WQ0034082_Regional Office Historical File Pre 2018

•
ATA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coieen H. Sullins Dee Freeman
Governor Director Secretary
June 3, 2009
Mr. Doug Armstrong, Director of Facilities Planning and Construction
Novant Health, Inc.
200 Hawthorne Lane
Charlotte, NC 28204
Subject: Permit No. WQ0034082
Presbyterian Hospital - G Wing Expansion
Tax Parcel #127-038-01
C-MU Tracking # 600-09-550
Wastewater Collection. System Extension
Mecklenburg County, North Carolina
Dear Mr. Armstrong:
In accordance with your complete application received on May 27, 2009 we are forwarding
herewith Permit No. WQ0034082, dated June 3, 2009, to Novant Health, Inc., 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date of issuance until rescinded, and shall be subject to the conditions and limitations as specified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.
Mooresville Regional Office
Location: 610 East Center Ave., Suite 301 Mooresville, NC 26115
Phone: [phone] Fax: [phone] Customer Service: 1-877-623-6746
Internet: www.ncwaterquality.org
An Equal opportunity 1 Affirmative Action Employer — 50% Recycled110% Post Consumer paper
NonrthCarolina
Naturally

Mr, Doug Armstrong
Page 2
June 3, 2009
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 for the
construction and operation of approximately 62 linear feet of 8-inch gravity sewer and the discharge of
18,750 gallons per day of collected domestic wastewater into the Charlotte Mecklenburg Utilities existing
sewerage system 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 Environrnent and Natural
Resources and considered a part of this permit.
The sewage and wastewater collected by this system shall be treated in the Sugar Creek tNTUP
(NPDES No. NC0024937) prior to being discharged into the receiving stream,
Assessing subsequent impacts to the downstream collection system is the complete
responsibility of Charlotte Mecklenburg Utilities. Charlotte Mecklenburg Utilities must utilize whatever
tracking tools necessary for planning additions of sewer flow in order to maintain compliance with the
WQCS00001 permit requirements.
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 Mr. Michael Parker at
[phone].
Electronic copies'
Cc:
Sincerely,
6 gl-------
fbr Coleen H. Sullins
Meredith Moore, Mecklenburg County Development of Water Quality
Barbara Gross, CMU
Philip Edwards, Mecklenburg County
Wesley E. Sherrill, P.E., Site Solutions
Mooresville Regional Office, Collection System Permit File
Surface Water Protection Central Files
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 2B .0506(a), and public notice shall be provided as required by
North Carolina General Statute §143-215.1 C.
1

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.
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 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 2T. the
Division's Gravity Sewer Design Criteria adopted February 12, 1996 as applicable; the Division's
Minimum Design Criteria for the Fast -Track Permitting of Pump Station and Force Mains adopted
June 1, 2000 as applicable; and other supporting materials may subject the Permittee to an
enforcement action by the Division, in accordance with North Carolina General Statutes §143-
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 28 .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 28 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, lane
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 3rd day of June, 2009.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
for Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number WQ0034082

Permit No, WQ0034082
June 3, 2009
Owner/WQCS
Doug Armstrong
200 Hawthorne Lane
Charlotte, NC 28204
PE
Wesley Sherrill, P.E.
Site Solutions
2320 W. Morehead Street
Charlotte, NC 28208
WQCS/WWTP
Barbara Gross
CMU
5100 Brookshire Blvd
Charlotte, NC 28216
Complete and submit this 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 khan es resu9tin in non-comtiance with this
regulations or r`ninirnun' de
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.
ENG EER' CERTIFICATION
Parti
0 Final
as a duly registered Professional Engineer in the State of North Carolina,
having been authorized to observe (Eil periodically, LI weekly, [I full time) the construction of Presbyterian
Hospital - F Wing Expansion, a Mecklenburg 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.

0
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0
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'USE THE TAB KEY TO MOVE FROM FIELD TO FIELD!
OwnerlPermittee:
la. NovantHealth, Inc.
Full Legal Name (company mundclpahtj, FfOA, utility, etc.)
1 b. Doug Armstrong- Director ttf FacilltGes PGann ng and Construction
Signing Official Name and Title (Pleas
lc, The legal entity who will own this syst+
0 Individual DI Federal 0 Municipal'
Id, 2(t0 Hawthorne Lane
Mailing Address
if. NC
State
h [phone],..
Telephone
Project (Facility) inform.
Presbyterian, Hr spital! — G W n Exgans ran mm
Brief Project Name (permitwili r er to this nay
Contact Person °
r.-
3a. Nlesle Y -Ser
Sherrill — Site Solutions
Name and Affiliation of Someone Who
3b. [phone]
Phone Number
1. Project is ► New
0
Application Number:
(to be completed by CWC7y
A NCAC 2T .0106 (b) for authorized signing
I
unty 0 Private Partnership Eg Corporation 0 Other (specify):
1e Charlotte
City
1 g 282'04 �....._
Zip Code
ij. darmstrong j pvanthealth.org
E-mail
n Answer
2b. Mpcktrburg_..__...,
County Where P
odifPeahon (of an existing permit) If Modi
2. Owner is 0 PuM c (skip to item B(3)) Private (go to
2a. tf private, applicant will be,
Retaining Ownership (fe, store, church, single office, etc_) or
© Leasing units (lots, townhomes, etc. - skip to ftem 8(3))
0 Selling units (lots, townhomes, etc. - go to Item B(2b))
Charlotte Meckli
Owner of 41 rift
4a, Sugar Creek
Name of WWTF
is Application
wsherril sate
utionsp a_co
p, facfflties awned by a (must choose one)
© Public Utility (Instruction C)
❑ Homeowner Assoc./Developer (Instruction D)
aburgUtility D partment tCMUD)
r Treatment Facility (VVINTF) Treating Wastewater From This Protect_
Project
4. NG0024937
WVWTF Permit No.
5a, CMUD =5b. 8-inch
©wryer of Downstream SeeriReceiving Sewer Sze 0 Force
8 The origin of this wastewater. is (check. all that apply):
© Residential Subdivision
© Apartments/Condominiums
© Mobile Home Park
0 School
© Restaurant
0 Office
Permit # of Downstream Sewer (In strtic tltrn E
[0 Retail (Stores. shopping centers)
© Institution
® Hospital
p Church
] Nursing Home
0 Other (specify):
7. Volume of wastewater to t eallo aced or permitted for this particular p
'Do not include future flows or previously permitted allocations
8. If the permitted flow is zero, indicate why:
© Pump Station, Outfall or Interceptor Line where flow will be permitted in s rbsec went permits that connect to this line
[ , Flow has already been allocated in Permit No.
0 Rehabilitation or replacement of existing sewer with no new flow expected (see 15A NCAC 02T .0303 to determine if a
permit is required)
i-0 % Domestic/Commercial
Industrial (attach
descnpton )
(RO. contact your Regional Office
Pretreatment staff)
°Y© Other (specify):
ect:
18,750 gallons per day
1 1"A 12i07

9. ' Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2T .0114 for
the vatue 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).
75 additional plumbing fixtures x 250 gpd = 18,750 gpd
Fixtures were used instead of beds because this project does not include the addition of any beds.
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (Inches)
Length (feet)
New Gravity or Additions!
Force Main
8
62
gravity
Q
11. Summary of Pump Stations w! associated Force Mains to be Permitted (attach additional sheets as necessary)
W
Pump Station Location ID (self chosen - as shown on plans/map for reference)
Z
O•
O.
- --
Design Flow Power Reliability Option
(MGD) Operations{ Point 1 - permanent generator w1ATS;
GPM @TDH 2 - portable generator wlMTS
...-_. _. __...-_.-
Force Main Size
----
Force Main Length
- -
Z
0
17,
Pump Station Location ID (self chosen.-
as shown on planslmap
for reference)
E
Ct
Design Flow
! Operational Point
(MGD) 1 GPM @TDH
1
Power Reliability Option ,
1 - permanent generatorwlATS;
2 - portable generator wlMTS
Force Main Size
Force Main Length
Z
1-
c
Pump Station Location ID (self chosen • as shown on planslmap for reference)
dDesign
m
Flow T
(MGD) Operational Point
1 GPM @TDH
Power Reliability Option
1 - permanent generatorwlATS;
2 - portable generator wIMTS
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 ❑ No If Yes, permit number of 2nd treatment facility NC0024970, NC0024945
(RO - if "yes" to B,12 please contact the Central Office PERCS Unit)
13. Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force
Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC Chapter 2T as
applicable?
® 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 TO THE VARIANCE WITH YOUR APPLICATION
FTA 12/07

14_ Have the following permits/certify dans'been sub for approval for the system or project to be served''
'WetlartdfStream Crossings - General Permit or 401 Certification? 0 Yes 0 No ® N/A
Sedimentation and Erosion Control Plan? 0 Yes 0 No N/A
Stormwater? 0 Yes 0 No ® N/A
15 Does this project include any high priority Hines, [see 15A. NCAC 02T 0402 (2)1involveaerial liras, siphons, or interference
manholes)? These lines will e consid red high priority and must be checked once every six monttry
Check it Yes 0 and provide details
1. ©wnerrPermitteeIs Certification. (Signature of irgning Official and Project Name)
to
Armstrong , attest that this application for Presbyterian Hospi of G Wing
Ex artsia?t has been reviewed by me and is accurate and complete to the best of my knowledge, 1 understand that if
d parts of this application are not completed and that if all required supporting documentation and attachments
chided, this application package is subject to being returned as incomplete, Note In accordance with North
General Statutes 143-215.6A and 143-215.68, any person who knowingly makes any false statement,
representation, or certification in any plication shall be guilty of a Ciass 2 misdemeanor, which may include a fine not
d $ 00 as well s civil peles up to $25,000 per violation,
Signing {ffca,`* r;_ttre
Date
ENGINEERING DESIGN DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL OF THiS
APPLICATION. THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR PROXIMITY
of) TO OTHER UTILITIES, D'ESiGN CALCULATIONS, ETC, REFER TO 15A NCAC 02T _0305
Z
0
1- 2. Professional Engineers Certification: (Signature of Design Engineer and Project Name)
1, 'Wesley E, Shertall .attest that this appcation for Presbyterian 1-lospital- GWing_ has been reviewed by me
l8 and is accurate, complete end consistent with the information in the engineering plans, calculations, and all other
j . 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 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 143-215.6A and 143-215.68, any person who knowingly
makes any false statement, representation, or certification in any applcatlon 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 v/olatlon
2a. Wesley E, Sherrill
Professional Engineer Name
2b. Site Sotutrons
F
2c, 2320 W, Morehead Street
Mailing Address
2h. _...(704)52
FacsimP
FTA1?.(r7

CHARLOTTE
CHARLOTTE-MECKLENBURG
UTILITIES
March 16, 2009
Mr. Tristan McMannis
Site Solutions
2320 West Morehead Street
Charlotte, NC 28208
SUBJECT: WATER AND SEWER FLOW ACCEPTANCE
PRESBYTERIAN HOSPITAL — G WING EXPANSION
TAX PARCEL# 127-038-01
C-MU TRACKING# 600-09-550
In response to your request, a flow acceptance study of the subject site has been completed and the
following has been determined:
Charlotte -Mecklenburg Utilities agrees to accept the net gravity sewage flow of 18,750 gallons per day
(75 additional plumbing fixtures x 250 gpd/fixture) from this project for transmission to the Sugar Creek
Wastewater Treatment Plant; NPDES permit number NC0024937, for treatment. This acceptance of flow
is based on the existing capacity of the designated publicly owned treatments works. Please see
attached basin map and flow tracking form.
Charlotte -Mecklenburg Utilities agrees to furnish water to the subject project. The water quality to the
subject project is regulated by the State Drinking Water Act Amendments of 1986 and The Water Supply
Management Plan, dated October 2005, (WSMP # 05-01702 & PWS ID # 0160010) on file with the Public
Water Supply Section of NCDENR. However, CMU cannot guarantee a constant pressure or quality of
flow.
Charlotte -Mecklenburg Utilities does not expect any of the above conditions to preclude water or sewer
service to the subject site. However, the applicant should understand that due to the involvement of other
agencies and continuing growth of the water and sewer system, the ability to provide service for future
projects cannot be guaranteed nor reserved. Connection to the CMU system is accepted on a first come,
first served basis.
The applicant should understand that this letter is not authorization to construct private water or sewer
systems, as the appropriate local or State permits are required prior to construction. if the appropriate
authorization to construct permits are not obtained and construction has not started within one (1) year of
issuance of this flow acceptance: and payment for any service connection(s) has not been received within
(1) year of issuance of this flow acceptance, this flow acceptance approval shall be rescinded and a new
flow acceptance request must be made. If you have any questions, please do not hesitate to contact me
at [phone].
Barbara Gross
Engineering Assistant
New Services Section
CHARLOTTE-MECKLENBURG UTILITIES
Customer Service Division • New Services Section
www.cmutilities.com
5100 Brookshire Boulevard
Charlotte, NC 28216
Ph: 704/399-2221
Fax: [phone]' 9

Charlotte -Mecklenburg Utilites
TP Service Areas w`sth Basins

c. WWTP facility's pennitteed flow
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
f Total flow f©r this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
State of North Carolina
Departnyent of Environment and Natural Resources
Division of Water Quality
Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE --10/07)
Project Applicant Name:
Project Name for which fl
More than one FTSE- 10/07 ma
pump stations along the route
e 1ut on
is being requested: _PLC ...ttosrp t a1 - c 'king ExpansY.or�
5e reguireel rr cr lragdc projeeowner cr "the WPM) is sac t risponsibleJOr all
he proposed 114: stewater fiow.
1, Complete this section only if you are the owner of the wastewater treatment plant.
a.. WWTP Facility Name: McAlpine Creek,
ek, Sugar
NC30245, NC0024937
b.
WWTP Facility Permit �#: Nc0 ©24 970 49
.._ d--_-- ..�,
All flows are in l 'lGD
99.0 ..
11.97
0.01875
77..32
78r:
Ii. Complete this section for each pump station you are responsible fear along the route of this
proposed wastewater flow.
List pump stations located between the project connection point and the WWTP
Pump Station Name
Approx. Capacity, i GD Approx. Current Avg.
(Firm/I)esign) Daily Flow, MGD
ation. Statement:
a mh ee w�� , certify that, to the best of my knowledge, the addition of the
e 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. 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 II for which I am the responsible party. Signature of this fora indicates
acceptnee of this ater flow,
Signing
Signature
Date

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80°51.000' W
80°51.000' W
TM! map printed on 03/27/09 from "North Carolina.tpo" and "Untitled.tpg"
80°50.000' W 80°49.000' W
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Fnnke3 ftpsn TO 0! 6 i t01 Nafxarwal0o r pirrc li°Idings f a r w tope corn)
WGS84 80°48.000' W
WGS84 80°48.000' W

Hospit

North Carolina Secretary of State Page 1 of 1
North Carolina
Elaine F. Marshall DEPARTMENT OF THE
Secretary SECRETARY OF STATE
PO Box 29622 Raleigh, NC 27626-0622 (919j807-2000
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Corporation Names
Name Name Type
NC Novant Health, Inc. Legal
NC Presbyterian Health Prev Legal
Services Corp.
Non -Profit Corporation information
SOSID: 0116543
Status: Current -Active
Date Formed: 4/1/1983
Citizenship: Domestic
State of Inc.: NC
Duration: Perpetual
Registered Agent
Agent Name: McGee, Lawrence U
Registered Office 2085 Frontis Plaza Boulevard
Address: Winston Salem NC 27103
Registered Mailing 2085 Frontis Plaza Boulevard
Address: Winston Salem NC 27103
Principal Office Address: Accounts Payable Dept.
PO Box 25686
Winston-Salem NC 27114
Principal Mailing
Address:
No Address
http://www.secretary.state.nc.us/corporations/Corp.aspx?PitemId=4931559 5/28/2009

Permit Number WQ0034082
Central Files: APS SWP�
06/03/09
Permit Tracking Slip
Program Category
Non -discharge
Permit Type Fast Track
Gravity Sewer Extension, Pump Stations, & Pressure Sewer
Extensions
Primary Reviewer
michael.parker
Coastal SW Rule
Permitted Flow
18750
Facility
Facility Name
Presbyterian Hospital - G Wing Expansion
Location Address
Owner
Status
Active
Project Type
New Project
Version Permit Classification
1.00 Individual
Permit Contact Affiliation
MajorlMinor
Minor
Region
Mooresville
County
Mecklenburg
Facility Contact Affiliation
Owner Name
Novant Health Inc
Dates/Events
Owner Type
Non -Government
Owner Affiliation
Doug Armstrong
& Construction Director Facilities Planning of
200 Hawthorne Ln
Charlotte NC 28217
Orig Issue App Received Draft Initiated
06/03/09 05/27/09
Regulated Activities
Hospital
Wastewater collection
Outfall NULL
Scheduled
Issuance
Public Notice Issue
06/03/09
Requested/Received Events
Additional information requested
Additional information received
Effective Expiration
06/03/09
Waterbody Name
Stream Index Number Current Class
Subbasin

Permit No, WQ0034082
June 3, 2009
OwnerfWQCS
Doug Armstrong
200 Hawthorne Lane
Charlotte, NC 28204
PE
Wesley Sherrill, P,E,
Site Solutions
2320 W. Morehead Street
Charlotte, NC 28208
WQCS/WWTP
Barbara Gross
CMU
5100 Brookshire Blvd
Charlotte, NC 28216
Complete and submit this 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 pny chancres resulting in non-compliance with this permit,
rrulations or minirnum 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' a CERTIFICATION
Ej Partial
Final
sa# I. sietzu. as a du registered Professional Engineer in the State of North Carolina,
having been authorized to observe $ periodically, E] weekly, Eli full time) the construction of Presbyterian
Hospital - F Wing Expansion, a Mecklenburg 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,
4

Novant HEALTH
Remarkable People Ie. Remarkable Medicine
TRANSMITTAL
Date: June 10, 2009
To:
Wesley Sherrill, P.E.
Site Solutions
2323 W. Morehead Street
Charlotte, NC 28208
From:
Doug Armstrong
Director
Facilities Planning, Design and Construction
Nova t Health
PO Box 33549
Charlotte, NC 28233-3549
Reference:
Permit No. WQ0034082
Presbyterian Hospital — G Wing Expansion
Tax Parcel #127-038-01
C-MU Tracking # 600-09-550
Wastewater Collection System Extension
Mecklenburg County, North Carolina
sage:
Attached is Permit No. WQ0034082 for the G-Wing Expansion from
the NCDENR. Send the form and supporting documentation with
regi sired attachments to the following address with proof of receipt
by the vision.
Mooresville Regional Office
Surface Water Protection
610 East Center Avenue, Suite 30
Mooresville, NC 28115