WQ0031151_Regional Office Historical File Pre 2018

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources .
Alan W, Klimek, P.E. Diteetor
Division of Water Quality
December 27, 2006
Mr. Berry Webb
City Manager
City of Belmont
PO Box 431
Belmont, North Carolina 28012
Subject: Permit No. WQ0031151
Lowe's at Belmont Project
Wastewater Collection System Extension
Gaston County, North Carolina
Dear Mr, Webb,
In accordance with your application received on November 30, 2006, we are forwarding
herewith Permit No. WQ0031151 dated December 27, 2006, to the City of Belmont 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the date of issuance until rescinded, and shall be subject to the conditions and limitations as specified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 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.
Permitting of this project does not constitute an acceptance of any part of the project that does
not meet 1) 15A NCAC 2T; 2) the Division of Water Quality's (Division) Gravity Sewer Minimum Design
Criteria adopted February 12, 1996, as applicable; 3) 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. 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.
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 Belmont for the construction and operation of approximately 1,257 linear feet of
One
None
Aaturally
Mooresville Regional Office 610 East Center Ave., Suite 301 . Mooresville, NC 28115 Phone: [phone] Fax [phone]
Internet: http://www..ncrnw ate rcl u a lity.o.rg/ Customer Serve 1-877-623-6748
An Equal 0ppo6unty/Affirmave Action Employer - 50% Recycled/10% Post Consumer Paper

Mr. Webb
Page 2
December 27, 2006
8-inch gravity sewer and the discharge of 16,550 gallons per day of collected domestic wastewater into
the City of Belmont existing sewerage system, pursuant to the application received November 30,
2006, 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 Environment and Natural
Resources and considered a part of this permit.
The sewage and wastewater collected by this system shall be treated in the City of Belmont
WWTP (Belmont NPDES No. NC0021181) 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 information concerning this matter, please contact Marcia Allocco at (704)
663-1699.
Sincerely,
cc: Mooresville Regional Office, Surface Water Protection (WVVTP Permit No, NC0021181)
James Freeland, Freeland & Kauffman, Inc.
Surface Water Protection Central Files
Deborah Gore, PERCS

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:
1. 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 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 2T .0403. If an individual
permit is not required, the following performance criteria shall be met as provided in 15A NCAC 2T
.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 maintenance 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.
e. 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 28 .0506(a), and public notice shall be provided as required by
North Carolina General Statute §143-215,1C,

4. This permit shall not be 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.
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 2T .0116, 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 27; 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-
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 NCG010000, and any requirements pertaining to wetlands
under 15A NCAC 2B .0200 and 15A NCAC 2H ,0500.
11. Noncompliance Notification:
The Permittee shall verbally report to a Division of Water Quality employee at the Mooresville
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, 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 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, 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 27th day of December, 2006,
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
J2
fir Alan Wf'Klimek, PiE„ Director
Division of Water Quality
By Authority of the Environmental Management C;omrnission
Permit Number W00031151

Fast Track Engineering Certification
Permit No. WQ0031151
December 27, 2006
City of Belmont
PO Box 431
Belmont, NC 28012
Complete and submit tjs 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 re uired for an chan esresuitinq.jnnoncomrhancewth this em ulations or
minimum design criteria.
This project shall not be considered complete nor allowed to operate until this Engineer's Certification and all
required supporting documentation have been received by the Division. 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
, as a duly registered Professional Engineer in the State of North Carolina, having been
authorized to observe ([11 periodically, [11 weekly, full time) the construction of the Lowe's at Belmont, a Gaston
County project for the 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 2T; 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
MOORESVILLE REGIONAL OFFICE
SURFACE WATER PROTECTION
610 EAST CENTER AVENUE, SUITE 301
MOORESVILLE NC 28115
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
0
31151
Central F APS SVVP
12/22106
Permit Tracking Slip
Program Category Status Project Type
Non -discharge In review New Project
Permit Type Version Permit Classification
Gravity Sewer Extension, Pump Stations, & Pressure Sewer A Individual
Extensions
Primary Reviewer
marciaiallocoo
Permitted Flow
16560
Factlit/
Facility Name
Lowe's of Belmont
Location Address
Owner
Owner Name
City of Belmont
Dates/Events
Orig issue App Received Draft Initiated
11/30/06
Regulated Activities
commercial or industrial, other
Wastewater coilection
Outfall N. L
Scheduled
Issuance
Permit. Contact Affiliation
Major/Minor Region
Minor Mooresvlile
County
Gaston
Facility Contact Affiliation
Owner Type
Government - MUnicipal
Owner Affiliation
Barry
PO Box 431
Belmont
Webb
NC 28012
Public Notice issue Effective Expiration
FeatikestediReceiyq. given
Additional informalion requested
Additioni inforrtrOortfottoived
Waterbody Name
Stream Index Number Current Class Subbasin

FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, ANI) FORCE MAINS
PAGE 3
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Apphca64n Number.
(to be completed by )
Owner.
City of Belmont
Full Legal Name (company, melee]
HOA, utility, etc.)
Barry L. Webb, �..j, ty Manager
igning Official Name and Title (Please review 15A NCAC 2H .0206(b) for authorized i nin
The legal entity who will own this system is:
Individual L] lederal_W Municipality,(Q State/County Private Patnershrp C] Corperatiora JJ 0ttrer {speciry)
d. 115 N. Main Street (P.0. lox 431)_
Mating Address
North Carolina
State
04-825-5586
Telephone P F
Project (Facility) information:
s of Belmont
nt
28012
Zip Code
Email
Gaston
Brief Project Name (permit will refer to this name) Coun
CaWad Person:
Todd Slmrnons
Name and Affiliation of Someone Who Can Answer Qu
Phone Number
Project is New [] Mtatfitic tiort (oaf an existing pc
s About thi
Application
n t fk-ine.com
Project is Located
If Modification, Permit Nu,:
For modifications, attach a separate sheet clearly explaining the reason for the modification (Le, adding another
phase, changing line size/length, etc,). Only include the modified Information In this permit appiicati©n - do not
-I duplicate project Information in 0(7) and B(10-11) that has already been included in the original permit.
Owner is ® Public (skip to item 8(3)) El Private (go to item 2(a))
If private, applicant will be: 211.
0 Retaining Ownership (re. store, church, single office, etc.) r
0 Leasing units (lots, townhomes, etc. - skip to ftern 8(3))
0 Selling units (lots, townhornes,, etc. - go to item IB(2b))
City of Belmentr
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
-4a. City of BeimentWWaste WaterTreatrnent Plant 4b.NC0021181
Name of WWTF ��. WV+ITF Permit No.
a. City of Belmont
Owner of Downst
n rat this wa
sal Subdivision
0 Apartments/Condominiums
QI Mcbile Home Park
�I School
El Restaurant
j Office
to
22"
Volume of wastewater t to atloate
`Do not include previously perm
f the permitted flow is zero, indicate why:
El Interceptor Line - Flow will be permitted in subsequent permits that connect to this line
0 Row has already been allocated in Permit No.
❑ Rehabilitation or replacement of existing sewer with no new flow expected
apply):
Force
Permit Number of p
© Car Wash
Institution
0 Hospital
El Church
Nursing Home
® Other (specify): Commercial
d by a (mus
0 Public Utility (Instruction 111)
Ei Homeowner Assoc./Developer (Instruction IV)
(if known)
D o mestlrlC omene r cia1.
% Industrial
% Other (specify)_
his particular project ifi 56© gallons per day
cations
FTA 02/03 - Rev. 3 04/05

EAST? AICI+ APP iCATfi)N for GRAVITY SEWERS, PUMP STATI INS, AID 0 CE MAINS
PAGE 4
Provide the wastewater flow calcutaticons used in determining the permitted flow in accordance with 15A NCAC 2H
.0219(1) for Item t3(7) or the design flow for line or pump station sizing if zero flow in the space below. Values other than
that in 15A NCAC 2H ,0219(1)(1-2) must be supported with actual water or wastewater use data in accordance with 15A
NCAC 2H .02100)(3)_
Size (inches)
& PVC
LINE LE
ttach additional streets if necessary)
Length (feet) _.. Gravity or Force Main
(use the pull down menu)
1,257 ft.
Pump Stations to be Permitted (attach additional sheets as ne
Gravity
Location ID ; Power Reliability Option
chosen as shown on Design Flown) Operational Point ` (1- dual line feed; 2- permanent generator w/ATS; t.
tans for cross reference F3
�._._..__r.__.,...._._r._.._. _D.w,_.. I,__._6AG._).._, GPMfigTt]NwPartablevenerator wftelernetryr 4 wetvvell storage)_
Does the sewer system comply with the Minimum Design Criteria for Fast Track Permitting of Pump Stations and Force
Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC 2H .0200 as applicable?
El Yes © No If no, please reference the pertinent minimum design criteria or regulation and Indicate why a
variance Is requested. SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS
PERTINENT 7O THE. VARIANCE WITH YOUR APPLICATION
f. Hlrrve the fallowing permits/certificati©ns been submitted for approval?
4 tlsnd/Strearn Crossings - General Permit or 401 Certification? EJ Yes D No ® N/A
Sedimentation and Erosion Control Piari? Z Yes EJ No 0 N/A
Stoumwater? Yes L. No Q N/A.
4. goes this protect involve aerial lines or siphons? Check if yes: �#
Tines .will Jze_m dered_ ttri. k .cn eservesas ar93lZsm -- __._..m.
5, l uses this project have gravity sewer tines designed t rrtinimur t slopes'? 0
Eta a that the AMeinn w,1I met.accept t more 1 mtt r tdi Lie tr�r alatr aLep .Lint la s t tr
tsar d prior to subs ttting the foal ens i s oaa.
A 0?Jt1 - ev. fl4

FAST -TRACK APPLICATION for GRAY TY SEWERS, PUMP STATIONS, ARGE
.PAGE 5
Use the Division's guidance document entitled, "DETERMINING STREAM CLASSIFICATIONS FOR FORM FTA 02103
(FAST -TRACK SEWER SYSTEMS)" to collect and record the stream classification data below (attach additional sheets as
necessary). This documentis available from our web site or by contacting the appropriate Division of Water Quality
tonal office (see instructions for addresses) PR indicate the following,
A Stream Classification is not needed because all parts of the project are at least 100 feet away from any down slope
A Stream Classification is not needed because the design does not depend on wet well storage s power reliability
option for any pump station near a Class C down slope walerbody.
Location ID on Map
elf chosen -as shown on Name of s laterbody Strea
for cross-reTerence) Waterbody a_....,. ... County Rfver Boa Yr Index
Submit
4
" x '11 COLOR topographic map as required in Instruction
regardless of whether a classification Is provided!.
Waterbody
Glassificalivrn
t, Sl attest that this application for Lowe's of Belmont
has been revid by me and Is accurate and complete to the best of my knowledge, I understand that it all required
parts of this application are not completed and that if all mqulred supporting documentation and attachments aria not
included; this application package is su'bjocl to being returned as incomplete. Note: to accordance with North Carolina
Genera/ Statutes 143-215 6A and 143-215, 68, any person who knowingly makes any false statement, representation, or
certification In any application shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed $70,000
as wrap as cr`vi1 . ;reifies ,.. 'ot `. SrtJtltl ridr violation.
re
ssional Engineer's Certification.
ttesl that this application for Lowes of Belmont has been reviewed by me and is accurate, complete and consistent
with the mill motion in the engineering plans, calculations, and all other supporting documentation to the best of my
knowledge, 1 further attest that to the best of my knowledge the proposed design has been prepared in acc ardance with
the applicable regulations, Gravity Sewer Minimum Design Criteria for Gravity Sewers adapted February 12, 1996, and the
Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 and the
watershed classification in accordance with Division guidance. Although certain portions of this submittal package may
have been developed by otherpmfessionals, inclusion of these materials under my signature and seal signifies that 1 have
reviewed this material and have judged d to be consistent with the proposed design. Note. In accordance wrap NC
General Statutes 143-215.6A and 143-215.6E3, enyperson who knowingly makes any false statement, representation, or
certifrcation in any application shaft be guilty of a Class 2 misdemeanor which may include a fine not to exceed $f Q 000 as
wolf as civil penalties up to $25,000 per violation,
2a, James R. Freeland
Professional Engineer Name
b. Freeland & Kauffman, .Inc.
Y, Crr ineering Firm
c 2flg ,Vest Sloane Avenue
�llrtoJ Address
• Pre2
City i Stag: } Zip
8 2 ;3-5g7
Tetephane Facsinitor E-mail
Seal; Sig
FTA 02/03 Iaev. 3 tl ltti5
waterbody; AND,

OPOSED COMMERCIAL DEVELOPMENT
BELMONT, NORTH CAROLINA
uth Tryon Street -Suite I(70
e, North Carolina 23203
QUADRANGLE
7.5 MINUTE SERIES (TOPOGRAPHIC)

Engineers:. Landscape
209 VV. Stone r versue ESQ
Greenville, S,C f 2a939
PAY
TO THE
ORDER OF
OR..
DATE
ll'0L335COD 2L91:2038 L00L'3523".

Michael F Easley, Governor
A
Co
January 22, 2008
Barry Webb, City Manager
City of Belmont
P.O. Box 431
Belmont, North Carolina 28012
SUBJECT: Lowe's at Belmont
Permit No. WQ0031151
Wastewater Collection System Extension
Final Engineering Certification
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen Sullins, Director
ivision of Water Quality
Dear Permittee;
The Division received a final engineering certification for the subject project on October '29, 2007.
A full review of the certification materials may or may not be conducted. It is assumed that receipt
of this certification indicates compliance with all regulations, design criteria and the permit. Please
be reminded that the Permittee is responsible for keeping a copy of the final record drawings for
the life of the project. If you have not received a copy, please contact your consultant
immediately to obtain a copy.
You are receiving this letter because the Division has you listed as the responsible party. if this
permitted system is no longer owned by you, please complete Form PNOCF-S as this permit is not
automatically transferable. Form PNOCF-S can be downloaded from
2o.ennstate.naus/ndpulnaguapps.html#Sewer.
If you have any questions concerning this document or the completion of Form PNOCF-S (if
necessary), please contact Ms. Dee Browder at the letterhead address or via E-mail at
[e-mail].
Sinereiy,
tL
1Robert Krebs
urface Water Protection Regional Supervisor
Enclosure
Cc James Freeland, Freeland and Kauffman
Surface Water Projection Section Central Files (ceetification page only)
Orte
NorthCaro i a
y
Pretreatment, Emergency Response and Collection Systems Unit Internet http:Iih2o,enr,nc state.usindpu
1617 Mail Service Center, Raleigh, NC 27699-1617 An Equal Opportunity Action Empioyer
Telephone [phone] Fax [phone]% recycled/10% post -consumer paper

Fast Track EngineeringCertification
Permit No. WQ0031151
December 27, 2006
City of Belmont
PO Box 431
Belmont, NC 28012
Complete and submit his 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 tolhe project should be clearly identified on the record drawings or in written summary form, Perrn
modifications are required for any changes resulting in non-compliance with this permit, regulations or
minimum design criteria.
This project shall not be considered complete nor allowed to operate until this Engineer's Certification and all
required supporting documentation have been received by the Division, Therefore, it is highly recommended
that this certification be sent In a manner that provides proof of receipt by the Division.
ENGINEER'S CERTIFICATION
[11 Partial M Final
pelts g. fir —EEL -POOP , as a duly registered Professional Engineer in the State of North Carolina, having been
authorized to observe ( periodically, El weekly, El full time) the construction of the Lowe's at Belmont, a Gaston
County project for the 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 2T; 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:
eaMip'
SEND THIS FORM & SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS
MOORESVILLE REGIONAL OFFICE
SURFACE WATER PROTECTION
610 EAST CENTER AVENUE, SUITE 301
MOORESVILLE NC 28115
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,

FRBELAND AND KAUFFMAN, INC.
is veers L7.Landscape Architects
209 West Stone Avenue
Greenville, South Carolina 29609
(8641233-5497
FAX [phone]
TO Mooresville Regional Office
Date
7, 2007
Attention:
We are send"sng to you Attached
Shop Drawings Prints
Copy of Letter
THESE ARE TRANSMITTED as checked belr
LJFor approval
1]For your use
LJAs requested
QFor review and comment
FOR BIDS DUE
REMARKS
COPY TO David Isenhour — Town of Belmont, NC
RE: Lowe's of Belmont
der separate cover via
Approved as submitted
]Approved as noted
]Return for corrections
El
The following:
E] Paper Vellums J Specifications
lResubmit copies fog Koval
©Submit copies for distribution
Return corrected prints
PRINTS RETURNED AFTER LOAN TO US
Please let me know if any addition information is required.
Signed:
Todd Sirtnr°nons. PE 864-672.426

16,74 Ef (7ev
Icy AaZe
r

CityCt LOWES
Tet
Fax
E-mad:
P/O, No,
2007
Inspection Report / 1
Weather
Dry
ieyors Name
DONALD
Pipe Segment Reference
No
Certificate No.
T 1309
Survey Customer
System Owner
Date Cleart
Pre -Cleaning
Jetting
ti23 PARKING LOT
LOWES
Loc, detafls
Location Code
Use of Sewer
Dranage Area
Flow Control
Length surveyed
Not Controlled
154.46 ft
Upstream MH
Dowstream MH A
Dir. of Survey Upstream
SecbonLenqth 161.85 ft
Purpose of Survey Pre -Acceptance
Year Laid
Year Rehabiiitated
Tape Media No, DVD
Add n
Dia/Height
'n
8 inch
Polyvinyl Chloride
1:375 Position
Observation Photo
7.40, Downstream Manhole, Survey Begins
Upstream Manhole, Survey Ends, REMARK: MANHOLE NOT
SET
°SR
OMR
0000
SPR
0
MPR
0
OPR
0
"1,41.19,0
SPRI
MPRI
0
QPRt

City
WES
Inspection
TeX
Fax.
Report /
Date
712412007
P1O, No.
Weather
Dry
Surveyor's Name
DONALD
Pipe Secarneni Reference
No
Certificate No,
T 1309
Survey Customer
System Owner
Date Clean
Pre -Cleaning
Jetting
Street123 PARKING Lf3T
City LOWES
ocdetails
ovation Cc
Purpose of Surrey
Year Laid
Year Rehabilitated
Tape / Media No,
Pre -Acceptance
OVD
Use of
ura�e Area
Flow Control Not Controlled
Lenatlt surveyed 198.26 ft
Upstream MR
Dowstream MR
Dir. of Survey
Section Length
B
C
Downstream
205.67 ft
Joint Length
Dia./Height
Material
Linrrirw Method
8 inch
Polyvinyl Chloride
Add. Information :
1:475 Position
Observation
Upstreertt Manhole, Survey Begins
Downstream Manhole, Survey Ends
Photo
R
0
R
PR
PR
OPR
0
0
SPRI
PR
PR
0

LOWES
Inspection Report / 1
Tel:
Fax:
E-mail:
Dae P/O. No Weather
4/Z0Q7 Dry
Certificate No,
T 1309
Survey Customer
ystem Owner
Surveyor's Name
DONALD
t Reference
Date Cleaned
-Cleaning
Jetting
Section No
3
Sewer Category
Street123 PARKING LOT
City LOWES
Lcc. details
Location Code
Purpose of Suivey Pre-Acce
Year Leis)
Year Rehabilitated
Tape / Media No, DVD
Drwnae Area
Fbw Cornrot Not Controlled
Length u y 14231 ft
JMLenJt
oi
Dia Iiiefght
Add. Information
ini
Upstream MH
Dowstream MH C
Di. of Survey Downstream
Section Length 149.71 ft
8 inch
Polyvinyl Chloride
1:350 Position
Observation Photo
Downstream Manhole, Survey Begins
Upstream Manhole, Survey Ends
OSR
0000
MR
SPR
0
MPR
SPRI
0
MPRI
0
CIRRI
0

Cdy:LOWE
te
712412907
Certificate No,
T 1309
Tet
Fax,
EmaL
Inspection Report /1
P/0. No
Survey Customer
Weather
Dry
System Owner
Surveyors Name
DONALD
Date Cleaned
Srett23 PARKING OT
City LOWES
detail
e
Use of Sewer
Drainage Area
Flow Control
Length survey
Saftar
Not Controlled
Purpose of Survey
Year Laid
Year Rehabilitated
Tape I Media No:
Segment Reference
Pre -Cleaning
Jetting
Section No
4
Sewer Category
Upstream MH
wstream MH E
Ir. of Survey Downstream
Sectki'r Lerrg1i
JointLargth
ialHeight 8 inch
Materia Polyvinyl Chloride
Lfrrna Method
1:750 Position
Observation Photo
Upstream Manhole, Survey Begins
Downstream Manhole, Survey Ends
0000
0000
MPR
0
evvoktrre, rxtrr
OPR
0
0
PRt
OPRI
0

Citm : LilfuE
Ter
Fax
Inspection Report f 1
Date
7
Certificate No.
T 1309
P,r©. No.
y c:usccame
eaine
System Owner
ame PetSe L ttnerat Refe+ren
DUAL
Sewer C
t9 3 PARKING LOT Use caf evrer Sanitary Upstream MH E
LOWES Drainage Area Dcrwsttearm hiiht E
details Flow Control Not Controlled Dir. of Survey Upstream
Iron Length surveyed 55:76 ft Section Len th S3.16'ft
Purpose of Survey
Year Laid
Year Rehabilitated
Tape / Media No.
Pre -Acceptance
1:150 Position
Dia,�Height. B inch
i tatertai Polyvinyl Chloride
Lini
Observation Photo
7.46 Downstream Manhole, Survey Begins
63.t6 Upstream Manhole, Survey Ends
PR
°PRI

City : t_,
Date
712412007
PD. N.
Inspect on
Weather
Dry
Surveyors Name
DONALD
Pii
Referenoi
tificate No.
T1309
Survey Customer
123 PARKING LOT
LOWES
details
on Code
Purpose of Survey Pre-Acepiance
Year Laid
Year Rehabilitated
"ape r Media No. DVD
stem Owner
Use 0f r
Drain.. N Area
Flew Control
Length surveyed
Add. Information
Sant
t C
63.86 It
Date Cleaned
Pre-Dteanang
J ,its
Upstream MH p
DowStream MH G
Dir. of Survey Downstream
Section 71.25 ft
tcint Le
Dia./Height 6 inch
Material Polyv'trayl
Luting Met
Position Observation
Upsica anhoie, Survey Begins
Photo
71. 25 Downstream nhole, Survey Ends
iS+
a
iMR
SPR 0
MR
0
SPR1
0PRt

City : LO ES
Tel
Fax:
E snsi
Date
7/7A/2007
Inspection Report 1 1
P,/O, No, Weather Surveyor's Name Pipe Segment Reference
Dry D©NALD
nNo.
ertifioate
T 1309
Survey Customer
ystern Owner Date Cleaned
Pre-Cleanin
Jetting
Street123 PARKING LOT
City LOWES
Log, details
Location Code
Use of Sewer
Drainage Area
Flow Control
Length surveyed
Not Controlled
82.01 ft
Upstream MH
Dowstream MH
rvey Upstream
enctth 89.41 ft
Purpose of Survey Pre -Acceptance
Year Laid
Year Rehabilitated
Tape / Media No. DVD
Add. Information
1:200 Position
Dia./Height 8 inch
ateraal Polyvinyl Chloride
et
Observation
740 Downstream Manhole, Survey Begins
89.41
Upstream Manhole, Survey Ends
Photo
R
0
SPR
0
PR
0
oPR
a
PRI
0

CiIv LOWES
Date
7/24/2007
Certificate No,
T 1309
P/O, No,
Survey Customer
Inspection Report 1
Weather
Dry
Systern Owner
Surveyors Name
DONALD
Date Cleaned
Tel:
Fax,
Pipe Segment Reference
Pre -Cleaning
Jetting
Street123
City
Loc, details
n
e
PARKING LOT
LOWES
Use of Sewer
Drarnage Area
Flow Control
Length urveyed
Not Controlled
123.95 ft
Upstream
Dowstream MH I
Dir, of Survey
Section Length
Section No,
8
Sewer Category
Downstream
Purpose of Survey
Year Laid
Year Rehabilitated
Tape 1 Media No,
re -Acceptance
Joint Length
DiaJHeight 8 inch
Material Polyvinyl Chloride
Lining Method
Add, Information:
1300 Position
R
0000
Observation
7 40 Upstream Manhole, Survey Begins
OMR
0000
Downstream Manhole, Survey Ends
MPR OPR
0
t VC= tICI 10011161T {1,
SPRI
MPRI
0
Photo
()PRI.
0