WQ0043564_Application_20220629

RECEIVED/NCDEQ/DWR
I. PRESUBMITTAL INFORMATION: W Qoo '/ 354
1. Contacted representative from regional office (Pre -submittal)?:❑ ® Yes 0
2. Contact name (For Regional Office): Ori Tuva
I1. APPLICANT INFORMATION:
1. Applicant's name (Municipality, Individual, Corporation, etc): Corporation
2. Applicant type: ❑ ❑ Municipal ❑ ❑ State ❑ ❑ Privately -Owned Public Utility
0 ❑ ❑ County El Other: lienejaI Contractor/Owner
3. Origin of Wastewater:
O r 0 Residential Subdivision
of
❑ ❑ Apartments/Condominiums
❑ ❑ Mobile Home Park
❑ ❑ School
❑ ❑ Restaurant
❑ ❑ Office
MAY 1 2 L022
WQROS
❑ NialOORESVILLE REGIONAL OFFICE
❑ ❑ Retail (Stores, Shopping Centers) Domestic:
❑ ❑ Institution
❑ ❑ Hospital
❑ ❑ Church
❑ ❑ Nursing Home
❑ ❑ Other (specify)
4,. Signature authority's name: Juan Gomez per 15A NCAC 02T .01061bl
Title: Operations Manager
S. Applicant's mailing address: 5009 Monroe Rd Sure 201
City: Charlotte State: NC Zip: 28205-
6. Applicant's contact information:
Phone number: (704)5-049
11I. CONTACT/CONSULTANT INFORMATION:
1. Contact name: George D. Barrier. PE
Title/Affiliation: Principal Engineer
2. Contact's information:
Phone number: [phone]
IV. RECEIVING FACILITY INFORMATION:
Email: juan@rivusl1c corm
Commercial:
Industrial:
Other:
Email: earolinasepticsysterns(d1carolina.rr.com
If more than 1 facility has agreed to accept the wastewater, please list all the owners, facility names, and permit
numbers as a separate attachment)
1. Owner: Charlotte Water
Z_Faciiity name: McAlpine Creek WWTP
3. Facility permit number:
4. WWTF permit number:
5. WWTF contact name: John Flap
Title/Affiliation: Manager
WWTF contact information:
Phone number: [phone] Email:
APPLICATION YKH 01-16 Page 3 of 5

VI. CERTIFICATION:
V. PROJECT INFORMATION:
1. Location of Project (physical address): 639, 643, 647, & 651 Tennyson Drive, Charlotte, NC
Approximate Coordinates (Decimal Degrees): Latitude: 35 .. 25272o Longitude:-80.8894510
2. Duration of Pump and Haul Request (Six Months Typical): 6-mos
3. Has a prior permit been issued? ❑ ❑ New ❑ ❑ Prior Pump & Haul Permit
Permit No.:
4. Permanent Method of Wastewater Disposal: Waste Water Treatment in a WWTP
S. Date Permanent Disposal will be available: 4/1/2422
6. Have permits / approvals for permanent disposal been obtained?
❑ ❑ Yes ®❑ No Permit Number:
7. Is there a Pretreatment Program in effect? ❑ ❑ ❑ Yes Z No
8. Describe any pretreatment prior to pumping and hauling:
9. Volume of Wastewater Generated: 1440 Gallons per Day
1o. Explain how the wastewater flow was determined: ®15A NCAC 02T .0114 or ❑ Representative Data If
representative data, describe:
11. Describe Tank / Container wastewater will be pumped from (attach description if necessary): (3) 4000-gal
concrete tanks equalized by adjoining 4" PVC equalization pipes installed below full tank level
12. Is Tank / Container in place or will it be installed (attach description if necessary):
to be installed per attached plan
13. What type of high water alarm does the container have (and/or):
❑ ❑ Audible and Visual ®❑ Telemetry (Auto Dialer / SCADA)
telemetry will notify the hauler, Stevens Trucking, of full tank
1. Applicant's Certification: (Signature of Signing Official and Project Name)
I, Monica Rivera Ricab LLC
attest that this application for has been reviewed by me and is
accurate and complete to the best of my knowledge. I understand 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. I understand that issuance of a permit will require pump and haul facilities or
activities to be inspected at least daily by me or a designated representative. Note: In accordance with North Carolina
General Statutes 143-215.6A and 143-215.613, 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.
la.
Signing Official Signature
04/05/2022
Date
ENGINEERING DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL.
ACTIVITIES SHALL BE INSPECTED AT LEAST DAILY BY THE PERMITTEE OR IT'S REPRESENTATIVE PER 15A NCAC 02T .0204(d).
APPLICATION P&H 01-16
Page 4 of 5

THE ENGINEER'S CERTFICATION IS REQUIRED FOR ACTIVITIES THAT RESULT IN THE PRACTICE OF ENGINEERING PER G.S. 89C-3.
ENGINEERING DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL. IF CERTIFICATION BY AND ENGINEER IS REQUIRED,
THIS PAGE IS NOT NECESSARY.
2. Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
I, George D Barrier ,attest that this application for Ricab. LC
een
reviewed by me and is accurate, complete and consistent with the information in the engineering plans, calculationsaand 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 all the applicable regulations. Although other professionals may
have developed certain portions of this submittal package, inclusion of these materials under my signature and seal signifies
that I have reviewed this material and have judged it to be consistent with the proposed design. Note: In accordance with
NC General Statutes 143 2 _15.6A and 143-215.68, any person who knowingly makes any false statement, representation, or
certification in any application shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed $10,000 as
well as civil penalties up to $25,000 per violation.
2a• George D. Barrier, PE
Professional Engineer Name
2b. Carolina Septic Systems, PC
Engineering Firm
2c. 3901 Davis Lane
Mailing Address
`€2d. Charlotte
City
2e. NC 2f. 28269
State Zip
2i.
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12g. [phone] 2h, p y �°
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NC PE Seal, Signature & Date
APPLICATION P&I10I -1 6
Page 5 of 5

Carolina Septic Systems, PC
PO Box 26072
Charlotte, North Carolina 28269
May 2, 2022
Monica Rivera
Ricab, LLC
c/o Juan Gomez
5009 Monroe Rd, Suite 201
Charlotte, North Carolina 28205
RECEIVED/NCDEO/DWR
MAY 1 2 2022
WQROS
MOORESVILLE REGIONAL OFFICE
Subject: P&H Application Cover Letter
639, 643, 651, 647, and 709 Tennyson Drive, Charlotte, NC28208
Dear Ms. Rivera,
Carolina Septic Systems, PC. has been engaged by my client, RICAB, LLC, to prepare the
Pump and Haul Application for their properties ; 639 Tennyson Drive, PID: 06507132, 643
Tennyson Drive, PID: 06507128, 647 Tennyson Drive, PID: 06507129, and 651
Tennyson Drive, PID: 06507130, Charlotte, North Carolina 28208.
My client, RICAB, LLC, was issued building permits by Mecklenburg County Building
Standards to construct single family residences at 639, 643, 647 and 651 Tennyson Drive
in Charlotte. The permits were issued based on Mecklenburg County Building Standards'
understanding that simultaneous to construction of the homes, municipal water and sewer
service would be installed by Charlotte Water along Tennyson where taps would be provided
to each home. After construction of the homes was well underway, Charlotte Water notified
my client that installation of the municipal sewer would be significantly delayed for up to a
year. My client desires to install a pump and haul system to temporarily dispose of the
municipal waste water and I have prepared and am submitting the appropriate application
for your approval and permit issuance.
If you have any questions or require additional information, please contact me on my cell
phone at 704-201-1487. I appreciate the opportunity to provide you with our professional
services.
Respectfully submitted,
Carolina Septic Systems, PC
By,
b- ---
George D. Barrier, PE
Principal Engineer

2022
CHARLOTTE
W _ TER
System Protection
Flow Free
4222 Westmont Drive
Charlotte, NC 28217
704.336.4783
PUMP and HAUL PERMIT FOR:
Septage and Portable Toilet Waste, service and transport
STEVENS SEPTIC SERVICES
Charlotte Water Septage Hauler Permit Number: SH #027
The above stated company is hereby permitted to service and transport septage and
portable toilet waste within Mecklenburg County to a permitted and licensed disposal
facility. Such operations shall comply with all applicable Federal, State and local
regulations, the provisions of the City of Charlotte Sewer Use Ordinance and the
conditions herein.
Effective Date of Permit
January 12. 2022
Expiration Date of Permit
December 31, 2022
Bill Gintert
Environmental Compliance Manager
Date

Stevens Trucking and Septic Services
3317 New Salem Road
Monroe, NC 28110
[phone] - Office
[phone] - Mobile / Text
[e-mail] - email
March 16, 2022
Customer: Monica Rivera
Ricab, LLC
c/o Juan Gomez
5009 Monroe Rd Ste. 201
Charlotte NC 28205
Project Address: 639 Tennyson Drive PID 06507132
643 Tennyson Drive PID 06507128
647 Tennyson Drive PID 06507129
651 Tennyson Drive PID 06507130
Charlotte NC 28208
Contact Number: [phone]
Stevens Trucking and Septic Services is a Licensed Septic
Contractor and hauler with the capability and willingness to perform
the pump and haul activity.
We have attached a Receiving Facility Letter from the owner/
authority of the receiving wastewater treatment facility, as
required by 15A NCAC 02T .0204(b), stating that the pumped and
hauled wastewater will be accepted and specifying the volume and
type of wastewater that will be accepted. The letter is signed by an
authorized signing official in accordance with 15A NCAC 02T .0106(b).
If you have any questions, please let us know.
Sincerely,
Chris Stevens
Stevens Septic Service

CHARLOTTE
WI.JER
AUTHORIZATION TO DISCHARGE SEPTAGE TO A WASTEWATER TREATMENT
FACILITY
I, Bill Gintert / Environmental Compliance Manager
Charlotte Water - System Protection (CLTWater - SP)
4222 Westmont Drive Charlotte, NC 28217 704-336-4407
Do hereby authorize Terry Stevens
(Authorized Representative)
Of Stevens Septic Service
(Septage Management Firm Name)
To dispose of Septage X Portable Toilet Waste
Note: 1) Grease trap waste is not allowed at the disposal sites,
2) Re - introducing partially treated liquid into a grease trap is not allowed in the
Charlotte Water system.
From: Mecklenburg County and Surrounding Areas;
(County or other Geographic Area)
At the below named Wastewater Treatment Facility; Septage shall be discharged;
McAlpine Creek Wastewater Treatment Plant (MCWWTP) Septaqe Receiving Station
Between the hours of 7:30 a.m. until 11:00 a.m. and 12:00 p.m. until 3:45 p.m. Mon. -Fri.
Fee assessments and waste determinations will be required at the discretion of the wastewater treatment
facility. The facility has the ultimate prerogative to deny discharges of any wastes to the incoming
wastewater stream.
This authorization will be effective: January 1:t 2022
This authorization shall be valid until: December 31512022
Signed:
(Environmental Compliance Manager)
Date: 11 ^ 3z..o
Note: Falsification of this document by the Septage management firm shall lead to permit revocation.

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