WQ0039737_Regional Office Historical File Pre 2018

Water Resources
ENVIRONMENTAL QUALITY
January 1 I, 2018
Warren Wood, City Manager
City of Hickory
76 North Center Street
Hickory, NC 28601
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Interim Director
Subject: Permit No. WQ0039737
City of Hickory
R3100A Utility Extension
Wastewater Collection System Extension Permit
Catawba County
Dear Mr. Wood:
In accordance with your application received. January 10, 2018, we are forwarding herewith Permit No.
WQ0039737 dated January 11, 2018 to the City of Hickory (Peuiiittee) for the construction and operation.
upon certification 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from the date of issuance until rescinded and shall be subject to the conditions and limitations as specified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 the following conditions contained within this permit:
Condition 11.1: This permit shall not be automatically transferable; a request must be made and approved.
Condition 11.4: Requires that the wastewater collection facilities be properly operated and maintained in
accordance with 15A NCAC 2T .0403 or any individual system -wide collection system
permit issued to the Permittee.
It shall be the responsibility of the Permittee to ensure that the as -constructed project meets the appropriate
design criteriaand rules. Failure to comply may result in penalties in accordance with North Carolina
General. Statute § 1.43-215.6A 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.
State of North CaroEnviran,t ental Quality Toter Resourees oa r t amlity Req onai E Aerations
Mooresville Regionli t?l tc 610 East Center Avenue, Strata 3G}l (Moores ille, l r lr Carol na 1111;
704 663 1699

If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to
request an adjudicator)/ 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 information concerning this matter, please contact lion Snider at [phone] or
via e-mail at ton.snider ainedenr. ov.
Sincerely,
by W . Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ
cc: Miles A. Wright, PE (E-copy)
Mooresville Regional Office Files
Water Resources Central Files
PERCS (Escopy)
Page 2 of 8

Environmental
Quality
STATE OF NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
WASTEWATER COLLECTION SYSTEM EXTENSION' PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North
Carolina as amended, and other applicable Laws, Rules, and Regulations, permission is hereby
granted to the
City of Hickory
Catawba County
for the construction and operation of approximately 4,597 linear feet of 8 inch gravity sewer as
a dry line constructed within a NCDOT project for future use and the discharge of 0 gallons per
day of collected wastewater into the City of Hickory existing sewerage systern, pursuant to the
application received. January 10, 2018, and in conformity with 15A NCAC 2T; 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 Purnp 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 a part of this
permit.
This permit shall be effective from the date of issuance until rescinded and shall be subject to
the specified conditions and limitations contained therein,
by W. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ
By authority of the Environmental Management Commission
Permit Number: WQ0039737
Permit Issued:.
January 11,
Page 3 of 8

SUPPLEMENT TO PERMIT COVER SHEET
City of Hickory is hereby authorized to:
Construct, and then operate upon certification the aforementioned wastewater collection extension.
Permitting of this project does not constitute an acceptance of any part of the project that does not meet
I 5A NCAC 2T; the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996, 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 herein. Division
approval is based on acceptance of the certification provided by a North Carolina -licensed Professional
Engineer in the application. It shall be the Permittee's responsibility to ensure that the as -constructed
project meets the appropriate design criteria and rules.
Construction and operation is contingent upon compliance with the Standard Conditions and any Special
Conditions identified below.
SPECIAL CONDITIONS
1) This dry line shall have 0 flow until an application for permit modification for an incr a
in flow has been submitted to and approved by the Division. [15A NCAC 02T.0304 (b)J.
II. STANDARD CONDITIONS
1. This permit is not transferable. In the event there is a desire for the wastewater collection 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. [15A NCAC 02T.0104; G.S 143-215.1(d3)]
2. This permit shall become voidable unless the wastewater collection facilities are constructed in
accordance with the conditions of this permit; 15A NCAC 2T; 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 materials unless specifically mentioned herein, [15A NCAC
3. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data. [15A NCAC 02T .0110]
4. 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 1.5A NCAC 2T ,0403. If an individual
permit is not required., the .following performance criteria shall be met; [15A NCAC 02T .0108(b)]:
a. The sewer system shall be effectively maintained and operated at all times to prevent discharge
to land or surface waters, and to prevent any contravention of groundwater standards or surface
water standards.
b. A map of the sewer system shall be developed and shall be actively maintained,
Page 4 of 8

c. An operation and maintenance plan including pump station inspection frequency, preventative
maintenance schedule, spare parts inventory and overflow response has been 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.
e. High -priority sewer lines shall be inspected at least once per every six months and inspections
documented.
g.
A general observation of the entire e system shall be conducted at least once per year.
Overflow's 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 §143-215.1C.
h. A Grease Control Program is in place as follows:
1 For public owned collection systems, the Grease Control Program shall include at least
biannual distribution of educational materials for both commercial and residential users and
the legal means to require grease interceptors at existing establishments. The plan shall also
include legal means for inspections of the grease interceptors, enforcement for violators and
the legal means to control grease entering the system from other public and private satellite
sewer systems.
2. For privately owned collection systems, the Grease Control Program shall include at least bi-
annual distribution of grease education materials to users of the collection system by the
permittee or its representative.
3. Grease education materials shall be distributed more often than required in Parts (1) and (2)
of this Subparagraph if necessary to prevent grease -related sanitary sewer overflows.
i. Right-of-ways and easements shall be maintained in the full easement width for personnel and
equipment accessibility.
j. Documentation shall be kept for Subparagraphs (a) through (i) of this Rule for a minimum of
three years with exception of the map, which shall be maintained for the life of the system.
5. The Permit -tee shall report by telephone to a water resources staff member at the Mooresville Regional
Office, telephone number [phone], as soon as possible, but in no case more than 24 hours
following the occurrence or first knowledge of the occurrence of either of the following:
a. Any process unit failure, due 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 SSO and/or spill over 1,000 gallons; or
c. Any SSO and/or spill, regardless of volurne„ that reaches surface water
Voice mail messages or faxed information is permissible, but this 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 and submitting
Part 1 of Form CS-SSO (or the most current Division approved form) within five days following first
Page 5 of 8

knowledge of the occurrence. This report must outline the actions taken or proposed to be taken to
ensure that the problem does not recur. 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. [G.S. 143-
215.1C(a1)]
6. 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, [ISA NCAC 02T,0108(b)]
7. 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 fortn. A complete certification is one where the form is
fully executed and the supporting documents are provided as applicable. 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,
If the permit is issued to a private entity with an Operational Agreement, then a copy of the
Articles of Incorporation, Declarations/Covenants/Restrictions, and Bylaws that have been
appropriately filed with the applicable County's Register of Deeds office shall be submitted
with the certification.
A complete certification is one where the form is fully executed and the supporting documents are
provided as applicable. Supporting documentation shall include the following:
a. One copy of the project construction record drawings (plan & profile views of sewer lines &
force mains) of the wastewater collection system extension. Final record drawings should be
clear on the plans or on digital media (CD or DVD disk) and are defined as the design drawings
that are marked up or annotated with after construction information and show required buffers,
separation distances, material changes, etc.
b One copy of the supporting applicable design calculations including pipe and pump sizing,
velocity, pump cycle times, and level control settings, pump station buoyancy, wet well storage,
surge protection, detention time in the wet well, and force main, ability to flush low points in
force mains with a pump cycle, and downstream sewer capacity analysis, If a portable power
source or pump is dedicated to multiple stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, include travel
timeframes, shall be provided.
c. Changes to the project that do not result in non-compliance with this peonit, regulations,. or the
Minimum Design Criteria should be clearly .identified on the record drawings, on the certification
in the space provided, or in written summary form.
Prior to Certification (Final or Partial): 'Permit modifications are required for any changes resulting
in non-compliance with this permit (including pipe length increases of 10°A or greater, increased
flow, pump station design capacity design increases of 5% or greater, and increases in the
number/type of connections), regulations, or the Minimum Design Criteria, Requested modifications
or variances to the Minimu.m, Design Criteria will be reviewed on a case -by -case basis and each on
its own merit..Please note that variances to the Minimum Design Criteria should be requested and
approved during the permitting process prior to construction. After -construction requests are
discouraged by the Division and may not be approved, thus requiring replacement or repair prior to
certification & activation. [15A NCAC 02T .0116]
Page 6 of 8

1➢. Gravity sewers installed greater than ten percent below the minimum required slope per the Division's
Gravity Sewer Minimum Design Criteria shall not be acceptable and shall not be certified until
corrected. If there is an unforeseen obstacle in the field where all viable solutions have been
examined, a slope variance can be requested from the Division with firm supporting documentation.
This shall be done through a permit modification with fee. Such variance requests will be evaluated
on a case -by -case basis. Resolution of such request shall be evident prior to completing and
submitting the construction certification. [ 15A NCAC 02T.0105(n)]
9. A copy of the construction record drawings shall be maintained on file by the Permittee for the life
of the wastewater collection facilities. [15A NCAC 02T .01161
10. Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 2T; the
Division's Gravity Sewer Design Criteria adopted February 12, 1996, as applicable; the Division's
Minimum Design Criteria for the 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 § 143-21.5.6A
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. [15A
NCAC 02T .0104; 15A NCAC 02T .0108(b-c)]
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.
[15A NCAC 02T .0110; 15A NCAC 02T .0108(b)]
12. 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 the Division any other Federal, State, or
Local government agencies which have jurisdiction or obtaining other permits which maybe required
by the Division or any other Federal, State, of Local government agencies. [G.S. 143-215.1(b)]
Page 7 of 8

FAST TRACK SEER ENGINEERING CERTIFICATION
PERMITTEE: CITY OF HICKORY
PERMIT #: WQ0039737
PROJECT: R3 I a©A. UTILITY EXTENSION
ISSUE DATE: JANUARY 11, 2018
This project shall not be considered complete nor allowed to operate in accordance with standard
Condition 7 of this permit until the Division has received this Certification and all required supporting
documentation. It should be submitted in a manner that documents the Division's receipt. Send the
required documentation to the Regional Supervisor, Water Quality Regional Operations Section at the
address noted in the page Tooter.
Any wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Certification shall be considered a violation of the permit and shall subject the Permittee to
appropriate enforcement actions. The Permittee is responsible for tracking all partial certifications up
until a final certification is received by the Division. A Final Certification shall be a complete set of
record drawings and design calculations regardless of whether partials have been submitted.
PERMITTEE'S CERTIFICATION
I, the undersigned agent for the Permittee, hereby state that this project has been constructed pursuant to
the applicable standards & requirements, the Professional. Engineer below has provided applicable
design/construction information to the Permittee, and the Permittee is prepared to operate & maintain the
wastewater collection system permitted herein or portions thereof.
Printed Name, Title
Signature Date
ENGINEER'S CERTIFICATION
as a duly registered Professional En ineer in the State of North Carolina,
having been authorized to observe ( periodically, P weekly, [J full time) the construction of the
project name and location as referenced above for the above Permittee 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; the Division of
Water Resources' (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 w/signature & date:
Final [1 Partial (include description
Certification Comments/Qualifiers (attach if necessary):
NCDWR
hdnnrr�c�ril4,
uality Regional Operations Section 610 East Center Avenue, Suite 301, Mooresville, NC 28115
i nffer© Phr,rP' irnna F,A3_1ACP FAN.- 17nan_r��-;ntfn

Division of Water Resources
State of North Carolina
Department of Environme.nttml Quality
Division of Water Resources
IS 1. NCAC" 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number;
A
d
ned
APPLICANT INFORMATION:
1. Applicant's name: City of Hickory (company, murticipalit HOA, utility, etc.)
2 Applicant type: ❑ Individival1 ❑ C:orporatia n. ❑ Ciew rat Partnership ❑ Privately ( i eti Publl
© Federal
- g name.: Warren
�_�, s rren Wood per
�. t nature auth�'artt�.',
Title: City hla.naner
4. Applicant's mailing address
City:Hickory° State: NC
Z"op: 2860
❑ State/Con raty Municipal
(h)
Applicant's contact into. ntatlottt
Phone number: (828) a2a3-7412 Email Address: woodhdhickorvnc aov
PROJECT IFOR\I'UION:
1. Project name: R3100A wUtility:Extension
2, Application/Project status: Z Proposed (Nei Pertu t) ❑ Exiting Permit•'`Project
If a modification., provide the existing permit number: V »t10 and issued date:
If new construction but part of a master plan, provide the existing permit number: W Q00
3, County where project is located: Catawba
4, Approximate Coordinates (Decimal Degrees;: I attitude: 35,606 Longitude:-81.1.13Ci "
5. Parcel. lD (if applicable):
(or Parcel It) to closest downstream sewer)
III. CONSULTANT INFORMATION::
I. Professional 1- nnineer:'vliles A. Wright,,PE
Firm. Wright & Associates
Mailing address: 209 1' Ave South
City: Conover State: NC
Phone, number: [phone]
Zip: 286 I J-
ilta°ratl Address: mi
License 'kutrilet•. 24934
riQhtandassOi a
IV. WASTEWATER TREATMENT FACILE"T"F (WWTF) INFORMATION:
I. Facility Name: Permit Number:
Owner Name: cite' of Hickory
RECEIVING DOWNSTREAM SEWER INFORMATION Ct:tdifferent than VWTF):
,Permit Nun;'laer(s): AtiaQa.
y' tar: st=i.l
Owner Namei`s).
Dowraastrearn (Re
NA inch
FORM: ETA, 04-. 6 Prge 1 of

GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Ow
lithe Applicattt is a Develop;
tithe .Mpphc;an is a l [,,ina'Prer
Onin of wastewater: (check all t
© Residential Owned
❑ Residential Leased
❑ School t` preschool f" da
❑ Food and drink fac.
❑ Businesses offices I fact(
Nature of w;astewat.er
:d Public Utility, has a Certificate of Public C
'yes ON/A
Ly
apply}:
0 Retai..l (stores, centers, malls)
❑ Retail with food preparation/service
Q Medical/denial ' veterinary facilities
Q Church
Nursing Home,
°fo Dome.-ticr'C.ornmercial
o Industrial {4 I 5 A NC "sd;' d£
ce
ry been attached?
been attached`.'
attached''
❑ Car Wash
Hotel and'or Motels
❑ Swimming. Pool =°`Clubhouse
Swimming Pool/Filter Backwash
® Other (Expi ain in Attachment)
�Fu Commercial
aPretreatment Program in effect?
Has a flow reduction be•rn approved under 15:i N 'tC } 1 J(t)? ❑ yes
If yes, provide.a cony of flow reduction approval IeRer
Sumrnari
ater generated by project:
tablishment Type (see O T,tl1IA
See
dwelling; proposed ar
;and residential property
ing:S_...4 :A�q,)
den tial deve
d south or east of the
b Per I5A NCAC 02'T ,0[144.
desiito Ilow rat
determined using available flow datta, water as
Wastewater generated b•y project: Q GPI (per l
Do not include future flows; or previously per
If permitted flow is zero, ina
Q Pump Station or (.gravity
why:
❑ now has already been allocated in Permit mber'
Rehabilitation or replacement of
❑ Other (Explain): Dry •
lsti[
No
'No. of Units Flow
design
GPD
GPF)
(aPL)
GPE)
minimum Ilowper
s; public access f acilities located near high public use areas;
coastal Waterway to be used as vacation rentals as defined
ishments not identified [in table I 5A NC,Ac 0
occupancy or operation patterns, and other measured
wt)
ermined in subsequent permits tha.
xpected
Conn
FORM: FTA 0t-1 b

VIE GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC Gravity Sewers):
1, Summarize gravity sewer to he permitted:
Size (inches)
Length (feet) rietaterial
Section If & of the MDC for Permitting of Gra.vity Sewers contains information related to design, criteria
Section 111 contains information related to minimum slopes for gravity sewerts)
Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
PUMP STATION DESIGN CRITERIA (If Applicable) —02,T ,0305 & MDC (PUT „ Stations]Foc
COMPLETE FOR EACH PIMP STATION LNCLUDED IN THIS PROJECT
1, Pump station number or name
Approximate Coordinates (Decimal Degrees): Latitude: Longitude: -
3, Desig.nflovv of the pump station: millions gallons per day (tirm capacit))
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 Purnp Station
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15],1 NC A C 02T ,030.50-0,1 ):
ID Standby power source or 'pump with automatic activation and telemetry - 15.A .NCAC 02T „0305(h)(1)(13,);
Required for all pump stations with an average daily flow greater than or equal to 1.5000 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:
EJ Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)( 1)(C)
or
[1] Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 021 03o500( 1xc):
It shall be demonstrated to the Division that the portable source is owned or contractedby the applicant (draft agreement)
and is compatible with the station,
f 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 thriefratries, shall be provided
in the case of a multiple station, power outage,
FORM: FTA 04-16 Page 3 of 5

SETBACKS & SEPARATIONS — (02B ,0200 & 15A NCAC 02T .0305(0):
1, Does the proje,ct comply with all separations found in I 5,\ r44505i t) gIgfg
IA NCAC 0217.0305(f) contains minimum separations that shall be provided for sewer systems:
Storm sewers and other 'utilities not listed. below (vertical, 2/1 inches
Water m.ains (vertical -water over sewer including in benched trenches)
Water mains (horizontal)
Reclaimed water lines (vertical reclaimed,/
Reclaimed water lines (horizontal - reclaimed over sewer)
**Any private or pu.blic, water supply source, including any wells, WS-I waters of Class I or
Class II impounded reservoir's used as a source of drinking water
**Waters classified WS (except VS-1 or VS-V), B„ SA, ORW, HQW, or SB from normal
high water or tide elevation), and wetlands (sce item IX,2)
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches.
Ans building toundatt
I An v basement
Z Yes
Setback Parameter* Separation Respire(
Top slope of embankment or cuts of 2 feet ur more vrtieaLhei.ght
1 Drainage systems and interceptor drains
Any swimming Pools
Final earth grade (vertical)
8nches
10 feet
inches
2 feet
50 feet
10 feet
5 feet
10 feet
":eel
5 feet „..,
10 feet
.36 inches
5,A NCIAC 02 II„0,305i g) contains alternatives where separations in 02T,030,5afl cannot be achieved.
**Stream classifications can be identified u,sing the Division's NC_Surface Water C assi rex/ions el. -graze
• Ifnoncompliance with 02/1/.0c,05(1) orcg), see Section X of this application
2. Does the project comply with separation requirements for %verlands'.? (50 feet of separation) fl 't es
▪ See the Division's draft separation .requirements for situations 'where separation cannot he 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
No ID NIA
3- Does the project comply with setbacks found in, the river basin rules per 15,.\ NC.A.0 02.B 1)2.00? Z Ye' 0 No El NIA
I'l/his would include Trout Buffered Streams per $A NCAC 2B4O20;
4 Does the project require coverage authorization under a 404 Nationwide or
individual -permits or 401 Water Quality Certifications?
• Information can be obtained from the ,401 Buffer Permitting ,Branch
Lllves El No
5, Does project comply with l5A 02'F,0105.(c.t(6) (addition.ai permits/certifications)? El Yes LI No
Per 1,..5A NCAC 0.1 (,),5' e'10 directlyrelated environmental permits or cenification 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, stonnwater management plans, etc,),
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NC,AC, 021.0,..102. "high -priority, sewer" means "any aerial sewer, sewer contacting surface wiiterS, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer,
El Yes flNo NIA
• if yes, include an attachment with details for each iine, including type (aerial. line, size, material, and loatiun)
High priority lines shall be inspected by the permit -tee 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: FITA 04-16 Page ,4 of 5

X. CERTIFICATIONS:
1, Does the submitted system comply with ).5.A : 02T. the M nmtuv
and Force M:tins ethee;,st vi2rsitsth and the Graeqs, Sewer MitheitIrn L.
Z Yes0 No
UN°, complete and submit the VariancetAlternative Design Request application (VADC 10-14) and suppo
review. Approval of the r ottestis required prior to submittal of the Fasi
2. Professional Engineer's Certification:
1, (les k, attest that this application for
(Professional EngitQer's name from Application Item 111. I.)
riteria for the Permitnzeptii ttirthe Sthtipres
est version:, as applicable'?
a documents for
rack AprOcation and supportinu documents.
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 tny 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. Pomp 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 1 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::i",iti,.:
North Carolina Professional Engineer's seal, signature, and date: „.
: ,... .
- :4-
SEAL —
24934
3, Applicant's Certification per 15A NCAC 02T ,0 06(b):
1, '0,171:11
(Signature Authoritys rlame & tide fm Application Item 1.3.)
A
11‘
attest that this applicationfor
has been reviewed by me and is accurate and complete to the best of my knowledge. 1 understand that d'art1 required parts of
this applicationare not completed and that if all required supportingdocumentation and attachments are not included, this
application package is subject to being returned as (ncomplete. 1 understand that any discharge of ,vastewatet 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, andlor criminal prosecution, 1 will make no claim against the Division of Water Resources should a condition
of this permit be violated. 1 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 143H2l5.6ft any person who knowingly makes any fa se
statement, representation, or certification in any application package shall be glair,' 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,
Date.
FORM: FTA 04- 16
Page 5 of 5

USGS
science for a changing world
U.S. DEPARTMENT OF THE INTERIOR
U.S. GEOLOGICAL SURVEY
PROP.
Olivers SEWERLINE
Crossroads

PROP.
SEWERL9NE
R3100 utility
Wife a des rjrAt err fray your map.

WRIGHT:
209 l' Ave. South ' Conover, NC 2861; • [phone]
January 9, 2018
NCDEQ
Water Quality Section
610 East Center Ave
Mooresville, NC 28115
Re: R3100A Utility Extensions
Please find the attached:.
1) One (1) Original Fast Track Sewer System Extension Application
2) One (1) Copy Fast Track Sewer System Extension Application
3) One Application Fee ($480)
4) One (1) Original Site Map
5) One (1) Copy of Site Map
6) One (1) Original Street Level Map
7) One (1) Copy Street Level Map
If you have any questions or need further information, please contact me.
Thank you,
Miles A. Wright, PE
CIVIL ENGINEERS SURVEYORS

Luckman, Debbie
From: Miles A, Wright, PE, PLS <miles@wrightandassociates,us>
Sent: Wednesday, January 10, 2018 3:07 PM
To: Luckrnan,, Debbie
Cc: Tuvia, Ori A
Subject: [External] RE: Fast Track application for City of Hickory
CAUTION: External ernaiL Do not click links or open attachments unless verified.0.Send all suspicious email as an attachment to
[e-mail]..
Deborah, l had talked with Ori about this earlier, the project has 0 flow and is not connecting to
Any existing lines. It is a dry line that the County is installing within a NCDOT project for future
Use, We were told that in this case we did not need a Flow Tracking Sheet since we are not connecting
To an existing sewer.
Just let me know if we need to do anything else.
Thanks
Miles A. Wright, PE, L
[phone]
(828) 850-21.60
Ave South
Conover, NC 28613
WRIGHT
ASSOCIATES
S
From: Luckman, Debbie[mailto.debbie,[e-mail]]
Sent: Wednesday, January 10, 2018 2.50 PM
To: [e-mail]
Subject: Fast Track application for City of Hickory
Miles,
I received the application for City of Hickory/R310OA Utility Extension today.
However, I am not able to enter it into the system because it does not have a Flow Tracking sheet,
I will hold this if you can get it to me within the next few days. It can be emailed to me.
Please call if you have any questions.
Thank you

ber W 0039737
Pro ram at oryi
Nonctscharg
Permit Type
Gravity Sewer Exxtensiod, Pump taliens, & Pressure ewer Extensions
Prim ry Reviews
lon.snider
Cstet Wule
Perrot
0
Fad fly
d Flow
Central Files. APS
Permit Tracking Slip
N.otave
Version
1.©0
Perm
oratact A
Project Type
New Praiact
Permit Classifica
Individual
Facility Name
R 100A Ulility Extension
Location Address
Owner
Regloar
Mociresville
County
Catawba
Facll"ety Contact AIllatlon
City of Hickory
0rig issue
111 t3i8
Scheduled
App Recetrred Draft In[tiateri issuance'
10012018
Regulated Activiti
Wastewater collection
tt%a
Government 4 Municipal
PO Box 388
Hickory
1t018 1d 2018
Requested !Received Events
NC 28601
Expiration
9
Additional information requested
Additional information received
Waterlooc
Name
Sire Index Num
Current C
Subbasin