WQ0038712_Sewer Extension Permit Status Update_20210708

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Governor ? i r �
DIONNE DELLI-GATTI
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Secretary ,`"' =.'`y
S.DANIEL SMITH NORTH CAROLINA
Director Environmental Quality --
June 15,2021
Kim Greenwood -
Town of Walnut Cove RECEIVED
PO Box130
Walnut Cove,NC 27052-0130 JUL 0 8 n21
Subject: , Engineering Certification Request
Town of Walnut Cove NCDEQ/DWRINPDES
Stokes County
Dear Permittee:
Based on a review of our records for permits issued during the period of 2016 through 2017, it appears that
the Division of Water Resources(Division) has not yet received a final engineering certification in accordance
with 15A NCAC 02T.0116,as well as the standard conditions of the permit,for the Wastewater Collection
System Extension Permit(s) listed below.
• Permit No.WQ0038712: Replacement of Three Sewage Pump Stations issued on 9/2/2016
If the permitted facility,or any portion of the facility,has been constructed and is in operation,a complete
engineering certification is required to be submitted prior to placing the,system into service. It should be
noted that failure to certify a sewer extension permit appropriately in accordance with the provisions of 15A
NCAC 02T.0116 may result in enforcement action.A complete certification is one that includes a copy of
the construction record drawings(plan and profile views of all sewer lines), pump station design
calculations(if applicable),and the certification form as provided with the original permit. Please note
that the Division may not acknowledge the receipt of certifications, however,the status can be viewed
at any time using our online Sewer Extension Permit Tracker located on the Municipal Permitting Unit
website.
If the permitted facility has not been constructed and will not be constructed,the Permittee may request
to have the permit rescinded by returning the attached Status Update form. If the Permittee no longer
owns the facility or the Permittee's name has changed, please return the attached Status Updaterequesting
information for ownership/name change. Please note that Permits are not automatically transferable in the
event the project site is now owned by others.
The Division requests a response from the Permittee by July 14,2021.
The Status Update form on the back of this letter should be completed and included with all submittals.
If you have any questions regarding this outreach program,please contact Collin Geersen via e-mail at
[e-mail]. Alternatively,voice mail messages can be left at(919)707-3608.
Sincerely,
Christyn L. Fertenbaugh, P.E., Environmental Engineer
Municipal Permitting Unit, Division of Water Resources
cc: Winston-Salem Regional Office,Water Quality Section Regional Operations[electronic]
Municipal Permitting Unit[electronic copy]
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Salisbury DepartmentStreet1 of1617 EnMailvironmentalServicecenter I Raleigh Quality I DivisionNorth of Water Resources
Carona 27699-1617
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Request for Engineering Certification Date of Letter: June 15,2021
Sewer Extension Permit Status Update
Please complete the applicable portion of this form for each permit and return this form and supporting documents by July 14,2021
to the attention of Collin Geersen at the Division's Municipal Permitting Unit by the delivery method below:
NCDEQ/DWR
WQPS—Municipal Permitting Unit
By U.S.Postal Service: By Courier/Special Delivery: By Email:
1617 Mail Service Center 512 N.Salisbury St.Suite 925 Collin Geersen
Raleigh, NC 27699-1617 Raleigh, NC 27604 [e-mail]
Permit No.:WQ0038712 Permittee: Town of Walnut Cove
Project Name: Replacement of Three Sewage Pump Stations
Project Status (Complete Signature&Date section below. Check appropriate box'to indicate Permittee's response.)
Name&Title(print):
Signature: Date:
Comments:
SEWER NOT YET CONSTRUCTED
❑ The Permittee certifies that the permitted project has not been constructed but shall be constructed in the future in conformity
with the approved Permit, project plans,specifications,and supporting documents.The Permittee understands that the
appropriate certification documents will need to be forwarded to the Division prior to operation. Subject permit shall be
maintained in Active status. NOTE: If sewer will never be built,please complete Permit Rescission Request section below.
SEWER HAS BEEN CONSTRUCTED
❑ Engineer's Certification: The Permitted project has been constructed and the required Certification page and supporting
documents are being submitted to the Division with this form.
OWNERSHIP/NAME CHANGE
❑ The Permittee requests information to apply for ownership or name change. Please provide email and phone number below for
follow-up.
Permit Rescission Request
The Permittee requests that the subject permit be rescinded and certifies that the permitted sewer system has not been and shall
not be constructed nor made operational.By signing below,we acknowledge that should we wish to operate a non-discharge sewer
system in the future,we shall apply for and receive a new Wastewater Collection System Permit. •
Name&Title( t): \ Y\ \`�`(�0.�` �
Signature: 1W�a ,y� Date: . _�,`
Comments:C��l,t�
Contact Information Updates for Permittee
Updated Contact Person&Title(Print):
Updated Mailing Address:
Updated Email: Updated Phone: