WQ0034402_Permit (Issuance)_20091027

r ANANCDENR
North Carolina Department ofEnvironlnent and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
October 27, 2009
Moore County Public Utilities
Dennis Brobst, Public Works Director
Post Office Box 1927
Carthage, NC 28327
SUBJECT: Permit No. WQ003�402
Hospice & Palliative Care
Wastewater Collection System Extension
Moore County
Dear Dennis Brobst, Public Works Director:
In accordance with your application received October 12, 2009, we are forwarding herewith Permit
No. WQ0034402 dated October 27, 2009, to Moore County Public Utilities for the construction and
operation of the subject wastewater collection system extension. This permit shall be effective from the
date of issuance until rescinded, and shall be subject to the conditions and limitations as specified therein.
This cover letter shall be considered a part of this permit and is therefore incorporated therein by
reference.
Please pay particular attention to Permit Condition 3, which requires the wastewater collection
facilities be properly operated and maintained in accordance with 15A NCAC 02T .0403 or any individual
system -wide collection system permit issued to the Permittee.
Permitting of this project does not constitute an acceptance of any part of the project that does not
meet 15A NCAC 02T .0305; the Division of Water Quality's (Division) Gravity Sewer Minimum Design
Criteria adopted February 12, 199�, as applicable; and the Division's Minimum Design Criteria for the
Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000, as applicable, unless
specifically mentioned therein. Division approval is based on acceptance of the certification provided by
the North Carolina -licensed Professional Engineer named in the application. It shall be the Permittee's
responsibility to ensure that the as -constructed project meets the appropriate design criteria and rules.
Failure to comply may result in penalties in accordance with North Carolina General Statute § 143-215.6A
through § 143-215.6C, construction of additional or replacement wastewater collection facilities, and/or
referral of the North Carolina -licensed professional Engineer to the licensing board.
Non thCarolina
aturally
North Carolina Division of Water Quality 225 Green Street — Suite 714 Fayetteville, NC 28301-5043 Phone [phone] Customer Service
Internet: www.ncwaterquality.org FAX [phone]
An Equal Opportunity/Affirmative Action Employer — 50% Recycled110% Post Consumer Paper

"F_111115 DIUUJL, F ULMU VV U1riJ LJIIGGLUI
Page 2
October 27, 2009
In accordance with provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, �ules, and Regulations, permission is hereby granted to the Moore
County Public Utilities,for the constri. tion and operation of 1157 linear feet of 8-inch gravity sewer to serve
as part of the Hospice & Palliative Care project and 1970 gallons per day of collected domestic wastewater
into the Moore County Wastewater Treatment Plant, pursuant to the application received October 12, 2009,
and in conformity with 15A NCAC 02T .0305; the Division's Gravity Sewer Minimum Design Criteria
adopted February 12, 1996, as applicable; the Division's Minimum Design Criteria for the Fast -Track
Permitting of Pump Stations and Force Mains adopted June 1, 2000, as applicable; and other supporting data
subsequently filed and approved by the Department of Environment and Natural Resources and considered
as part of this permit.
The sewage and wastewater collected by this system shall be treated in the Moore County
Wastewater Treatment Plant (NC0037508) prior to being discharged into the receiving stream.
If any parts, requirements, or limitations contained in this.permit are unacceptable, you have the right
to request an adjudicatory hearing upon written request within 30 days following receipt of this permit. This
request must be in the form of a written petition, conforming to Chapter 150B of North Carolina General
Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC
27699-6714. Unless such demands are made, this permit shall be final and binding.
If you need additional inform tion concerning this matter, please contact Trent Allen at (910) 433-
3322. 1
Sincerely,
for Coleen H. Sullins, Director
cc: Fayetteville Regional Office, Water Quality Section (WPCF Permit No. NC0037508)
David E. Richmond, McGill Associates, Post Office Box 1136, Hickory, North Carolina 28603
PERCS

4.
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
This permit shall be effective from the date of issuance until rescinded and shall be subject to the
following specified conditions and limitations:
I
1. This permit shall'; become voidable unless the wastewater collection facilities are constructed in
accordance with the conditions of this permit; 15A NCAC 02T .0305; the Division of Water Quality's
(Division) Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as applicable; the
Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains
adopted June 1, 2000 as applicable; and other supporting materials unless specifically mentioned herein.
2. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data.
3 The wastewater collection facilities shall be properly maintained and operated at all times. The Permittee
shall maintain compliance with an individual system -wide collection system permit for the operation and
maintenance of these facilities as required by 15A NCAC 02T .0403. If an individual permit is not
required, the following performance criteria shall be met as provided in 15A NCAC 02T .0403:
a. The sewer system shall be effectively maintained and operated at all times to prevent discharge to
land or surface waters, and any contravention of the groundwater standards in 15A NCAC 2L .0200
or the surface water standards in 15A NCAC 2B .0200.
b. A map of the sewer system shall be developed and shall be actively maintained.
c. An operation and maintenanjce plan shall be developed and implemented.
d. Pump stations that are not (connected to a telemetry system shall be inspected every day (i.e. 365
days per year). Pump stations that are connected to a telemetry system shall be inspected at least
once per week.
c. High -priority sewer lines shall be inspected at least once per every six-month period of time.
f. A general observation of the entire sewer system shall be conducted at least once per year.
g. Inspection and maintenance records shall be maintained for a period of at least three years.
h. Overflows and bypasses shall be reported to the appropriate Division regional office in accordance
with 15A NCAC 2B .0506(a), and public notice shall be provided as required by North Carolina
General Statute § 143-215.1 C.

Y. A11" 1JG11111L N11411 1/1/L 1/C LJallJIUXa1/1G. 111 Ulf- GVGlIL LICK 1J Cl UCJ11G lUl L11C WCLSLCWULCI UU11CGL1U11
1
facilities to change ownership, or there is a name change of the Permittee, a formal permit request shall
be submitted to the Division accompanied by documentation from the parties involved, and other
supporting materials as may be appropriate. The approval of this request shall be considered on its
merits and may or may not be approved.
5. Construction of the gravity sewers, pump stations, and force mains shall be scheduled so as not to
interrupt service by the existing utilities nor result in an overflow or bypass discharge of wastewater to
the surface waters of the State.
6. Per 15A NCAC 02T .0305, upon completion of construction and prior to operation of these permitted
facilities, the completed Engineering Certification form attached to this permit shall be submitted with
the required supporting documents to the address provided on the form. A complete certification is one
where the form is fully executed and the supporting documents are provided as applicable.
7. A copy of the construction record drawings shall be maintained on file by the Permittee for the life of
the wastewater collection facilities.
8. Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 02T .0305; the
Division's Gravity Sewer Desi�n Criteria adopted February 12, 1996 as applicable; the Division's
Minimum Design Criteria for thq Fast -Track Permitting of Pump Station and Force Mains adopted June
1, 2000 as applicable; and other supporting materials may subject the Permittee to an enforcement action
by the Division, in accordance with North Carolina General Statutes § 143-215.6A through § 143-215.6C.
9. In the event that the wastewater collection facilities fail to perform satisfactorily, including the creation
of nuisance conditions, the Permittee shall take immediate corrective action, including those as may be
required by this Division, such as the construction of additional or replacement facilities.
10. The issuance of this permit shall not exempt the Permittee from complying with any and all statutes,
rules, regulations, or ordinances that may be imposed by other government agencies (local, state and
federal) which have jurisdiction, including but not limited to applicable river buffer rules in 15A NCAC
2B .0200, erosion and sedimentation control requirements in 15A NCAC Ch. 4 and under the Division's
General Permit NCGO10000, and any requirements pertaining to wetlands under 15A NCAC 2B .0200
and 15A NCAC 2H .0500.

IL Noncompliance Notification:
The Permittee shall verbally report to a water quality staff member at the Fayetteville Regional Office,
telephone number [phone], as soon as possible, but in no case more than 24 hours or on the next
working day, following the occurrence or first knowledge of the occurrence of either of the following:
a. Any process unit failure, du� to known or unknown reasons, that renders the facility incapable of
adequate wastewater transport, such as mechanical or electrical failures of pumps, line blockage or
breakage, etc.; or
b. Any failure of a pumping station or sewer line resulting in a by-pass directly to receiving waters
without treatment of all or any portion of the influent to such station or facility.
Voice mail messages or faxed information is permissible but shall not be considered as the initial verbal
report. Overflows and spills occurring outside normal business hours may also be reported to the
Division of Emergency Management at telephone number [phone] or [phone]. Persons
reporting any of the above occurrences shall file a spill report by completing Part I of Form CS-SSO (or
the most current Division approved form), within five days following first knowledge of the occurrence.
This report shall outline the actions taken or proposed to ensure that the problem does not recur. Per
Condition I (2), Part II of Form CS-SSO (or the most current Division approved form) can also be
completed to show that the SSO was beyond control.
Permit issued this the twenty- seventh day of October 2009.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
`g � I 4&4�
for Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number WQ0034402

r a31 1 l al -it G11r_111GG1111Z' %.Gl lulcallyll
Permit No. WQ0034402
October 27, 2009
Complete and submit this form to the permit issuing regional office with the following:
• One copy of the project record drawings (plan & profile views of sewer lines) of the wastewater collection system extension
• Supporting design calculations (selected pumps, system curve, operating point, available storage if portable generator(s) or
storage greater than longest past three year outage reliability option selected) for any pump stations permitted as part of this
project
• Changes to the project should be clearly identified on the record drawings or in written summary form. Permit modifications
are required for anv chances resulting in non-compliance with this hermit_ regulations or minimum design criterin
This project shall not be considered completq nor allowed to operate until this Engineer's Certification and all required supporting
documentation have been received by the DNision. Therefore, it is highly recommended that this certification be sent in a
manner that provides proof of receipt by the Division.
ENGINEER'S CERTIFICATION
❑ Partial ❑ Final
I, , as a duly registered Professional Engineer in the State of North Carolina, having been authorized to
observe (❑ periodically, ❑ weekly, ❑ full time) the construction of the Hospice & Palliative Care project in Moore County for
the Penmittee hereby state that, to the best of my abilities, due care and diligence was used in the observation of the construction
such that the construction was observed to be built within substantial compliance of this permit; 15A NCAC 02T .0305; the
Division of Water Quality's (Division) Gravity Sewer Minimum Design Criteria adopted February 12, 1996, as applicable; the
Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000, as
applicable; and other supporting materials.
North Carolina Professional Engineer's
seal, signature, and date:
SEND THIS FORM & SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS
FAYETTEVILLE REGIONAL OFFICE
225 GREEN STREET, SUITE 714
FAYETTEVILLE NC 28301
The Permittee is responsible for tracking all partial certifications up until a final certification is received. Any wastewater flow
made tributary to the wastewater collection system extension prior to completion of this Engineer's Certification shall be
considered a violation of the permit and shall subject the Permittee to appropriate enforcement actions.

Permit Number WQ0034402
Program Category
Non -discharge
Permit Type Fast Track
Gravity Sewer Extension, Pump Stations, & Pressure Sewer
Extensions
Primary Reviewer
trent.allen
Coastal SW Rule
Permitted Flow
1970
Facility Name
Hospice & Pallaitive Care
Location Address
Central Files: APS SWP
10/27/09
Permit Tracking Slip
Status
Project Type
Active
New Project
Version
Permit Classification
1.00
Individual
Permit Contact Affiliation
Major/Minor Region
Major Fayetteville
County
Moore
Facility Contact Affiliation
Owner Name
Owner Type
Moore County Public Utilities
Government - County
Owner Affiliation
Dennis L. Brobst
PO Box 1927
Carthage NC 28327
Dates/Events
Scheduled
Orig Issue App Received Draft Initiated Issuance
Public Notice IssUq Effective Expiration
10/27/09 10/12/09
10/27/09 10/27/09
Regulated Activities
Requested/RecAved Events
Wastewater collection
Additional information requested
Additional information received
Outfall NULL.
Waterbody Name Stream Index Number Current Class Subbasin