WQ0039343_Regional Office Historical File Pre 2018

Water Resources
Environmental Quality
July 28, 2017
Scott Neisler, Mayor
City of Kings Mountain
P.O, Box 429
Kings Mountain, NC 28086
ROY COOPER
Governor
MICHAEL S. REGAN
.Secretary
S, JAY ZIMMERMAN
Director
Subject: Permit No. WQ0039343
City of Kings Mountain
Long Branch Force Main Replacement
Wastewater Collection System Extension Permi
Cleveland County
Dear Mr. Neisler:
In accordance with your application received July 17, 2017, we are forwarding herewith Permit No.
WQ0039343 dated July 28, 2017, to City of Kings Mountain (Permittee) 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from the date of issuance until rescinded and shall be subject to the conditions and limitations as specified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 Ila4:
Requires that the wastewater collection facilities be properly operated and maintained
in accordance with 154 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 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.
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 150E 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.
-7—"—Nothi g 'Co mparews -.
State of North Carolina j Environmental Quality l Water Resources Water Quality Regionai Operations
Carolina, 28115
Mooresville Regional Office i 61© East Center Avenue, Suite 301 M©oresvif
704-663-1699

If you need additional information concerning this matter, please contact Barry love at 70) 235-21.43
or via effimail at barry.love@ncdenr. ov
Sincerely,
by W: Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional Office
Division of Water Resources, NCDEQ
cc: Joel E. Wood, P.E. (e-copy)
Regional Office Files
Water Resources Central Files
PERCS (e-copy)

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
City of Kings Mountain
Cleveland County
for the construction and operation of approximately 15,000 linear feet of 12-inch force main (replacement
of existing Vine), as part of the Long Branch Force Main Replacement project, and the discharge of no new
flow of collected wastewater into the City of Kings Mountain existing sewerage system, pursuant to the
application received July 17, 2017, 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 Pump Stations and Force Mains adopted June 1, 2000, as
applicable; and other supporting data subsequently filed and approved by the Department of
Environmental Quality 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
condiicar irrtitations contained therein.
tby W. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional Office
Division of Water Resources, NCDEQ
Permit. Number: WQ0039343
Permit Issued: July 28, 2017

SUPPLEMENT ���������������� �U����
~v��n v o.m~v�"u~"� ^ o �� PERMIT n .°���x~n� SHEET
v
City of Kings Mountain is hereby authorized to:
Construct, and then operate upon certification the aforementioned wastewater collection extension, The
sewage and wastewater collected bvthis system shall be treated inthe City ofKings Mountain Pilot Creek
Wastewater Treatment Plant inaccordance with Permit NmmberN[QO2O737.
Permitting of this project does not constitute an acceptance of any part of the project that does not meet
25A N[A[ lT; 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 axapplicable, 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
l. No new flow shall be made tributary to the subject sewer system until an application for permit
modification for a:n increase in flow has been submitted to and approved by the Division. [15A NCAC
2. The abandonment of any existing wastewater facilities including septic systems being replaced by new
newer infrastructure shall be done in accordance with the applicable agency having compliance
oversight on such facilities. [15A NCAC 02T,0105(c)(6)]
11. STANDARD CONDITIONS
1. This permit isnot transferable. Cmthe event there isadesire for the wastewater collection facilities
tochange ownership, orthere is a name change of the Permittee,aformal permit request shall be
submitted to the Division accompanied by documentation from the parties involved, and other
supporting materials asmay beappropriate. The approval ofthis request shall beconsidered units
merits and may o[may not beapproved, [1SANCA[O2T.UlO4;G.5l4J'2lS.l(d])]
2. This permit shall become voidable unless the wastewater collection facilities are constructed in
accordance with the conditions of this permit; 15A NCA[ 2l; the Division's Gravity Sewer Minimum
Design Criteria adopted February 12,1996iaoapplicable; the Division's Minimum Design Crit*hafor
theFa»t'Tn*ckPemnhtingofPumpStationsnndForreMainoadnpted]upe1^2U0O asapplicable; and
other supporting materials unless specifically mentioned herein. [15A NCAC 02T.01101
]. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data. [15AN[A[02T.0110]
4

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 15A N[4[ 2T .040I If an individual
permit is not required, the following performance criteria shall be met. [15A NCAC 02T M08(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.
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 tea telemetry system shall beinspected everyday (i.e.365
days per year). Pump stations that are connected to atc|emetry 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 inspectionsare
documented.
f. A genera� observation of the entire sewer system shall be conducted at least once per ye
g. Overflows and bypasses shall be reported to the appropriate Division regional office in accordance
with 15ANCA[2B .0586(o),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�
L For public owned collection systems, the Grease Control Program shall include at least
biannual distribution of educational materials for both cornmercia| 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.
l For privately owned collection systems, the Grease Control Program shall include atleast bi-
annual distribution of grease education materials to users of the collection system by the
perm|ttceorits representative.
1 Grease education materials shall be distributed more often than required in Ports (I) and (2)
of this Subparagraph if necessary to prevent grease -related sanitary sewer overflows.
Right-of-ways and easements shall be maintained inthe full easement width for personnel and
equipment accessibility.
i 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 Permhtee 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,
following the occurrence or first knowledge of the occurrence of either of the following:
a. Any process unit failure, due toknown orunknown reasons, that renders the facility incapable
of adequate wastewater transport, such as mechanical or electrical failures of pumps, line
blockage orbreakage, eto.;or
b. Any SSQand/or spill over 1,0O0gallons; or
c. Any SSO and/or spill, regardless of volume, 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 attelephone number (800) 858'8368 or (9I9) 733'3300.
Persons reporting any Vfthe above occurrences shall file aspill report bycompleting and submitting
Part | of Form CS-SSO (or the most current Division approved form) within five days following first
knowledge ofthe occurrence. This report must outline the actions taken orproposed tobetaken tV
ensure that the problem does not recur. Part ||ofForm CS-SSO(orthemost current Division approved
form) can also be completed to show that the SSOwas beyond control. [G.S. 143-215.1C(p1)]
6. Construction of the gravity sewers, pump stations, and force mains shall be scheduled »o as not to
interrupt service by the existing utilities nor result in an overflow or bypass discharge of wastewater
tethe surface waters ofthe State. [15ANCA[02T.0108(b)l
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 tothe address provided unthe form, Acomplete certification isone where the form is
fully executed and the supporting documents are provided asapplicable. 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 xh^U subject the PennhJec to
appropriate enforcement actions,
ifthe permit isissued toaprivate entity with an Operational Agreement, then acopy ofthe Articles
of incorporation, Dedaratio ns/Covenants/Restrictions, and Bylaws that have been appropriately
filed with the applicable County's Register of Deeds office shall be submitted with the certification.
Acomplete certification isone where the form isfully executed and the supporting documents are
provided nsapplicable. 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 dear 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,
ve|ncity, 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 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
timefrannes,shall beprovided.
c. Changes tothe project thatdonutre»u|tinnon-comp|iancewiththlspennit,regu|ation\nrthe
Minimum Design Criteria should beclearly identified onthe record drawings, onthe certification
inthe space provided, orinwritten summary form.
Prior toCertification (Final urpart|a|)- Permit modifications are required for any changes resulting in
non-compliance with this permit (including pipe length increases wfI0%orgreater, 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 Minimum Design Criteria will be reviewed omaoase-bv'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 toconstruction. After -construction requests are discouraged by the
Division and may not be approved, thus requiring replacement or repair prior to certification &
activation. [I54NCA[UZT.Ol16l
8. Gravity sewers installed greaterthanten 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. [25ANCACOZT.01U5/n>]
g. A copy of the construction record drawings shall be maintained on file by the Permittee for the life of
the wastewater collection facilities. [15A NCA[8IT .01161
18 Failure to abide by the conditions and limitations contained in this permit; iSA NCAC 2T; the Division's
Gravity Sewer Design Criteria adopted February 12' 1996, as applicable; the Division's Minimum
DesignChteriafortheFoat-TrackPermbt|ngofPunmpStationandForcoK8ainxadnpted]uncI,2O0O
as applicable; and other supporting materials may subject the Permittee to an enforcement action by
the Division, in accordance with North Carolina General StotutcsgI43'2lS.64 through §143`I15.6C,
construction of additional or replacement wastewater collection facilities, and/or referral of the North
Carolina dice nsed Professional Engineer to the licensing board. [15A 0[A[ 021' .0I041 15A N[A[ 02T
11. In the event that the wastewater collection facilities fail to perform satisfactorily, including the
creation of nuisance conditions, the Pernnhtee shall take immediate corrective action, including those
as may be required by this Division, such as the construction of additional or replacement facilities.
[15AN[A[02T.0118;16AN[A[027-0108(b)]
12, The issuance of this permit shall not exempt the Permittee from complying with any and all statute�
rules, regu)a1�ons, orordinances that may be imposed by the Division any other Federal, State, or
Local government agencies which have jurisdiction orobtaining other permits which may be

required by
215.1(b)1
h
an oar any other Federal, State, oo Local governgovernment agencies. [G... 1 -

FAST TRACK SE
PERMITTEE:
PERMIT #:
PROJECT:
ISSUE DATE:
ER ENGINEERING CERTIFICATION
City of Kings Mountain
WQ0039343
Long Branch Force Main Replacement
July 28, 2017
This project shall not be considered complete nor allowed to operate in accordance with 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
the Regional Supervisor, Water Quality Regional Operations Section at the address at the bottom,
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. 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
ENGINEERS CERTIFICATION
i, , as a duly registered Professional En ineer in the State of North Carolina,
having been authorized to observe (LI periodically, —1 weekly, 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 P] Partial (include description)
Certification Comments/Qualifiers (attach if necessary):
State of North Carolina ° Envmonrnental Quality 'water Resources dater amity R.
peranen

LONG BRANCEI FORCE MAINREPLACEMENT
PROJECT DESCRIPTION
City of Kings Mountain is proposing to cost ct ap rc xiinatcly l ,000 LJ F.
cif l '" se er force main, alc c with the appropriate °aloes, fittings Ind appurtenances,
The propose . force main will replace an existin l " force main that is nearing the end
fits useful life cycle and is he ornint a liability t s the Town hccause;c t the eonst €r
eed nt'maintenan..ee, The proposed fiats main a 11 transport was r ter from the
xistit . Long Branch Lilt Station to the Town's existing gravity sewer system. The
proposed for
aiin s ill run north east from the exi
atcd on Range Road to existing grasp
nes a
Long Branch lift taticn
iiitsiry. 74. The three Ma
replacement will not add any additional customeoas to the existing system.
The sewer line will he constructed inside the NCDOT right of way or in a puhlie
utilityfi ease ent belonging to the City of Km s Mountain. After the construction -tion of the
proposed serer
naintain the -nee
Wastewater Facility ( V TE # NC 0020737).
is complete the City of Kings Mountain w`
way, operate, an
sprain. The wastewater all he treated at the pilot Creek

T R OF TRANSMITTAL
liaJoel E. Wood & A
Plannat)g * Engineering
TO: NCGtENR
Mo
Regional
ter Quality Sec,
Center Ave,
Mooresville, NC:' 28115
StIOP DRAWINGS
StJRML"LTAI.S
PR INi`5_ _..�._
UNITED ST A"I"I" MAIL
OVERNIGHT
RCIVAI_.
I'OR YOUR USE.
2
SftiN
0 USE
NO.
sociates, L.L.C..
DATE: 6/29/2017
NTE Energy Sewer Extension Div. 11
k `user Permit
SPEC A: ONS
OTHER
SOLI REM T"S
COST ESTIMATE
E
CALCULATIONS
'RNIGI{ NEXTAITER.NOOt'
2"i6 DAY DELIVERY
PRh1 IMINARY
,OR CONSTRUCI-ION
AS REQUESTED
Applic
S48(10 I lee
USGS Topo Pr nj cl Map
Street Level Project Map
SE DETAIL
LAND
COURIER. SERVICE
REVIEW & COMMENT
BID DOCUMENTS
PERMIT
CR
DISTRIRUTI
APPROVED AS SLTI3T`,
APPROVED AS NOT°I I)
REVISE & RESUBMIT
P.O. Box 296 • Clover, SC 29'710 2160 Filbert Highway • York, SC 29745
Phone [phone] • Fax [phone]

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
11'A 04-16 & SUPPORTING DOCUMENTATION
Applic
to e completed by I)\VR)
All items must bc completed or the application will be returned
APPLICANT INFORMATION:
Applicant's name: Cjtvof Kings Mountain (company, municipality, 1IOA, utility, etc.)
Applicant type;
[1] individual El Corporation
Ell Federal CI State/County
El] General Partnership
Municipal
3. Signature, authority's name: Scott Neisler per 15A NC.AC 021 ..0106(11)
Title: Mayor
4. .Applicant's Inailing address: P.O. Box 429
City; Kings Mountain State: NC Zip: 28086-
5. Applicant's contact information:
Phone number: [phone] Email Address: [e-mail]
11. PROJECT :INFORMATION:
1_Project name: Long Branch Force Mani Replacement
El Privately -Owned. Public Utility
LJ Other
MOORESVILLE REGII.I"'NAI, OFFICE
RECIAVELVNADelikiRICE YR
WORDS
2, Application/Project status: Proposed (New Pernnt) LJ Existing Permit/Project000REsoLLE REGIONAL OFFICE
fa modification, provide the existing permit number: WQ00 and issued date:
Ifnew constructionbut part o.f a master plan, provide the existing permit number: WQ00
3. County where project is located: Cleveland
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.2386Longitude: -81.4508'
5, Parcel ID (if applicable): 616.13,
(or Parcel ID to closest downstream sewer)
111. CONSULTANT INFORMATION:
I. Professional Engineer: Joel E. Wood License Nu . 7571.
Firm: foci E. Wt-xid & Associates, PLLC
Mailing address: P.O. Box 296
City: Clover State: SC, Zip: 29710-
Phone number: [phone] Em.ail Address: kelwood@comppriuninet
1V. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1, Facility Name: Pilot Creek Wastewater Facility Permit Number: NC,` 0020737
Owner Name: City:of-Kings Mountain
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Num ber(s): WQ NC 0020737 Downstream (Receiving) Sewer Size: 19 inch
Stein Wide Collection System Permit Number(s) ( if applicable): WQCS
Owner Name(s): City of Kings Mountain
FORM: ETA 04-.16
Page 1 of 5

GENERAL REQUIREMENTS
E. Jf the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
El Yes ElNo N/A.
If the Applicant is a Developer of lots to be .sold, has a Developer's Operational Agreement (FORM: DEAa been attached?
0 Yes 0 No EINIA
3, If the Applicant is a IR 'petty Owners' ss—iation, has an Operational .Agreement (FORM: 110A) been attached?
0 Yes El -No EIN/A
4, Origin of wastewater: (check all that apply):
Residential Owned
El Residential Leased
fl School / preschool day care
0 Food and drink facilities
ji Businesses offices facto es
Nature of wastewater
Retail (stores, centers, malls)
El Retail with food preparation/service
El Medical dental / veterinary facilities
Church
LJ Nursing Home
Car Wash
LJ Hotel and/or Motels
0 Swimming Pool ,IClubhouse
Lil Swimming Pool/Filter Backwash
0 Other (Explain. in Attachment)
% Domestic/Commercial "/0 Commercial
'! industrial (See 15A NCAC o21 03_(20))
s there a Pretreatment Program in effect? El Yes [1] No
Has a flow reduction been approved under 15A NCAC 02/17 ,0114(f)'? 0 Yes g No
Itlyes, provide a copy of now reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114().)
IJO Aet—t flu
a
Daily Design Flow' "
gal,
eah
gali
gal/
gall
gal
No. of Units Flow
GPD
GPD
GPD
GPD
GPD
CiPD
Total GPD
See 15A NCAC 021.01 14(b), (4),,_.(0( [land (ej(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 ea.stof the Atlantic ,Intracoastal Waterway to he used as vacation rentals as defined
in G..S.
b Per 1.5.A -NCAC 0.2T .0114(c), design flow rates tiir establishments not identified [in table 1,5A. NCAC 02 T,0114] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8, Wastewater generated by project: 0 GPD (per 1,5A NCAC 021 .0114)
Do not include future flows or previously permitted allocations
If permitted .flow is zero, indicate why:
[1] 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:
El Rehabilitation or replacement of existing sewer with no new tIoNV expected
El Other (E\phnu).
FORM: FTA. 04-1.6
Page 2 of 5

Vil. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity° Sewers):
Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
NA
RECEIVEDNCDENRIDVP4R
A_ 2 8 RV
WOROS
MOORE RV REGIONAL OFFIC
Section 1.1 & 111 of the MDC tbr Permitting of Gravity Sewers contains information related to design criteria
Section 11 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
VIM PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Main :
COMPLETE FOR EACH PUMP STIVIION INCLUDED IN THIS PROJECT
Pump station number or name: 1",;,.-
1A
2. Approximate Coordinates (Deci.inal Degrees). Latitude: Longitude: -
3 Design flow of the pump station: millions gallons per day (firm capacity) - 1 il % s . Ck
4 Operational point(si of the pump(s), izallons per minute at feet total dynamic head (TD11) (--- - -,4 -,-'' .
5, Summarize the force main to be permitted (for this Pump Station
Size (inches) Length (feet) Material
12 15,000 PVC — -./- •-$ ..,.), ,,,,,,,,,..,i
Power reliability in accordance with 15(1, NC,AC 021 .0.1305ih OJJ
c c,iv‘
w
w; r
471, t1,4
0 Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(1)( )(By.
Required for all pump stations with an average daily flow greater than or equal to 1.5,000 gallons per day
Must be permanent to fa.cility
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 NCA(' 02T
0305(h)(1)(C7)
or
E Portable pumping unit with plugged emergency pump connection and telemetry - I5A NC AC 02T .0305(100 )(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.
lithe portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stationsstorage
capacities and the rotation schedule of the portable power source or pump, including travel timetrames, shall be provided
in the case of a multiple station power outage.
FORM: ETA 0'4-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NC:AC 02T .0305(4):
I. ,Does the project comply with all separations tbund in 15A NCAC 021 ,0305(j) & (z)
15A NCAC 02T.0305(1) contains minimum separations that shall be provided tbr ewer 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) 10 feet
Reclaimed waterlines (vertical - reclaimed over sewer)
Reclaimed water lines (horizontal - reclaimed over sewer)
'*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
**Waters classified WS (except WS-I or \APS-Nil, B, SA, ORW, HOW, or SB from normal
high water (or tide elevation) and wetlands (see item IX2)
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
Any building ibundation
Any basement
Fop slope of embankment or cuts of 2 feet or more vertical height
Drainage systems and interceptor drains
Any swimming pools
Final earth grade (vertical)
Yes El No
2 feet.
100 .feet
50 feet
10 feet
5 feet
10 feet
10 feet
5 feet
10 feet
36 inches
15A NCAC 02:F.0305(g) contains alternatives where separations in 02T.0305(t) cannot be achieved.
**Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
If:noncompliance with 021,9305(1) (g), see Section X of this application
2, Does the project comply with separation requirements for wetlands? (50 feet of separation) E Yes El No El 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
e As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per OA NCAC 0213 0200? Yes El No Eli NA
This would include Trout Buffered Streams per 15A NCAC 2[3.0202
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
11 Yes [A No
5. Does project comply with I.5A NCAC 021..0 05(c)(6) (additional. permitslcertifications)? Yes Ej No
Per I5A NCAC 02 E0105(c)(6J., 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, storniwater management plans, etc.).
6. Does this project include any sewer collection lines thatare deemed "high -priority'?"
Per 15A NCAC 02E0402, "high-priorityseer" means an 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 Ej No El N/A.
If yes, include an attachment with details for each line, including type (aerial line, size., material, and location).
Highpriority lines shall 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 com.ply with 1.516k NCAC 02T, the Minimum Design Criteria Ibr the Permitting_of Pump St.i:
and, Force Mains (latest version) and the Gravity Sewer Minimum Design Criteria (latest versionas applicable?
Yes Ej No
IfNo, complete and submit the Varian.ce/Alternative 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,
2. Professional Engineer's Certification:
(Profess. nal Engineer's
„1ioiii Application Item111,1,
attest that tlus application for
has been reviewed by me and is accurate, complete and consistent with the intbnnation 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 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 143-215,613, 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
includea fine not to exceed $10,000„ as well as civil penalties up to $25,000 per violation,
North Carolina Professional Engineer's se NA OD* e:
7..
SEAL r • •
P-0169
:41.•
•
ASSOC
110
3, Applicant's Certification per 15A NCAC 02T .0106(b):
(Signature .Authority's name & title Irom Application Item 1,3.)
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 inc]uded, 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. 1 will make no claim against the Division of Water Resources should a condition
ofthis 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 ine as
incomplete.
attest that this application for
NOTE - In accordance with General Statutes 143-215,6A and 140, 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 tine not to exceed $10,000 as well as civil penalties up to $25.000 per violation.
Signature:
Date:
.E0RM: ETA 04-16
Page 5 of 5

FICERIEDINCD5NROWR
WOROS
MOORESVUE REGIONAL 'OFFICE
oF Water ilesourc'c..5
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: City of Kings Mountain
Project Name for which flow is being requested: Long Branch Force Main Replacement
More than one FTSE may be requiredfor a single project if the owner of the WW/'P is not re,s-ponsible for all pump
stations along the route of the proposed wastewater ow.
. Complete this section only if you are thc owner of the wastewater treat elm plant.
a. WWTP Facility Name: Pilot Creek Wastewater Facility
b. WWTP Facility Permit #: NC0020737
All :ows are in MGD
c. WWTP facility's permitted flow 6.0
d. Estimated obligated flow not yet tributary to the WWTP .3
e. WWTP thcility's actual avg, flow 1,7
f Total flow for this specific request 0
g. Total actual and obligated flows to the facility 2.0
h. Percent of permitted flow used
33.3%
11. Complete this section for each puinp 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) MGD MGD MGD MGD Flow Capacity***
N/A
* 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 (pf) 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):
Downstream Permit Number:
Page 1 of 6
FTSE 04-16

COIificatio
Scott Nei
State" e t'
as
o the best of "my knowledge that t`lae addition
the v0 iU "ae Of °rite t r tbe pert2 tt t this project has ben evaluated a... o ; i route to the
receiving waste', °atei tre atrracrat t`acilit) and that tlit flow from this project is n eat arctic gated to
cause any capacity related rani ary sewer- overflows or overburden any do nstrearra pump station
en route to the receiving treatment plant under normal circurnstances, ;i er the implementation
of the planned irtnproveme is identified ira the planning assessment ptere applicable, Chas
analysis has been pertbring accordance with local established policies and procedures using
tine best available data. Ibis certiticrrtion applies to those items listed above in Sections ns l and II
plus all attached ing assessaue€at addendum's for which p am the rµespoiv it le pasta.
Signature of this comas indicates acceptance of tfus wastewater flow.
flag

LONG; BPANCH roRCu MAIN [REPLACEMENT
KINGS MOUNTAIN, NO
LCCA LON MAP
SCALE, 1"= 15OD'
PROPER T'r Pr
JOEL I:_. WOOD & ASSOCIATES

LONG BRANCH FORCE MAN REPL ACEMEN f
K INGS youNTAIN, N
PROPERTY OF
JOEL E, WOOD & ASTX ATES

Pe tt Number WQ0039343
Peranit Type;
ravrty Sewer Extension. °"ramp Slat€ens.& Pressure Sewer Extensions
Primary+° t
harry, lave
Coastal SWRule
Per fitted Fiow
Facility
enfsl Files APS
7'$t0 17
Permit Tracking Slip
Status Project Type
Active New Project
Version
Permit Classlf€oat€on
Individual
P rr it or tact Affiliation
Facility Na....:
Long Branch Force Main Replacement
Location Address
Owner
Major1M
Minor
Foci
Contact Pail€ation
Region
t loorecvdlie
County
Clevelandi
Owner Name
City of Kings Mountain
DatesiEvents
Owner Type
Governmerit Muunacspal
Owner Affiliation
Stave Killian
Development Dire c or Economic and of planning
P+ Box 429
Kings Min NCr 28ti86042
Ong Issue
772812017
Apo Received
712017
Regulated Add
ves
Scheduled,
ted Issuance Public Notice issue
7/28 01 7
Requested ieeived Events
Church
Retail
Sabana
Outfall
Addetional inforn ation requested
Additional iurformation received
Ete.ttae Expiration
7/28/2017'
twaterbody Name
Strearnindes Number Cu
Subtrass`n

..�.�... mow:
JOEL E WOOD & ASSOCIATES LLC
P 0 BOX 296
CLOVER, SC 29710
PAY
TO THE
ORDER OF

RECEIVEDINCOENR
n n i
FAST TRACK SEWER ENGINEERING CERTIFICATION
PERMITTEE: City of Kings Mountain
PERMIT tt: WQ0039343
PROJECT: Long Branch Force Main Replacement
ISSUE DATE: July 28, 201„7
This project shall not be considered complete nor allowed to operate in accordance with Condition 7 of
this permit until the Division has received this Certification and all required supporting documentation. It
should be submitted in a mariner that documents the Division's receipt Send the required documentation
the Regional Supervisor, Water Quality Regional Operations Section at the address at the bottom.
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 Perrnittee to
appropriate enforcement actions, The. Perrnittee is responsible for tracking all partial certifications up
until a final certification is received. 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 perm tted herein or portions thereof,
Printed t4amc, Titie
41-4c1t. IRCIOIATCAS
ENGINEER'S CERTIFICATION
1, JL e tAloolc4 as a duly registered Professional Engineer in the State of North Carolina,
having been authorized to observe (El periodically, weekly, 14 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 021; 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: 6
\'‘
Final
Partial (include description)
Certification Comments/Qualifiers (attach if necessary):
7571
**4"rti 045.0
/
,/
1"/
Same or North Czatelenaf 1.ffial Qua ll5 Muer ReiCU:ces . Water Ql..Wets• ReLeicilai Oveation
Mooresvikle Regineea.": Office. (O Eas1 Center Meneite. ISINe1Marne's,l Neette Catohna 15