WQ0041176_Application (ATC)_20190920

RECEIVED State of North Carolina
Department of Environmental Quality
DWR SEP 11 2019 Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources DEO-FAYETTEVILLE REGIONAL OFFICE FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: �Aft4 (to be compacted by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Townof St Pauls (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: Jerry Weindel'per 15A NCAC 021' .0106(6)
Title: Mayor
4. Applicant's mailing address: 210 W.Blue Street
City: St. Pauls State: NC Zip: 28384-_
5. Applicant's contact information:
Phone number: (9rO) 865-51�64 Email Address: debraQstoaulsnc. ov
II. PROJECT INFORMATION:
1. Project name: Fairfield.
2. Application/Project status: 0_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: W000_
3. County where project is located: Robeson
4. Approximate Coordinates (Decimal Degrees): Latitude: 34.8153° Longitude:-78.9889°
5. Parcel ID (if applicable): 030837379300
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: C. Scott Brown License Number: 27452
Firm: 4D Site Solutions Inc.
Mailing address: 409 Chicago Dr. Ste. 112
City: Fayetteville State: NC Zip: 28306-_
Phone number: [phone] Email Address: sbrownng.4dsitesolutions.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Town of St. Pa t11s W WTP Permit Number: NCO020095
Owner Name: Town of St. Pauls
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than W WTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size: $ inch
System Wicle Collection System Permit Number(s iI a )l lieable): WQCS00187
Owner Name(s): Town of St. Pauls
FORM: FTA 04-16 Page] of 5

VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑No ON/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Ouerational ANcement {FORM_DEV). been attached?
❑ Yes ❑No NN/A
3. If the Applicant is a Home/Property Owners' Association. has an Operational A9reeiem (FO12V1: HOA) been attached?
❑ Yes ❑No ON/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: 100 % Domestic/Commercial %Commercial
_% Industrial (See 15A NCAC 02T.0 103(20))
L----)k-Is there a Pretreatment Program in effect? ❑ Yes ® No
6. Hasa flow reduction been approved under 15A NCAC 02T d11 14(1)? ❑ Yes ® No
➢ If yes, Provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(fl)
Daily Design Flow a,b
No. of Units
Flow
I bedroom units
240 gal/day
12
2,880 GPD
2 bedroom units
240 gal/day
28
6,720 GPD
3 bedroom units
360 gal/day
24
8,640 GPD
gal/
GPD
gal/
GPD
gall
GPD
Total
18,240 GPD
a See 15A NCAC 011 .01 140A (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 13A NCAC 02T.O l la] shall
be determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 18,240 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

VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 539 PVC
➢ 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 as not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable)— 02'f .U3115 & MDC IPumP Stutious/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 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 15A NCAC 02'i' .0305(h)(1).:
❑ 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(f)):
1. Does the project comply withal] separations found in 15A NCAC 02T .0305(f) &@ ( )
➢ 15A NCAC 02T.0305(f) contains minimum separations 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 trenches)
18 inches
Water mains (horizontal)
t0 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)
50 feet
**Any other stream, take, 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 heiglit
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth de vertical
36 inches
➢ 15A NCAC 02'1' 0305(e) contains alternatives where separations in 02'1'.WOW cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water C'lassilications weboaee
➢ If noncompliance with 02T.0305(Il or {L , see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ❑ Yes ❑ No [9 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 l5 A NCAC 02 B Q22 ❑Yes ❑ Ne N/A
➢ This would include Trout Buffered Streams per 15A NCAC 213.0202
4. Does the project require coverage/authorization under a 404 Nationwide or [:]Yes 0 No
individual permits or 401 Water Quality Certifications?
➢ Information can be obtained from the =101 A Buffer Permitunn_ Branch
5. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? Z Yes [:]No
Per 15A NCAC 02T.0105LtJLO), 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 I A NCAC 02'T N 2, "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 Z 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(ax5) 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 j5A NCAC OTE, the Nlinimum Design Criteria for the I'crmittine o]' Pumtt Stations
and Furce fvlains (latest version). and the Gravity Sewer Minimum Design Criteria (latest version) as applicable?
2.
0 Yes ❑ No
If No, complete and submit the Variance/Altemative 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.
that this application for
name from Application Item I11.1.)
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 143-215.6B, 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.
North Carolina Professional Engineer's seal, signature, and date:
SEAL
027452
�..•'�NGINEEP:��
3. Applicant's Certification per 15A NCAC 02T .0106(b):
,: Al eiA l cic / �% Yv/ _attest that this application for
Authority's name & title from Application Item 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 1143-215.0/k and I43-215bi3, 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: � i��a
Date: /
FORM: FTA 04-16 Page 5 of 5

State of North Carolina
Department of Environmental Quality
Division of Water Resources
,,; a ,.,,,.,:;, ,.., Flow Tracking(Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Fairfield Park Apartments
Project Name for which flow is being requested: Fairfield Park Apartments
More than one FTSE maybe required for a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewater,Jlow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: St. Pauls W WTP
b. WWTP Facility Permit #: NCO020095
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
It. Percent of permitted flow used
All, flows are in
0.50
0.469
0.01824
0.487
97.4%
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) MOD MGD
MGD MOD Flow
Capacity***
No.6 0.410 0.136
0.032 0.0018 0.05
0.086
No.1 0.665 0.266 0.092 0.0018 0.11 0.156
* 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): St. Pauls Collection System
Downstream Permit Number: WQCS00187
Page 1 of 6
FTSE 04-16

III. Certification Statement:
I 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 acceptance of this wastewater flow.
Signing
Date
Page 2 of 6
PTSE 04-16

September 10, 2019
NCDEQ
Fayetteville Regional Office C I V E
Attn: Trent Allen
225 Green Street, Suite 714
Fayetteville, NC 28301 SEP 1 1 2019
DEO•FAYETTEVILLE REGIONAL OFFICE
RE: Sewer Application, Fairfield Park Apartments, St. Pauls, North Carolina
Trent;
Attached is the sanitary sewer application package for Fairfield Park Apartments. A check for the
$480 review fee is also enclosed.
I look forward to working with you on this project. If you have any questions or concerns, please
feel free to contact us.
Sincerely,
41) Site Solutions Inc.
\ScBrown, PE
sbrown Cca4dsitesolutions.com
Enclosure
409 Chicago Drive. Suite 112, Fayetteville, NC 28306
office 910-426-6777 fax', 910-426-5777
On time, every time. i wwwADsitesotutions.coin

Division of Water Resources
�DWR
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number:
(to be completed by MR)
All items must be completed or the application will be returned RECEIVED
1. APPLICANT INFORMATION: SEP 11 2019
1. Applicant's name: Town of St Pauls (company, municipality, HOA, utility, etc.) /!q5?
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Prl5*EW4-D iih'OQPRfi CIVALliWFICE
❑ Federal ❑ State/County ® Municipal ❑ Other 9--�p.¢Soy, Co
3. Signature authority's name: Jerry Weindel per I iA NCAC 02T .010ti(b)
Title: Mayor
4. Applicant's mailing address: 210 W.Biue Street
City: St. Paula State: NC Zip: 28384-_
5. Applicant's contact information:
Phone number: 9( 10) 865-51_64 Email Address: debra(bstoaulsncgov
II. PROJECT INFORMATION:
1. Project name: Fairfield Park Apartments
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: W000_
3. County whers project is located: Robeson
4. Approximate Coordinates (Decimal Degrees): Latitude: 34.8153° Longitude:-78.9889'
5. Parcel ID (if applicable): 030837379300
FORM: FTA 04-16 Page 1 of 5

�nwRState of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Dlvislon of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: (to be completed by DWR)
All items must be completed or the application will be returned
1. APPLICANT INFORMATION:
1.
Applicant's name: Town of St Pauls (company, municipality, HOA, utility, etc.)
2.
Applicant type: ❑ Individual Ll Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County M Municipal ❑ Other
RECEIVEU
3.
Signature authority's name: Jerry Weindel per 15A NCAC 02T .0I06(b i
Title: Mayor
SEP 11 2019
4.
Applicant's mailing address: 210 W.Blue Street
pq.%
City: St. Pauls State: NC Zip: 28384-_ OEO-FAYETTEVILLE REGIONAL OFFICE
5.
Applicant's contact information:
Zbb..¢hOYt
Phone number: 910 865-5164 Email Address: [e-mail]
G %
I1. PROJECT INFORMATION:
1.
Project name: Fairfield Park Apartments
2.
Application/Project status: M 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: WQ00_
3.
County where project is located: Robeson
4.
Approximate Coordinates (Decimal Degrees): Latitude: 34.81530 Longitude:-78.9889°
5.
Parcel ID (if applicable): 030837379300
PoP
.nnEnna
_ a
FORM: FTA 04-16 Page i of 5

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SEP 11 2019
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Permit Number W00041176
Program Category
Non -discharge
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
Primary Reviewer
trent.allen
Coastal SWRule
Permitted Flow
18,240
Facility
Facility Name
Fairfield Park Apartments
Location Address
Owner
Owner Name
Town of St Pools
Dates/Events.
Central Files: APS _ SWP _
9/20/2019
Permit Tracking Slip
Status
Project Type
Active
New Project
Version
Permit Classification
1.00
Individual
Permit Contact Affiliation
Major/Minor Region
Minor Fayetteville
County
Robeson
Facility Contact Affiliation
Owner Type
Non -Government
Owner Affiliation
Jerry Weindel
210 W Blue St
Saint Paula NC 28384
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
9/20/2019 9/11/2019 9/20/2019 9/20/2019
Regulated Activities Requested !Received Events
Wastewater collection Additional information requested
Additional information received
Outfall
Waterbody Name Streamindex Number Current Class Subbasin

Central Files: APS _ SWP _
9/20/2019
Permit Number W00041176
Program Category
Non -discharge
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
Primary Reviewer
trentallen
Coastal SWRule
Permitted Flow
18,240
Facility
Facility Name
Fairfield Park Apartments
Location Address
Owner
Owner Name
Town of St Pauls
Permit Tracking Slip
Status
Project Type
Active
New Project
Version
Permit Classification
1.90
Individual
Permit Contact Affiliation
Major/Minor Region
Minor Fayetteville
County
Robeson
Facility Contact Affiliation
Owner Type
Non -Government
Owner Affiliation
Jerry Weindel
210 W Blue St
Dates/Events Saint Pauls NC 28384
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
9/20/2019 9/11/2019 9/20/2019 9/20/2019
Regulated Activities Requested /Received Events
Wastewater collection Additional information requested
Additional information received
Outfall
Waterbody Name Streamindex Number Current Class Subbasin