WQ0037886_Regional Office Historical File Pre 2018

North Carolina De
Pat McCrory
Governor
Mr. Danny Jackson, City Manager
City of Mount Holly
P.O. Box 406
Mount Holly, NC 28120
NCDENR
Dartment of Environment and Natural Resources
July 6, 2015
Subject: Permit No. WQ0037886
Magnolia Five
Wastewater Collection System Extension Permit
Gaston County
Dear Mr, Jackson:
Donald R. van der Vaart
Secretary
In accordance with your application received June 29, 2015, we are forwarding herewith Permit No.
WQ0037886 dated July 6, 2015, to the City of Mount Holly(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effective from the date of issuance until rescinded, and shall be subject to the conditions and limitations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 I1.4: 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 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 1506 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.
Mooresville Regional Office
610 East Center Avenue, suite 301, Mooresville, NC 28115
Phone: [phone] \ Fax [phone] \ Customer service 1-877-623-6748
Internet: www.ncwaterqualityorg
An Equal Opp ortunity\ Affirmative Action Employer — Made in part by recycled paper

Town of McAdemnfle
Permit No. WQ0037886
if you need additional information concerning this matter, please contact Barry Love at [phone]
or via e-mall at harrylove@ncdenr,gov,
for S. Jay Zimmerman, I:Ea
Director, Division of Water Resources
by Michael Parker, Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional Office
Division of Water Resources, NCDENR
cc: James P. Magennis, P. (electronic copy)
Regicinal Office Hies
Water Resources Central Files
PERCS (electronic copy)
Page 2 of 8

Atik
NCDENR
STATE OF NORTH CAROLINA.
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
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 Mount Holly
Gaston County
for the construction and operation of approximately 487.27 linear feet of 8-inch gravity sewer to serve 4
three -bedroom homes as part of the Magnolia Five project, and the discharge of 1,440 gpd of collected
domestic wastewater into the City of Mount Holly existing sewerage system, pursuant to the application
received June 29, 2015, and in conformity with 1.SA NCAC 2T; the Division's Gravity Sewer Minimum
Design Criteria adopted February 20, 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.
This permit shall be effective from the date of issuance until rescinded and shall be subject to the
cified conditions and limitations coed therein.
for S. Jay Zimmerman, P.G.
Director, Division of Water Resources, NCDENR
By Authority of The Environmental Management Commission
Permit Number: WQ0037886
Permit Issued: July 6, 2015
Page 3 of 8

SUPPLEMENT �������U^� �~������ �U����
.*��x " o_u.m�mx~vm v :�� PERMIT ~~���"_wv .�vvx~x~"
City of Mount Holly is hereby authorized to:
Construct, and then operate upon certification the aforementioned wastewater collection extension.
The sewage and wastewater collected by this system shall be treated in the City of Mount Holly
Wastewater Treatment Plant inaccordance with Permit NumberNCQ821156.
Permitting of this project does not constitute an acceptance of any part of the project that does not
meet 15A NCAC 2T; the Division's Gravity Sewer Minimum Design Criteria adopted February 20, 1996 as
applicable; and the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations
and Force Mains adopted June l, 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 Pe,mittee'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,
1. SPECIAL CONDITIONS
1. No flow in excess of the quantity permitted herein, 1,440 GPC\ shall be made tributary to the
subject sewer system until an application for permit modification for an increase in flow has been
submitted tnand approved bythe Division. <1SANCACO2T.O3Q4(b)]
Il. STANDARD CONDITIONS
I. This permit is not transferable. In the event there is a desire for the wastewater cnUcchmn facilities
to change ownership, or there is a name change of the Pe,mittee, a formal permit request shall be
submitted to the Division accompanied by documentation from the parties involved, and other
supporting materials as may be apprnpriate. The approval of this request shall be considered on its
merits and may or may not be approved, [15A NCACO2T.0104; &S 143-215.2(d3)]
2, This penn{1 shall become voidable unless the wmstevvate, collection facilities are constructed in
accordance with the conditions of this permit; 15A NCA[ 2T; the Division's Gravity Sewer Minimum
Design Criteria adopted February2O, 1996asapplicable; the Division's Minimum Design Criteria for
the Fast -Track Permitting ofPump Stations and Force Mains adopted June 1'Z[0Oasapplicable; and
other supporting materials unless specifically mentioned herein. [15A NCAC 02T.01101
1 This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data. [I5ANCACOZT.O1IO]
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[AC 2T �0403. If an individual
permit is not required, the following performance criteria shall be met: [15A NCAC 02T 0108(b)]-.
Page 4ofS

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 staoda/da.
b. A map of the sewer system shall be developed and shall be actively maintainecl�
c- Anoperation and maintenance plan including pump station inspection frequency, preventative
maintenance schedule, spare parts inventory and overflow response has been developed and
implemented,
' � Pump stations that are not connected to a telemetry system shall he inspected everyday (i.e.
365days per yoar'). Pumpstations that are connected to a telemetry system shallbe inspected
a1least once per week.
c. High'priorityeewer lines shall be inspected at least once per every six -months and inspections
are documented.
f� A general observation of the entire sewer system shall be conclVctecl at least once per year.
G Overflows and bypasses shall be reported to the appropriate Division regional office in
� accordance with 15A NCAC 2B 0506(a), and public notice shall be provided as required by North
Carolina General Statute §143-2l5.1L
h, AGreose Control Program is in place as follows,
1 For public owned noU*chom systems, the Grease Control Program shall include at least
' dresidentialuseoand
biannual disthbu�omofcducahnnahrna1oha|sfor both comnnemj | � an
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 systerns, the Grease Control Program shall include at least bi-
annual distribution of grease education materials to users of the collection system by the
perrnitteeorits representative.
3. Grease education materials shall be distributed more often than required in Parts (1)and (Z)
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.
S. The Permittee shall report by telephone to a water resources staff member at the Mooresville Regional Office, telephone number<704\ 663'1899, as soon mspossible, but in no case more than
24, following the occurrence or first knowledge of the occurrence of either of the followin&

a. Any process unit failure, due to known o/ unknown reasons, that renders the facility
incapable of adequate wastewater transport, such as mechanical or electrical failures of
pumps, line blockage mrbreakage, etc;or
b. Any SSOand/or spill over 1,O0Ogallons; ur
c. Any 5SOand/or spill, regardless nfvolume, that reaches surface water
Voice mail messages or faxed information is permissible, but this shall not be considered as the
initial xe/bo| report. Overflows and spills occurring outside normal business hours may also be
reported to 'the Division of Emergency Management attelephone number/8OO\ 858'0368or(9I9)
733'3300. Persons reporting any of the above occurrences shall file a spill report by completing and
submitting Part | of Form C5'5SO (or the most current Division approved form) within five days
following first knowledge ofthe occurrence. This report must outline the actions taken orproposed
to be taken to ensure that the problem does not recur. Part U of Form CS-56O (or the most current
Division approved form) can also bccompleted tnshow that the S3Owas beyond control. |G.S. 143'
6. Construction ofthe gravity sewers, pump stations, and force mains shall bescheduled soas not to
interrupt service by the existing utilities nor result in an overflow orbypass discharge Vfwastewater
tothe surface waters ofthe State. [15ANCA[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 form, 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 o violation of the permit and shall subject the
Permh1eetoappropriate enforcement actions.
If the permit is issued to a private entity with an Operational Agreement, them a copy mfthe
Articles of Incorporation, Dec aratio no/Covanants/Restrictons, and Bylaws that have been
appropriately filed with the app|1cab|eCounty/s Register ofDeeds office shall be submitted with
the certification.
Acomplete certification is one where the fVnn is fully executed and the supporting documents are
provided asapplicable, Supporting documentation shall include the following:
a. One copy of the project construction record drawings (plan 8' 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 orDVQ 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 tuflush |oxv 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
bmeframes,shall beprovided.
Page 6 of 8

c' Changes tnthe project thatdonotrcsuhinmnn-complioncewiththispenn\Lre@u|ahnns,orthe
K4inimwmDesign Criteria should be clearly identified onthe record drawings, on the certification
imthe space provided, orinwritten 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 nflU96orgreater, increased
d increases in the
Uovv pump station design capacity design increases of 5Y6 or greater, an ncre
number/type of connections), regulations, or the Minimum Design Criteria. Requested
' � U| b reviewed mnacase-by-case basis
modifications or variances to the Minimum Design Criteria w e
and each on its own merit. Please note that variances tothe 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 beapproved, thus requiring replacement or
repair prior tocertification & activation. |1SAN[ACOZT.8l1Gl
8 Gravity sewers installed greater than ten percent below the rnininourn 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 bedone through apermit modification with fee. Such variance requests will beevaluated
on a case -by -case basis. Resolution of such request shall be evident prior to completing and
submitting the construction certification. /lSAN[4CO2T.Q1U5<oD
9� A copy of the construction record drawings shall be maintained on file by the Permittee for the life
ufthe wastewater collection facilities. [15ANCACO2T.0I161
10, Failure to abide by the conditions and limitations contained in this permit; I5A NCAC 2T; the
Division's Gravity Sewer Design Criteria adopted February ZO, 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 Pennittee to an
enforcement action by the Division, in accordance with North Carolina General Statutes §143-215,6A
through §143-216.6C, construction of additional or replacement wastewater collection facilities,
and/or referral of the North [@rqVina-licensed Professional Engineer to the licensing board, [15A
N[A[02T.Q184;15AN[A[82T.Ol88(b-c)]
11. In the event that the wastewater collection facilities fail to perform satisfactorily, including the
creation of nuisance conditions, the PermiMLee shall take immediate corrective action, including
those as may be required by this Division, such as the construction of additional or replacement
facilities. [1SANCA[U]T.0I1O,1SANCACOZT.O1O8(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
obtaining other permits which may be
Local government agencies which have jurisdiction or o m�
required by the Division or any other Federal, State, of Local government agencies. iG.l 143-
Page 7 of 8

FAST TRACK SEWER ENGINEERING CERTIFICATION
PERMRTEE:
PERMIT #;
PROJECT:
ISSUE DATE:
City ofMount Holly
VVQ0037886
Magnolia Five
July 6,I015
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 to the Regional Supervisor, Water Quality Regional Operations Section at the address at
the bottom.
Any wastewater flow made tributary tmthe wastewater collection system extension prior tocompletion
of this Certification shall be considered a violation of the permit and shall subject the Prrmittee to
appropriate enforcement actions. The Permlttee 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
|,the undersigned agent for the Pennittee, hereby state that this project has been constructed pursuant
tmthe applicable standards & requirements, the Professional Engineer be\nxv has provided applicable
design/construction information to the Permittee, and the Pennitteeis prepared tooperate &maintain
the wastewater collection system permitted herein or portions thereof.
Printed Name, Title Signature
ENGINEER'S CERTIFICATION
Date
as a duly registered Professional E �n d`e State of North Carolina,
having been authorized to observe (| | periodically, weekly,
r
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 nhnervaMnm of the construction such that the
construction was observed to be built within substantial compliance of this permit; 1SA N[4CO2T; the
Division of Water Resources' (Division) Gravity Sewer Minimum Design Criteria adopted February 20,
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 [-] Partial (include description
Certification Comments/Qualifiers (attachifoccmssary):
NC DWR - Water Quality Regional Operations Section 610 East Center Avenue, Suite 301, Moores011e, NC 2811.5
����� I ­` "I 1'1- 1.- r—` 1�1 ��-

USE THE TAB KEY TO MOVE FROM FIELD TO FIELD
1. OwnerlPermittee:
1 a. The City of Mount Holly,
Full Legal Name (company, municipality, HOA, utility, etc.)
lb, Danny Jackson, City Manager
Application Number:
Ito be completed by DWR)
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b), for authorized signing officials)
1 c. The legal entity who will own this system is:
❑ Individual ❑ Federal Municipality 0 State/County ❑ Private Partnership 0 Corporatiorf.Cif{,Efity!lC.iU`11f'
0 ld PO Box 406
0
U
J
a.
a
Mailing Address
NC
State
lh 704-827-3931
Telephone
2. Project (Facility) Information:
2a, Magnolia Five
704-822-29:
Facsimile
Brief Project Name (permit will refer to this name'
3. Contact Person:
3a, Zarek Melton
le. Mount Holly
City
fig. 28120 __-
Zip Code
MDRESVILi...
danpyjackson tholly.us
E-mail
2b. Gaston
County Where Project is Located
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b. "Toy-y13._6701
Phone Number
1 Project is New ❑ Modification (of an existing perr
2. Owner is ® Public (skip to Item 8(3))
tr_
Ai_ OFFICE
3c, Z., t°toa.LT60 Z 1 Lea
E-mail
fication, Permit No.:
Private (g to Item 2(a))
2a, If private, applicant will be; 2b. If sold, facilities owned by a (must choose one)
0 Retaining Ownership (i.e. store, church, single office, etc,) or
0 Public Utility (Instruction D)
❑ Leasing units (lots, townhomes, etc - skip to item B(3)) 0 Homeowner Assoc /Developer (Instruction E)
0 Selling units (lots, townhomes, etc. - go to Item B(2b))
3, The City of Mount Holly
Owner of Wastewater Treatment Fa
4a. The Cif of Mount Holly
Name of WWTF
Treating Wastewater From This Project
4b, NC0021156
WVVTF Permit No.
City of Mount Holly5b. 8-in
y 00059
©Gravit 5c. �QrC ¢ .a�
Owner of Downstream Sewer ReceivingSewer Size Force Main # of Downstream Sewer
The origin of this wastewater is (check all that apply):
Residential Subdivision
❑ Apartments/Condominiums
El Mobile Home Park
0 School
0 Restaurant
❑ Office
Retail (Stores, shopping centers)
❑ Institution
❑ Hospital
❑ Church
❑ Nursing Home
❑ Other (specify):
struction F)
Domestic/Commercial
%© Industrial
(Attach Description)
% Other
Cy
(Attach Description)
7. Volume of wastewater to be allocated or permitted for this particular project; j 4 40'' gallons per day
*Do not include future flows or previously permitted allocations
8. if the permitted flow is zero, indicate why;
0 Pump Station, Outfall or Interceptor Line where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit No
❑ Rehabilitation or replacement of existing sewer with no new flow expected
(see 15A NCAC 02T .0303 to determine if a permit is required)
F FA l0-14 APPLICATION Page 4 of

Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2T,.01 14 for`.
the value in Item B(7) AND/OR the design flow for line or pump station sizing if a reduced or zero flow is being requested in
Item B(7), Values other than that in 15A NCAC 2T 0114 (b) and (c) must be supported with actual water or wastewater use
data in accordance with 15A NCAC 2T 0114 (f).
120gailBR/day/unit x 3 BR x 4 units = 1440 gal/day
Summary of Sewer Lines to be Permitted (attach additional sheets if ne+ss ary)
Size (inches)
8" PVC
Length (feet)
487 27
New Gravity or Additional
Force Main
'ummarr of Pump Stations wl associated Force Mains to be Permitted (attach additional sheets as necessary)
Pump Station Location ID:
(self chosen - as shown on planslmap for reference)
Longitude: Latitude:
Design Flow
(MGD)
Operational Point
GPM tTDH
Power Reliability Option
- permanent generator w/ATS;
2 - portable generator w/MTS
Force Main Size
Force Main Length !.
Pump Station Location ID: (selfchosen - as shown on planslmap for reference)
ongitude; Latitude:
Design Flow
(MGD)
Operational Poin
GPM ITDH
Power Reliability Option
permanent generator w1ATS;
2 - portable generator w/MTS
Force Main Size Force Main Length
12. Will the wastewater flow in the proposed sewer lines or pump stations be able to be directed to another treatment facility?
Yes X No If Yes, permit number of 2" treatment facility
R©— if "yes' to 3,12 please contact the Central Office PERCS Unit)
Does the sewer system comply with the Minimum Design Criteria for the Permitting, of Pump Stations and Force Mains
(latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC Chapter 2T as applicable?
X 'Yes ©No
If No, complete and submit the Variance/Alternative Design Request (VADC 10-14) application and supporting
documents for review. Approval of the request is required prior to submittal of the Fast Track And
supporting documents. WC, .Ito r
REiC IVEI' /NCk ENR/l7WR
WOROS
MOORESVILLE R .GIONAL OFFI
Page 5 of 6
OFFICE
4
)p
"CATION

14f Have the following permits/certifications been submitted for approval for the system or project to be served?
0
Wetland/Stream Crossings - General Permit or 401Certification?
Sedimentation and Erosion Control Plan?
Trout Buffer Waiver?
Storrnwater?
Yes 0 No X N/A
Yes Ej No X N/A
El Yes ENo X N/A
Yes El No X N/A
15, Does this project indude any high priority lines (15A NCAC 02T .,0402 j2j) involve aerial lines, siphons, or interference
manholes)? These lines will be.coneideredhigh priority and must be checked once every six months
Check if Yes: El and provide details:
1. Owner/Permittee's Certification: (Signature of Signing Official and Project Name)
it) "4/6SCICOPLI ,
, attest that this application for 6112,41) SejVC011—t4X.;11014194as been
reviewed by r e and is accurate and complete to the best of my knowledge. I und rstand that if all required parts of this
application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. Note: In accordance with North Carolina General
Statutes 1,43.-216,6A and 1.437215,6B any person who knowingly makes any false statement, representation, or
certification in any application sLjall b uilty of a Class 2 misdemeanor, which may include a fine not to exceed $10,000
as WeLas civil penalties hp to $ 5, ooq 8erviolation,
ENGINEERING DESIGN DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL OF THIS
APPLICATION. THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR PROXIMITY
TO OTHER UTILITIES, DESIGN CALCULATIONS, ETC. REFER TO 15A NCAC 02 T 0305
2. Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
1, James P. Magennis ,attest that this application for Magnolia Five has been reviewed by me and is accurate,
complete and consistent with the information in the engineering plans, 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
adopted 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 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 NC General Statutes 1-131216 6A and / 4...-,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 $10,000 as well as civil penalties up to $25,000 per violation.
2a. JamesMagennis
2b
2e
2d
Professional Engineer Name
Construction Materials EngipeOng & Consulting, PC
Engineering Firm
4401 Sho ton Road
Mailing Address
Charlotte
City
2g. 704-323-7734 2h, 704-665-5619
2e, NC 2f 28217
State Zip
2i. [e-mail]
Telephone
FTA 10-14 APPLICATION
Facsimile
E-mail
Page 6 of 6
NC PE Seal, Signature & Date

June 2., 2015
Project Narrative
Construction Materials Engineering & Consulting, PC
NC Engineering License # C-3512 - SC COA # 4239
"Bringing EFFECTPVE EFFICIENCY to Your Project"
This project is the extension of an 8-ineh gravity sanitary sewer line of approximately 488.78 linear
feet which includes two 4 foot diameter manholes and 3 new service laterals. The extension ties to
an existing line on the north side (lithe property currently operated by the City of Mount Holly.
This sewer extension is to serve 3 single family homes. 'Fhere is an existing home which is
currently part of the City of Mount Holly system and one tract "E" which will he tapped to the
existing sanitary line on the north side of the property.
4401 Shopton Road, Charlotte, NC 28217 Office: [phone] • Fax: [phone] n maxxattesnpnorn

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Name
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Classification : WS-
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State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Applications
(Fi SE 08-13)
Project Applicant Name: --I '14-6C1Tf 0 f' 14c Lt.
Project Name for which flow is being requested: MA-CA)c.,L. (J47 f/
More than one F7SE may he requiredfr a single praject if the owner of the WWTP is not respansibie for all pump
stations along the mate pf the proposed wastewater 1ovc
Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: I wa cir-7( oF mi. POLL `f
b. WWTP Facility Permit #: NI(.. 002 11S-6
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
c. WWTP facility's .actual avg, flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
11, Complete this section for each pump station you are responsibl
proposed wastewater flow.
List pump stations located between the project connection point and the WWTP:
or along the route of this
(A) (R) (C) (D)=(B+C) tE)=CA-D)
Design Obligated,
Pump Average Daily Approx, Not Yet Total Current
Station Firrn Row** Current Avg. Tributary 'How Plus
(Name or Capacity,* (Firm / 0), Daily Flow, Daily Flow, Obligated Available
Number) MOD MOD MOD MOD Flow Capacity***
* 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 23.
*** 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 < O.
Page I. of 6
rTS

111. Certification Statement:
Ni0k1 certify to the best of my knowledge that the addition of
the volume of wastewater to be permitted in this project has been evaluated along the route to the
receiving wastewater treatment facility and that the flow from this project is not anticipated to
cause any capacity related sanitary sewer overflows or overburden any downstream pump station
en route to the receiving treatment, plant under normal circumstances, given the implementation
of the planned improvements identified in the planning assessment where applicable. This
analysis has been performed in accordance with local established policies and procedures using
the best available data. This certification applies to those items listed above in Sections I and It
plus all attached planning assessment addendums for which I am the responsible party.
Signature of this form indicates accep4ce of this wastewater flow.
Date
Page 2 of 6
FTSE 08- 3

037
Prateitcry
Non -discharge
6
Permit Type
r vwty Sewer FxterasPump SSt farm
Pw°rraaary Revl
bar ove
Chas t VPiale
Pennine Flow
1,440
P"ac,slty Name
M. a Five
e Address
Pre
urn e t Extensions
Owner Name
City of Mount Holly
Central FH s. APS
Pi Tracking li
Active
Version
1.tit
Project Type:
New Project
individual
Permit Contact a4t alixfion
P
7/612015
Majorla wrar Region
Minor I lccreswrllle
6a tt clas8 d
t rl Issue APP Received t rx t tsaltBat e issuance
7a6P2616 6/291201 a
d Aar
Subdivision
ody Name
Public l4cstacs
aex t¢arawber
Faelllty aritect ttt'sll taa
(astwar
rouser Type
Graiernment m Mph up
Owner A,ttillxticrr
Danny Jackson
City Manager
PO Box 406
Mt Holly
7/612015
Casa rat k s:
Entrench
716t201
NC 291211
Satins