supporting documents to] -
review. Anoroval of the resuest is respired prior to submittal of the FastTrlick Application and supnorting documents.
Engineer's Certification:
name from Application Item 111.1
that this application for
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. 1 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
havejudged it to be consistent with the proposed design.
NOTE In accordance with General Statutes 143-215.6A and 143-215.6U, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanorwhichmay
include a fine not to exceed $10,000, as well as civil penalties up to $25,000 per violation.-..eewfA I � '/-�
North Carolina Professional Engineer's seal, signature, and (late;
3. Applicant's Certification per 15A NCAC 02T.0106(b):
name & title from Application Item 1.3.)
SEAL
020`2
,'Ikl
that this application for
has been reviewed by me and is accurate and complete to the best of my knowledge. 1 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 fit an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. 1 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 143.215.60, 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.
FORM: FTA 04-16 Page 5 ol'S

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NZ NC Surface Water Classifications
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