WQ0040200_Regional Office Historical File Pre 2018

MICHAEl.,: S,
A C I.TEPPER
intertrrr
August 7, 2018
Mr, Sam Misuraca, Manager
WEST BLOOMFIELD ACRES, LLC
821 West Eleven Mile Road
Royal Oak, MI 48067
Subject: Permit No.. W00040200
WEST BLOOMFIELD ACRES, LLC
SteelFab Farce Main Relocation
Wastewater Collection System Extension Permit
Mecklenburg County
Dear Mr. Misuraca:
In accordance with your application received August 3, 2018, we are forwarding herewith Permit No.
WQ0040200 dated August 7, 2018, to WEST BLOOMFIELD ACRES, LLC (Permittee) for the construction and
operation upon certification of the subject wastewater collection system extension. This permit shall he
effective from the date of issuance until rescinded, and shall be subject to the conditions and limitations
as specified therein, This cover getter shall be considered a part of this permit and is therefore
incorporated therein by reference.
Please pay particular atten
n to the following conditions contained within this permit_
Condition II.i. This permit shail not be automatically transferable; a request must be made and
approved,
Condition 1i.4: Requires that
ewater collection facilities be properly operated and maintained
to accordance w th 1.5A NC,AC 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, 6.714 Mail Service Center, Raleigh, NC
27699-6714, Unless such demands are made, this permit shall be final and binding.
State o1Nor,th c,. 3rohrta
>'`Nothing Compares` L t,
Quality Water Resources V:Vateri)a,aiir Re,„o;,n1G eratzt
M,xxr ., 11: Retoonal Office ` ik;t 4',a t rater ; to k,€ �t�[t maC}3 Uicra�r swtl
704 4563- i 644

If you need additional information concerning this matter, please contact Barr Love at (7 ) 235-2143
or via e-mail at barryiove@ncdenr,gov.
Sincerely,
DocuSigned by:
L'"
41- v il P4.4.4
F161FB69A2D84A3,„ for
byW. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section.
Mooresville Regional Office
Division of Water Resources, NCDEQ
cc: Jay Banks, P.E. (e-copy)
Charlotte Water (e-copy)
Tommy Rowland (e-copy)
Regional Office Files
Water Resources Central Files
PERCS (e-copy)
2

Environmental
Quality
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations, permission is hereby granted to
WEST BLOOMFIELD ACRES, LLC
- Mecklenburg County
for the construction and operation of approximately 1,120 linear feet of 6-inch force main (line relocation)
as part of the SteelFab Force Main Relocation project, and no new discharge of collected wastewater into
the Charlotte Water existing sewerage system, pursuant to the application received August 3, 2018, and
in conformity with 15A NCAC 2T; the Division's Gravity Sewer Minimum Design Criteria adopted February
12, 1996, as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump
Stations and Force Mains adopted June 1, 2000, as applicable; and other supporting data subsequently
filed and approved by the Department of Environmental Quality and considered a part of this permit. ,
This permit shall be effective from the date of issuance until rescinded and shall be subject to the specified
conditions and limitations contained therein.
,-DocuSfgned by:
for
-F161 FB69A2D84A3...
byW. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional Office
Division of Water Resources, NCDEQ
Permit Number: WQ0040200
Permit Issued: August 7, 2018
3

SUPPLEMENT TO PERMIT COVER SHEET
WEST BLOOMFIELD ACRES, LLC 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 Charlotte Water Irwin Creek
Wastewater Treatment Plant in accordance with Permit Number NC0024945.
Permitting of this project does not constitute an acceptance of any part of the project that does not meet
1.5A NCAC 2T; the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996, as
applicable; and the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and
Force Mains adopted June 1, 2000, 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.
Construction and operation is contingent upon compliance with the Standard Conditions and any Special
Conditions identified below.
SPECIAL CONDITIONS
No new flow shall be made tributary to the subject sewer system until an application for permit
modification for an increase in flow has been submitted to and approved by the Division. [15A NCAC
027.0304(b)1
This permit shall become voidable unless the agreement b
Charlotte Water for the collection and final treatment of
NCAC 02T.0304(h)1
Il. STANDARD CONDITIONS
ween WEST BLOOMFIELD ACRES, LLC and
as water is in full force and effect, [15A
This permit is not 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. [1.5A NCAC 02T.0104; G.S 143-215.1(d3)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'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 materials unless specifically mentioned herein, ['15A NCAC 02T.01101
4

3. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data. [15A NCAC 02T .0110]
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 NCAC 2T .0403. if an individual
permit is not required, the following performance criteria shall be met: [15A NCAC 02T .0108(b)]:
a. The sewer system shall be effectively maintained and operated at all times to prevent discharge
to land or surface waters, and to prevent any contravention of groundwater standards or surface
water standards.
b. A map of the sewer system shall be developed and shall be actively maintained. .
c. An operation and maintenance plan including pump station inspection frequency, preventative
maintenance schedule, spare parts inventory and overflow response has been developed and
implemented.
d. Pump stations that are not connected 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 -months and inspections are
documented.
f. A general observation of the entire sewer system shall be conducted 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 §143-215.1C.
h. A Grease Control Program is in place as follows:
1. For public owned collection systems, the Grease Control Program shall include at least
biannual distribution of educational materials for both commercial and residential users and
the legal means to require grease interceptors at existing establishments. The plan shall also
include legal means for inspections of the grease interceptors, enforcement for violators and
the legal means to control grease entering the system from other public and private satellite
sewer systems.
2. For privately owned collection systems, the Grease Control Program shall include at least bi-
annual distribution of grease education materials to users of the collection system by the
permittee or its representative.
3. Grease education materials shall be distributed more often than required in Parts (1) and (2)
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.
5

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,
The Permittee shall report by telephone to a water resources staff member at the Mooresville
Regional Office, telephone number [phone], as soon as possible, but in no case more than 24
hours, 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 S50 and/or spill over 1,000 gallons; or
c. Any SSO and/or spill, regardless of volume, that reaches surface water
Voice mail messages or faxed information is permissible, but this shall not be considered as the initial
verbal report. Overflows and spills occurring outside normal business hours may also be reported to
the Division of Emergency Management at telephone number [phone] or [phone].
Persons reporting any of the above occurrences shall file a spill report by completing and submitting
Part I of Form CS-SSO (or the most current Division approved form) within five days following first
knowledge of the occurrence. This report must outline the actions taken or proposed to be taken 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. [G.S. 143-215.1C(a1)]
6, 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. (15A NCAC 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 a violation of the permit and shall subject the Permittee to
appropriate enforcement actions.
If the permit is issued to a private entity with an Operational Agreement, then a copy of the Articles
of Incorporation, Declarations/Covenants/Restrictions, and Bylaws that have been appropriately
filed with the applicable County's Register of Deeds office shall be submitted with the certification.
A complete certification is one where the form is fully executed and the supporting documents are
provided as applicable. Supporting documentation shall include the following:
a. One copy of the project construction record drawings (plan & profile views of sewer lines & force
mains) of the wastewater collection system extension. Final record drawings should be clear on
the plans or on digital media (CD or DVD disk) and are defined as the design drawings that are
marked up or annotated with after construction information and show required buffers,
separation distances, material changes, etc.
6

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 to flush low points in
force mains with a pump cycle, and downstream sewer capacity analysis. !f a 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
timeframes, shall be provided.
c. Changes to the project that do not result in non-compliance with this permit, regulations, or the
Minimum Design Criteria should be clearly identified on the record drawings, on the certification
in the space provided, or in written 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 of 10% or greater, increased flow,
pump station design capacity design increases of 5% or greater, and increases in the number/type of
connections), regulations, or the Minimum Design Criteria. Requested modifications or variances to
the Minimum Design Criteria will be reviewed on a case -by -case basis and each on its own merit.
Please note that variances to the Minimum Design Criteria should be requested and approved during
the permitting process prior to construction. After -construction requests are discouraged by the
Division and may not be approved, thus requiring replacement or repair prior to certification &
activation. [15A NCAC 02T .0116]
8. Gravity sewers installed greater than ten percent below the minimum required slope per the Division's
Gravity Sewer Minimum Design Criteria shall not be acceptable and shall not be certified until
corrected. If there is an unforeseen obstacle in the field where all viable solutions have been
examined, a slope variance can be requested from the Division with firm supporting documentation.
This shall be done through a permit modification with fee. Such variance requests will be evaluated
on a case -by -case basis. Resolution of such request shall be evident prior to completing and submitting
the construction certification. [ 15A NCAC 02T.0105(n)]
9. A copy of the construction record drawings shall be maintained on file by the Permittee for the life of
the wastewater collection facilities. [15A NCAC 02T .0116]
10. 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,
construction of additional or replacement wastewater collection facilities, and/or referral of the North
Carolina -licensed Professional Engineer to the licensing board. [15A NCAC 02T .0104; 15A NCAC 02T
.0108(b-c)]
11. 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.
[15A NCAC 02T .0110; 15A NCAC 02T .0108(b)]
7

12, The issuance of this permit shall not exempt the Perm nee from complying with any and all statutes,
rules, regulations, or ordinances that may be imposed by the Division any other Federal, State, or
Local government agencies which have jurisdiction or obtaining other permits which may be
required by the Division or any other Federal, State, of Local government agencies. [G.S. 143-
215,1(b)

FAST TRACK SEWER ENGINEERING CERTIFICATION
PERMITTEE:
PERMIT #:
PROJECT:
ISSUE DATE:
WEST BLOOMFIELD ACRES, LLC
WQ0040200
SteelFab Force Main Relocation
August 7, 2018
This project shall not be considered complete nor allowed to operate in accordance with Condition 7 of
this permit until the Division has received this Certification and all required supporting documentation. It
should be submitted in a manner that documents the Division's receipt. Send the required documentation
the Regional Supervisor, Water Quality Regional Operations Section at the address at the bottom.
Any wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Certification shall be considered a violation of the permit and shall subject the Permittee to
appropriate enforcement actions. The Permittee is responsible for tracking al! partial certifications up
until a final certification is received. A Final Certification shall be a complete set of record drawings and
design calculations regardless of whether partials have been submitted.
PERMITTEE'S CERTIFICATION
I, the undersigned agent for the Permittee, hereby state that this project has been constructed pursuant
to the applicable standards & requirements, the Professional Engineer below has provided applicable
design/construction information to the Permittee, and the Permittee is prepared to operate & maintain
the wastewater collection system permitted herein or portions thereof.
Printed Name, Title
Signature Date
ENGINEER'S CERTIFICATION
I, , as a duly registered Professional En ineer in the State of North Carolina,
having been authorized to observe (n periodically, ❑ weekly, full time) the construction of the
project name and location as referenced above for the above Permittee hereby state that, to the best of
my abilities, due care and diligence was used in the observation of the construction such that the
construction was observed to be built within substantial compliance of this permit; 15A NCAC 02T; the
Division of Water Resources' (Division) Gravity Sewer Minimum Design Criteria adopted February 12,
1996, as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations
and Force Mains adopted June 1, 2000, as applicable; and other supporting materials.
North Carolina Professional Engineer's Seal w/signature & date:
❑ Final ❑ Partial (include description)
Certification Comments/Qualifiers (attach if necessary):
State of North Carolina I Environmental Quality 1 Water Resources{ Water Quality Regional Operations
Mooresville Regional Office' 610 East Center Avenue, Suite 301 'Mooresville, North Carolina 78115
704 663 1699

_DIvislon: of .Water:.Rescurces
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: tAi Q 00 aRO° (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: West Bloomfield Acres, LLC (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal El State/County ❑ Municipal
3. Signature authority's name: Sam Misuraca per 15A NCAC 02T .0106(b)
Title: Manager
4. Applicant's mailing address: 821 West Eleven Mile Road
City: Royal Oak State: MI Zip: 48067-
5. Applicant's contact information:
Phone number: [phone] Email Address: Sam@,oakridgemgt.com
❑ Other
II. PROJECT INFORMATION:
1. Project name: SteelFab Force Main relocation
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ00 and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Mecklenburg
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.2263° Longitude:-80.9809°
5. Parcel ID (if applicable): 113-391-21
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Jay Banks License Number: 28307
Firm: Banks Engineering
Mailing address: 1919 South Blvd. Suite 200
City: Charlotte State: NC Zip: 28203-
Phone number: [phone] Email Address: [e-mail]
W. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Irwin Creek WWTP Permit Number: 0024945
Owner Name: Charlotte Water
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s): Charlotte Water (formerly CMUD)
FORM: FTA 04-16 Page 1 of 5

GENERAL REQUIREMENTS
If the Applicant is a Privately -Owned Public 1 tiIty. has a Certificate of Public Convenience and Necessity been attached?
0 Yes 0No "'N/A
lithe Applicant is a Developer of lots to be sold, has a Do doper's (...)perittiona C nem ft)R\ 1„)1Aj been au:ached?
0 Yes 0No MIN/A
If the Applicant is a I tome/ Property 1),e, ners: hk, a 01 6:211e lowal been atlacher
0 Yes 0No ENIA
4. Origin of ,i.vasiewater, (check all that. apply):
E Residential Owned
LJ Residential 1.„„eased
0 School / preschool / day cane
0 Food and drink facilities
'0 Businesses I offices/factories
Retail (stores, centers, malls)
0 Retail v ith lood p parationtservi e
Li Medical veterinary facilities
Church
Nursing
5. Nature of wastewater : 100 Domestic/Commercial '14i. Commercial
Industrial ESee 1.5.A NCACO21 .0104_20i)
Is there a Pretreatmcn¢ Program in effect?
6. Flas a flow reduction hen approved tinder I 5A NCAC 02T J.1111410?
If yes, provide a copy of Row reduction approval letter
7. Summarize wastewater generated by project:
:stahlishment Type (see 02T .0 II 4(q)
—ar Wash
Aotel and/or Motels
Swimming Pool /Clubhouse
0 Swimming Pool/Filter Backwash
0 Other (Explain in Attachment.I
0 Ye LJNo
'es EY] No
Daily Design Flow
gO
No. of Units, FIo
GI'D
gal.'
gal/
CiPD
CiPD
CPI)
gal GPD
gal/ GPD
Tow/ 1 0 GPD
a See I5.ANSSs\S1,..02:11.„2114.1b1,...td.hsej1tattiillsk2..] for caveats to Wastewater design flow rates ( i,c,„ minimuill '110W per
dwelling: proposed unknown uon-residential development uses; public access facilities located near high public use areas;
and residential property located south or dim i-)f the Atlantic Intracoastal \Voterway to he used as vacation rentals as defined
in ( . 42A-4).
h Pci 1 5A NCAC 021 .01 14(c), design flow rates far establishments not identified lin table 15A NCAC 02„LO 4111 shall he
determined using, 'available flow data. W ter using fixtures, occupancy or operation patterns, and other measured data,
Wastewater generated by project: 0 GPD (per I 5,A NCAC 021 „O 1 14 )
Do not include future. flows or previously permitted allocations
IfRertnitted flow is ,e,ero, indicate why:
LI Pomp Station or Gravity Sewer where flow will he permitted in subsequent permits that connect to this line
[1 Flow has already been .'illocated in Permit Number:
L1 Rehabilitation or replacement of existing sewer With no new flow expected
El Other (Expl
FORM: Fr A 01
Page 2 of 5

GRAVITY SEWI:.
°:RIA Of Applicable) -
Section I I& t I I ofthe ,41[)( for Perratitt l
Section III contains information related to tta
C e si in lines to meet minimum slope requirement is not a
PP STATION N I)I*SIGs;\ CRITERIA (If Applicable).— O21{ 0 C)5
COMPLETE FOR EA('U Pt„!.MP Si ATtC
1. lamp stati'e: West, I31aomliled ,Acres MliP
?. A proxir rrte Coordinates tf)ecinttal C:)t reest' l..tttitucle: 35,226+'
w. Design flow of the pump s'per dad (firm capac,
4. Operational points) of the prtntp('s;): allons per minute at feet total dy
Summarize the force main to be perrttatte.d ( for this Pump Station):
rebated to design c.r
Lion of the MLIC
I'ttttcl)_Statitansx'I`aarc
PROJL( r
6, PorVCr relish
dance
etlttired for all laaat tp sta€le t s vvitla an
lttst be. penttane:nt to 'facility
Or if the pump Static tt has an averse daily
or
Length (feet) Material
,e^ daily
00 gallons per clay;
mis head (TD1-11
5,000> ritonsper.day
Portable power source Nv°ith manual activation, quick -connection receptacle and telemetry - I5A NCAC 021'
.0305(h)(1)(C)
[� Portable punapint tattit r� ith ftlta gel ctrtt r cnc taatmp onnec-tiort tartcl telettac.tt
It shall be demonstrated to the Division he portable sourceis owned car c.e
and is compatible with the tion.
if the portable power source or purap is dedicated to multiple pump stations, an
capacities and the rotation schedule gibe portable power source or pump, including trav
in the case of a n ult ple station power outage.
d
i'0?l`.0305(h)(t)iO:
the applicant (draf) arch
orage
vided
)4-16
Page 3 of 5

I\, SETBACKS & SEPARATIONS - (028 .0200 & 15A NCAC 021" .0305(fTh
I, foes the project comply with all separations tbund in J.ANL.L.AL0.7.),
5A NCA.C102`1,0305(0 contains minimum. separations that shall berovided fOr SCNVCI SYSSeMS:
Setback Parameter* _Seatration Required. _
Storm sewers and other utilities not listed below (vertical) 24 inches
Water mains (vertical -water over SCWer including in benched trenches) 18 incites,
10 feet. „...,
Water mainshurintaI)
R.eclaimed water lines (vertical - reclaimed over sewer)
Reclaimed water lines (horizontal reclaimed over sewer)
**Any private or public water supply source, including any wells. WS-1 waters of Class I or -
Class II impounded reservoirs used. as a source of drinkipg svater
aters classified WS (except WS-1 or WS-V), 13, S.A. ORW, HQW, or SB from normal
(or tide elevation) and wetlands (see tern
18 inches
2 feet
100 feet
50 !eel
"Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches 10 feet
Any building foundation 5 feet
Any basement 10 feet
j np Sk2pe of embankment or cuts (.1 2keo more scrtal
10 feet
.)rainage systems and interceptor drains
' El .No
„5 feet
11) I 0 'feet
Ally SlVilliMin gloo S
earth grade (yertical) 36 inches:
I.5A NCAC 021,0305(e) contains alternatives vhere separations in 02'1.0305(1) cannot be aehieved,
**Stream classifications can he identified using the Division's NC Surface Water Classifications webpage
If noncompliance with 02'r,0305( 11 11 (0, see Section X °IOUs application
Does the project comply with separation requirements for Wetlands'? (50 feet of separation) n ' n \ N N/A
I. See .the Division's draft separation requirements for :situations where separation cannot be meet
No variance is required if the alternative design criteria specified is utilized in design and construction
As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per I5A 02B „0200? NsA
1 hissvotild include Trout Buffered Streams per I 5A NCAC 213..0202
4, Does the project require coverage/authorization under a 404 Nationwide or
individual permits or 401 Water Quality Certifications?
Information can be obtained from the 401 & Buffer Penunine Branch
Yes Z No
5. Does project comply with 15,A NCAC 02T„0 I tiNcit.6) (additional permits/certifications)? Z Yes El No
Per 15A NCAC 021 ,0105(c)(6), directly related environmental permits or certification applications are being prepared, have
been applied for, or have been obtained, Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormwater management plans. etc,),
6. Does this projectinclude any sewer collection lines that are deemed -high-priority?"
Per 021.0402, -high-priority sewer" means "any aerial sewer, sewer contacting surface. waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
Yes No F] NtA
If yes„ include an attachment kV 411 details for each Inc including type (aerial line, size, naicral, ani Incation)
High priority lines shall he inspected by the permittee or its representative at least once every six -months and inspections
documented per ISJ NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection .permit,
M: 1 1 A 04-16 Page 4 ot 5

CERTIF1C 4T1ONSt
I„ Does the submitted system comply
ompletc and submit the ti'arianceAltett�ra°
purov al of the request ks recto f red pr
Engirt
B nk,& PE
(Profssion.
i)esign
submi
A
:ion T l41 and supporting documents for
Tract Aim l afid t s: ! sua►tae+r tliug documents�
has been reviesv'ed by me and is accurate, complete and consistent vvitlt dire irafantration supplied in the plans, sp ificatic n w
=tiering calculations, and all other supporting documentation to rite istst of rn knowledge. 1 ftttther attest that to the best
knowledge the proposed deign has been prepared in accordance with dire applicable regulations„ Gravity Sewer
rrnum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under nay signs. ure and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE - In accordance with General Statutes 143-2.15.diA and 143_.2I5.6B, any person who knowingly makes any false
statement, representation, or cert'ilyration in arty' appli tion package shrill be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $ 1 0,000, as well as civil penalties up to $25,00(3 per violation.
A pp-c
North Carolina Prot'cssiotral'Engineer°s seal,
yn
'CAC 02T ,0I06(b):
A, on.
ccurate and complkt1 understand that tf all re aired parts of
placation are not cottapleted and that if all required supporting documentation and attachments are not included, this
application package as strb t t Ira being returned as incomplete. l understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. 1 will make rw claim against the Division of Water Resources should a condition
of this permit he violated. 1 also understand drat ifall required parts of this application package are not completed and that if
all required supporting information and attachments are not included, this application package will be returned to me as
incomplete,
d date;
NOTE - In accordance with Genera! Swint
statement, representation, or certification in any
include a fine not to exceed $10,000 as well as ci
FOR si: FTA 04-16
attest that this application to
any person who knowingly makes any false
guilty of a Class 2 misdemeanor, which mav
violation„
Date;
Page 5 of 5

Polar s 3G Map — Mecklenburg County, North Carolina
SteelFab Force Main reloc
er are
pubic reco
Date Printed: 6/26/2'018 11:16:46 PM
DIP san sew to be
0, re pro pertyweit` in eG e€t tarp aunty end uscarrcpr d `r +rn rec tde Beds p ata k ' nrspa Si ya
hat the aforwn ntjoned public pnmrrerti` infonrraiim
SponsbFlity fur [he information cQntamed her n- _

UNITED STATES
DEPARTMENT OF THE INTERIOR
GEOLOGICAL SURVEY
© ai E.
Prcp sed
a"0 I Sari, Sew.
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH
AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
4854 IV SW
CHARLO
35080-B
1993
DMA 11854 I KW-StiUtS V142

1919 South Boulevard. Suite 200
Charlotte, North Carolina 25'203
NM 704,905 0530 4 13 704 780.4972
Ibanks©.Pcivilbanks corn ; www.civi,Vbanks.corn
June 21, 2018
Re: SteelFab Force Main relocation —+/- 1,„120 If of 6" DIP force main relocation
To whom it may concern,
SteelFab is in the process of re -grading their storage/laydown yard immediately west of the fabrication
facility to allow direct access to the storage yard(s), Currently, there is an elevated internal access drive
between these areas that will be lowered +/- 10 feet to create an at grade condition. Within this access
drive are several utilities (Power, Fiber optic & Sanitary Sewer force main) that are owned by outside
parties and will be relocated to allow for grading activities. Fiber optic line relocation was completed
last month and will be followedby sanitary sewer force main / overhead power lines,
Proposed +/- 1,120 If force main will be on a parallel route approximately 75-130 feet east of the current
location. Existing size and pipe material is 6" ductile iron and will be replaced in kind. Existing pump
station is owned by West Bloomfield Acres and serves a residential mobile home community. Tax parcel
ID for the pump station is 113-391-21 and 113-122-59 for the force main.
Included in this submittal are the following:
Fast Track Application
Stream classification
Street map
USGS Map
NC Water classification map
NC Secretary of State pump station ownership information
Sincerely,
Banks Engineering, PLLC

Trans.
Date: 08.02.18
Job Number: 1000002
Project Name: St Fab access rd. — 6" Private force main 'ocation
To NCDEQ
5uote 20C
1919 South Boulevard
Charlotte, NC 28203
TEL 104,780,4972
Attn: Barry
610 L. Center Avenue
NC28115
704,23.5.2 "143
We are sending these by
U.S, Mail
Other:
FedEir
d Deliver
We are sending you
Attached
El Shop Drawings
n Other.
Copies
2
2
2
2
2 ...
2
1
1
Under separate cover
ants/Plans
Samples Specifications
the following it
Change Orders
Dote
06, 21.18
06.21,18
No, Description
Fast Track Application
NC Water classification map
Stream Classification
Street map
USGS map
NC Secretary of State -- Proof of business registration
Review fee check 5480
Cover letter
06.21.18
06, 21,18
06.21.18
06,21.1E
06,21,18
06.21.18
These are transmitted as checked below:
For your use n Approved as submitted
nAs requested n Approved es noted
For review and comment I 1 Returned for corrections
Copy to: Signed
Page I.
Resubmit
Submit
Return
Copies for approval
Copies for distribution
Corrected prints