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HomeMy WebLinkAboutWQ0022731_Application_20030617FAST -TRACK APPLICATION for GRAVITY SEWELS, PUMP STATIONS, AND FORCE MAINS PAGE 1 Oki �`N A TFState of North Carolina \��GDepartment of Environment and Natural Resources C T. Division of Water Quality © c FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS (Pressure sewers systems are not to be included as part of this application package) INSTRUCTIONS: Indicate that you have included the following list of required application package items by checking the space provided next to each item. Failure to submit all required items will lead to your application being returned as incomplete or additional processing and review time. This form may be photocopied for use as an original. X I. Application Form - Submit one original and one copy of the completed and appropriately executed application form. Any changes to this form will result in the application being returned. The Division of Water Quality (Division) will only accept application packages that have been fully completed with all applicable items addressed. You do not need to submit detailed plans and specifications unless you respond NO to Item B(12). X II. Application Fee - Submit a check in the amount of $400 made payable to: North Carolina Department of Environment and Natural Resources (NCDENR). ❑ III. Certificates of Public Convenience and Necessity — If the application is being submitted in the name of a privately -owned public utility, submit two copies of the Certificate of Public Convenience and Necessity (CPCN) which demonstrates that the public utility is authorized to hold the utility franchise for the area to be served by the sewer extension. If a CPCN has not been issued, provide two copies of a letter from the North Carolina Utilities Commission's Public Staff that states that an application for a franchise has been received, that the service area is contiguous to an existing franchised area, and/or that franchise approval is expected. The project name in the CPCN or letter must match that provided in Item A(2a) of this application. ❑ IV. Operational Agreements — Submit one original and two copies of a properly executed operational agreement if the sewer extension is permitted by a private applicant and will be serving residential or commercial lots (e.g., houses, condominiums, townhomes, outparcels, etc.) that will be sold to another entity. If the applicant is a homeowners' association, use Form HOA 02/03. If the applicant is a developer, use Form DEV 02/03. EVEN IF THE PROJECT WILL BE TURNED OVER TO A MUNICIPALITY, FORM DEV 02/03 IS REQUIRED. X V. Flow Acceptance Letters — If the owner of the downstream sewers and/or WWTF is different from the applicant, submit two copies of a flow acceptance letter from the owner of the downstream sewers and WWTF, if different. Flow acceptance letters must contain the following minimum information: applicant and project name, amount of flow accepted, and name and permit number of the receiving sewers/WWTF. The flow acceptance must not expire prior to permit issuance and must be dated less than a year prior to the application date. Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific flow acceptance letter. X VI. Map — Submit an 8.5-inch by 11-inch COLOR copy of the portion of a 7.5-minute USGS Topographic Map along with this form. The map should identify the entire project area location as well as the closest downslope surface waters as clearly as possible. Each map portion must be labeled with the map name and number, the identified location of the sewer line and pump stations, and be of clear and reproducible quality. For instance, if the project involves 4 miles of interceptor sewer that traverses over or near several different waterbodies (or counties, basins, etc.), the map should have location ID's shown for each different waterbody (where the sewer line is within 100 feet of such waterbody - see Instruction VII). This location ID is self chosen and used to cross reference the location in Section C of the permit application. X VII. Stream Classifications — Section C • If any portion of the project is within 100 feet of any down slope surface water, Section C must be completed for the pertinent sections. • If the entire project area is a minimum of 100 feet away from any down slope surface waters BUT there is a pump station involved where a history of power outage is to be used to provide adequate design storage instead of dual feed or permanent or portable generator, Section C must be completed to demonstrate that the closest down slope surface water is Class C (see 15A NCAC 2H .0219(h)(3)(D)). • Use the guidance document entitled, "Determining Watershed Classifications for Form FTA 02/03 (Fast -Track Sewer Systems)" available from http://h2o.enr. state. nc. us/ndpu or by contacting the appropriate regional office. FTA 02/03 - Rev. 1 06/03 FAST -TRACK APPLICATION for GRAVITY SEWERS,.,PUMP STATIONS, AND FORCE MAINS PAGE 2 ❑ Vill. Environmental Assessments — If this project is subject to an Environmental Assessment (EA) [15A NCAC 01C .0500], this application can not be used. Send the project application on Form PSFMGSA 10/99 to the Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617. Applications can not be processed until a Finding of No Significant Impact (FONSI) or Environmental Impact Statement (EIS) has been issued. A copy is to be submitted with that permit application. X IX. Certifications — Section D The application must be certified by both the applicant and a North Carolina Registered Professional Engineer (PE). The applicant signature must match the signing official listed in Item A(1b). The PE should NOT certify the application if he/she is unfamiliar with 15A NCAC 2H .0200, the Gravity Sewer Minimum Design Criteria (most recent version) and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains (most recent version), as applicable to the project. Certification by a PE who is unfamiliar with these documents is subject to NC Board referral. THE COMPLETED.FTA 02/03 APPLICATION PACKAGE, INCLUDING ALL SUPPORTING DOCUMENTS AND $400 FEE, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE REGIONAL OFFICE ADDRESS COUNTIES SERVED Asheville Regional Office Avery, Buncombe, Burke, Caldwell, 59 Woodfin Place Cherokee, Clay, Graham, Haywood, Asheville, North Carolina 28801 Henderson, Jackson, Macon, (828) 251-6208 Madison, McDowell, Mitchell, Polk, (828) 251-6452 Fax Rutherford, Swain, Transylvania, Yancey Fayetteville Regional Office 225 Green Street Suite 714 Fayetteville, North Carolina 28301 Anson, Bladen, Cumberland, Harnett, (910) 486-1541 Hoke, Montgomery, Moore, Robeson, (910) 486-0707 Fax Richmond, Sampson, Scotland Mooresville Regional Office 919 N Main Street Mooresville, North Carolina 28115 Alexander, Cabarrus, Catawba, (704) 663-1699 Cleveland, Gaston, Iredell, Lincoln, (704) 663-6040 Fax Mecklenburg, Rowan, Stanly, Union Raleigh Regional Office 1628 Mail Service Center Chatham, Durham, Edgecombe, Raleigh, North Carolina 27699-1628 Franklin, Granville, Halifax, Johnston, (919) 571-4700 Lee, Nash, Northampton, Orange, (919) 571-4718 Fax Person, Vance, Wake, Warren, Wilson Washington Regional Office Beaufort, Bertie, Camden, Chowan, 943 Washington Square Mall Craven, Currituck, Dare, Gates, Washington, North Carolina 27889 Greene, Hertford, Hyde, Jones, (252) 946-6481 Lenoir, Martin, Pamlico, Pasquotank, (252) 975-3716 Fax Perquimans, Pitt, Tyrrell, Washington, Wayne Wilmington Regional Office 127 Cardinal Drive Extension Brunswick, Carteret, Columbus, Wilmington, North Carolina 28405 Duplin, New Hanover, Onslow, (910) 395-3900 Pender (910) 350-2004 Fax Winston-Salem Regional Office 585 Waughtown Street Alamance, Alleghany, Ashe, Caswell, Winston-Salem, North Carolina 27107 Davidson, Davie, Forsyth, Guilford, (336) 7714600 Rockingham, Randolph, Stokes, (336) 771-4631 Fax Surry, Watauga, Wilkes, Yadkin For more information, visit our web site at: http.-Ah2o.enr.state.nc.us/ndpu/ FTA 02/03 - Rev. 1 06/03 FAST -TRACK APPLICATION for GRAVITY SEWERS, PIMP STATIONS, AND FORCE MAINS PAGE USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number - (to / (to be completed by DWQ) v// v`i'Q 1. Owner: la. The Town of Aberdeen Full Legal Name (company, municipality, HOA, utility, etc.)- Z 1 b. William Zell, Town Manager 0 Signing Official Name and Title (Please review 15A NCAC 2H .0206(b) for authori d si ni g I ) Q 1 c. The legal entity who will own this system is: ❑ Individual ❑ Federal X Municipality ❑ State/County ❑ Private Partnership ❑ L70 -Other (specify): . �. 0 LL Z Z 0 a H Q c.i J a Q 10. 115 N. Poplar Street le. Aberdeen Street Address City 1f. North Carolina State 1g. 28315 Zip Code 1 h. (910) 944-7024 1 i. (910) 944-7459 Telephone Facsimile E-mail 2. Project (Facility) Information: 2a. Glen Laurel Subdivision Brief Project Name (permit will refer to this name) 3. Contact Person: 2b. Moore County Where Project is Located 3a. Neal Smith, Professional Engineer Name and Affiliation of Someone Who Can Answer Questions About this Application 3b. (910) 695-8825 3c. nsmith@nsengineering.com Phone Number E-mail 1. Project is X New ❑ Modification (of an existing permit) If Modification, Permit No.: For modifications, attach a separate sheet clearly explaining the reason for the modification (i.e. adding another phase, changing line size/length, etc.). Only include the modified information in this permit application - do not duplicate project information in B(7) and B(10-11) that has already been included in the original permit. 2. Owner is X Public (skip to Item B(3)) ❑ Private (go to Item 2(a)) ......... 2a. If private, applicant will be: 2b. If sold, facilities owned by a (must choose one) Z 0 Q 3. ❑ Retaining Ownership (i.e. store, church, single office, etc.) or ❑ Public Utility (instruction III) ❑ Leasing units (lots, townhomes, etc. - skip to Item B(3)) ❑ Homeowner Assoc./Developer (Instruction IV) ❑ Selling units (lots, townhomes, etc. - go to Item B(2b)) Moore County Public Utilities Owner of wastewater Treatment Facility (WWTF) Treating Wastewater From This Project 0 4a. Moore County Water Pollution Control Facility 4b. NC 0037508 LL Name of WWTF WWTF Permit No. Z 5a. Moore County Public Utilities 5b. �i 5c. Owner of Downstream Sewer Receiving Sewer Size Permit Number of Downstream Sewer (if known) 6. The origin of this wastewater is (check all that apply): WX Residential Subdivision ❑ Car Wash a X Apartments/Condominiums ❑ Institution 100 % Domestic/Commercial ❑ Mobile Home Park ❑ Hospital ❑ School ❑ Church % Industrial ❑ Restaurant ❑ Nursing Home % Other eci s (specify): El Office ❑ Other (specify): 7. Volume of wastewater to be permitted in this project: 65,760 gallons per day 8. If the permitted flow is zero, indicate why: ❑ Interceptor Line - Flow will be permitted is 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 FTA 02/03 - Rev. 1 06/03 FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 4 9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2H .0219(I) for Item 13(7) or the design flow for line or pump station sizing if zero flow in the space below. Values other than that in 15A NCAC 2H .0219(1)(1-2) must be approved prior to submittal of this application. Submit a separate request to the Division of Water Quality, Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617 in accordance with 15A NCAC 2H .0219(I)(3). 137 three/four bedroom houses/townehomes at 480 gallons per day = 65,760 gallons per day 10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary) Size (inches) Length (feet) Gravity or Force Main (use the pull down menu) 8" 7,380' 0 W Z H Z O U Z ENTER TOTAL LINE LENGTH IN MILES 1.4 miles O Q11. Summary of Pump Stations to be Permitted (attach additional sheets as necessary) Location ID Power Reliability Option (self chosen - as shown on Design Flow Operational Point (1-dual line feed; 2- permanent generator w/ATS; 3- 0 plans for cross-reference) (MGD) GPM TDH portable generator w/telemetry; 4-wet well storage) LL. Z H W a' 12. Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force m Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC 2H .0200 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 13. Have the following permits/certifications been submitted for approval? Wetland/Stream Crossings - General Permit or 401 Certification? ❑ Yes X No ❑ N/A Sedimentation and Erosion Control Plan? ❑ Yes X No ❑ N/A Stormwater? ❑ Yes X No ❑ N/A FTA 02/03 - Rev. 1 06/03 FAS -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 5 Q W H u 1. Use the Division's guidance document entitled, "DETERMINING STREAM CLASSIFICATIONS FOR FORM FTA 02/03 (FAST -TRACK SEWER SYSTEMS)" to collect and record the stream classification data below (attach additional sheets as necessary). This document is available from our web site or by contacting the appropriate Division of Water Quality regional office (see instructions for addresses) OR indicate the following: ❑ A Stream Classification is not needed because all parts of the project are at least 100 feet away from any down slope', waterbody; AND, ❑ A Stream Classification is not needed because the design does not depend on wet well storage as a power reliability option for any pump station near a Class C down slope waterbody. Location ID on Map (self chosen - as shown on Name of map for cross-reference) Waterbody County Project Location Aberdeen Creek Moore Waterbody Stream Waterbody River Basin Index Classification Lumber Basin Submit the 8.5" x 11" COLOR topographic map as required in Instruction VI regardless of whether a classification is provided! Applicant's Certification: Class"C" i, W i l l i ar)l Z qi J , attest that this application for G t e o Laurel S u bd w,�S,,oy% 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. Note: In accordance with North Carolina General Statutes 143-215.6A and 143-215.6B, 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 r vil penalties up to $25, 000 per violation. 1 a. �` 611 d3 Signing Official Sig ture Date 2. Professional Engineer's Certification: Z I attest that this application for 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 H best of my knowledge. l further attest that to the best of my knowledge the proposed design has been prepared in Q accordance with the applicable regulations, Gravity Sewer Minimum Design Criteria for Gravity Sewers adopted February V 12, 1996, and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June'. ll 1, 2000 and the watershed classification in accordance with Division guidance. Although certain portions of this submittal package may have been developed by other professionals, 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 W accordance with NC General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement, V representation, or certification in any application shall be guilty of a Class 2 misdemeanor which y include a fine not to 6, o exceed $10,000 as well as civil penalties up to $25,000 per violation. 1 p"t ,,, �e �o •• 2a. Nil S�,ah �,Y / ••. Professional Engineer Name 2b. NeatSAIA C.u<�inet�r��1t � 1oC.. � � S �L �� Engineering Firm t�°3t0 2c. 51 S SF_ a Coca St Address 2d. S o u`t'V► e! ✓1 ` �nQ S 2e. �0- 2f. a $ 3 7 • 41tt City State Zip 2g. 110 (095 982S 2h. '?10 695 883a 2i. USA A @,%e✓j,.ioea,.15, co," Telephone Facsimile E-mail Seal, Signature & Date FTA 02/03 - Rev. 1 06/03 FAST -TRACK APPLICATION for GRAVITY SEWERS, Pt:MP STATIONS, AND FORCE MAINS PAGE", USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number: (to be completed by DWQ)G(/QDO 1. Owner. 1a. The Town of Aberdeen --- Full Legal Name (company, municipality, HOA, utility, etc.)_ Z 1b. William Zell, Town Manager O Signing Official Name and Title (Please review 15A NCAC 2H .0206(b) for authori2 ad sionir ilipIT 2003 Q 1c. The legal entity who will own this system is: ❑ Individual ❑ Federal X Municipality ❑ State/County ❑ Private Partnership ❑ orp -Other (specify): 1d. 115 N. Poplar Street 1e. Aberdeen - 0 Street Address City LL Z 1f. North Carolina 1g. 28315 Z State Zip Code 0 1 h. (910) 944-7024 1 i. (910) 944-7459 1j. Telephone Facsimile E-mail U2. Project (Facility) Information: J 2a. Glen Laurel Subdivision 2b. Moore a a Brief Project Name (permit will refer to this name) County Where Project is Located Q 3. Contact Person: Q 3a. Neal Smith Professional Engineer Name and Affiliation of Someone Who Can Answer Questions About this Application 3b. (910) 695-8825 3c. nsmithansengineering.com Phone Number E-mail 1. Project is X New ❑ Modification (of an existing permit) If Modification, Permit No.: For modifications, attach a separate sheet clearly explaining the reason for the modification (i.e. adding another phase, changing line size/length, etc.). Only include the modified information in this permit application - do not duplicate project information in B(7) and B(10-11) that has already been included in the original permit. 2. Owner is X Public (skip to Item B(3)) ❑ Private (go to Item 2(a)) 2a. If private, applicant will be: 2b. If sold, facilities owned by a (must choose one) ❑ Retaining Ownership (i.e. store, church, single office, etc.) or ❑ Public Utility (Instruction III) Z M 1 ancinn unite (lntc tnwnhmmoc afn - chin fn Ifnm R/911 F 1 I-immMn.A.nnr Ace— /r)nvnlnnn /Inc♦rr.w♦Inn I\/1 3/ STAFFORD LAND COMPANY, INC. 1035 GLEN LAUREL 246 VALLEYFIELD LANE 66-1230/531 SOUTHERN PINES, NC 28387 (910)692-9808 DATE May 21, 2003 PAY TO THE ORDEROF N-C. Dept. of Environment and Natural Resources $ *400.00** Four Hundred Dollars and 00/100----------------------- CE1VTn1VlAL DOLLARS `--" 8 �•..�• FOR — - --- -- — ----M, 8. If the permitted flow is zero, indicate why: ❑ Interceptor Line - Flow will be permitted is 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 FTA 02/03 - Rev. 1 06/03 7 7, m tfI 11 I I I I C > I 0 ro ` 1 �,� ,,•' •f 1 f ( � ; ;�1 '(� ;1`' •11' -:N ,i; 1', � 1in111 \/) 1 • ;`. � . -_ l� -�I � III ';, !! I,, __--_-_; _; I, .4I'�� f� -;;. �, �.l 'fill=;: � ; _ / � `. ■ I � . � � � � � ,i ; �,. ` I Ali ' i- -�• a \ ,�` _ i/ J-11 A. V. It JY gli Wee Creek •Y 1\\\ r n 1 � \'�. \, I� ) 1 � i !�� tom— •/� �'�• °� ��i R '+W` /� ,N L • � +'r", � •� •M r�I . Q�� �' ^� ��I � a�+t v _° — / \ J� ,� �`. �.r��V` � 'T � ` �� I � �� ,1 !( `I .l w '� , � I v�•.aaa \p�'� .. . j;M •y,�\I I `�• \I �� �+.1 • I •-�• j/ �V!' k��o�� ,� rl ' Q." `V \ ��� .. %' '! J{:�(h • .'/ • • ••p 1:.. /^fir= 3c �:�.� '31\� 1 -/ 4� �'� � �` ( \� _ + � �.:,` �: �; ` •� ^�� , , . /. `• ••d'�., ,{ �'" �r , "' 1 ,, 1,->. Department of Public Utilities P.O. Box 1927 Carthage, NC 28327 up oan'r a� �aaxe April 30, 2003 Mr. Tom Wanko Neal Smith Engineering, Inc 575 SE Broad St. — Suite 11 Southern Pines, NC 28327 Dear Mr. Wanko: Dennis L. Brobst, Director Telephone: (910) 947-6315 Facsimile: (910) 947-1992 E-mail: dbrobst@co.moore.nc.us RE: Flow Acceptance letter for 137 Units at Glen Laurel Subdivision — Phase 2 thru 5, Aberdeen, NC. The Moore County Water Pollution Control Facility, NPDES # NC 0037508, presently has sufficient capacity available to conditionally accept up to 65,760 gallons per day from the above referenced project. This project will be required to comply with all specifications and requirements of the Town of Aberdeen, NC.. In addition all required fees must be paid to the Town of Aberdeen. Moore County Public Utilities will have to issue approval of the Parshal Flume Metering Station along with structures, easements and access roadway prior to this project being connected to the Moore County Sanitary Sewer Interceptor. Upon completion of the referenced project, the applicant's engineer is to provide our office with the following items: 1. Certification of Completion. 2. Complete set of As -Built drawings. If you have any questions or comments please call me at (910) 947-6315. Sincerely, MOORE COUNTY PUBLIC UTILITIES d&e--'C Ernie Black Engineering Project Technician Cc: Mr. Dennis Brobst, Director Mr. Delmo Frye, WWTP Superintendent Mr. Ricky Monroe, Public Works Director, Town of Aberdeen Mr. Giles Hopkins, Planning Director, Town of Aberdeen State of North Carolina Department of Environment and Natural Resources Division of Water Quality WATERSHED CLASSIFICATION ATTACHMENT Any changes made to this form will result in the application being returned. (THIS FORM MAY BE PHOTOCOPIED FOR USE AS AN ORIGINAL) INSTRUCTIONS: To determine the classification of the watershed(s) in which the subject project will be located, you are required to submit this form, with Items 1 through 8 completed, to the appropriate Division of Water Quality Regional Office Water Quality Supervisor (see Page 2 of 2) prior to submittal of the application for review. At a minimum, you must include an 8.5" by 1 V copy of the portion of a 7.5-minute USGS Topographic Map that shows the surface waters immediately downslope of the project. You must identify the location of the project and the closest downslope surface waters (waters for which you are requesting the classification) on the submitted map copy. If the facility is located in the Neuse River Basin, also include a copy of the soil survey map for the project location. The corresponding non -discharge application may not be submitted until this form is completed by the appropriate regional office and included with the submittal. 1. Applicant's name (name of the municipality, corporation, individual, etc.): Town of Aberdeen 2. Name and complete address of applicant: Town of Aberdeen, 115 N. Poplar Street City: Aberdeen State: NC Zip: 28315 Telephone number: ( 910 ) 944-7024 Facsimile number:( 910 ) 944-7459 3. Project name (name of the subdivision, facility or establishment, etc.): Glen Laurel Subdivision, Phase 2 thru 5 4. County where project is located: Moore 5. Name(s) of closest surface 6. River basin(s) in which the project is located: -Cape-Fenn /L%. Ah,4- ' 1-,W, 7. Topographic map name and date: Southern Pines, NC, Photo Revised 198+ ," 8. North Carolina Professional Engineer's seal, signature, and date: I TO: REGIONAL OFFICE WATER QUALITY SUPERVISOR o �i'•;�, pfA a 1c, a"yaSq 2 a � (" ��pe�tt'.77mt. r�ro°syyyvyyyc�f� �/t'i ,/0�` °�°0°�o�}r4a� :r Please provide me with the classification(s) of the surface waters, watershed(s), and appropriate river basin(s) where these activities will occur, as identified on the attached map segment: �► ,c / Name(s) of surface waters and river basin(s): ,�!&�i:- L4!( w Classification(s) (as established by the EMC): A &-3 C Proposed classification(s), if applicable: River basin buffer rules, if applicable: Signature of regional office personnel: Date: - e — FORM: WSCA 10/99 Page I of 2 DIVISION OF WATER QUALITY REGIONAL OFFICES Asheville Regional Office WQ Supervisor 59 Woodfin Place Asheville, NC 28801 Phone: (828) 251-6208 Fax: (828) 251-6452 Avery Macon Buncombe Madison Burke McDowell Caldwell Mitchell Cherokee Polk Clay Rutherford Graham Swain Haywood Transylvania Henderson Yancey Jackson Raleigh Regional Office WQ Supervisor 3800 Barrett Drive, Suite 101 Raleigh, NC 27609 Phone: (919) 571-4700 Fax: (919) 571-4718 Chatham Durham Edgecombe Franklin Granville Halifax Johnston Lee Nash Northampton Orange Person Vance Wake Warren Wilson Winston-Salem Regional Office WQ Supervisor 585 Waughtown Street Winston-Salem, NC 27107 Phone: (336) 771-4600 Fax: (336) 771-4630 Alamance Rockingham Alleghany Randolph Ashe Stokes Caswell Surry Davidson Watauga Davie Wilkes Forsyth Yadkin Guilford FORM: WSCA 10/99 Fayetteville Regional Office WQ Supervisor Wachovia Building, Suite 714 Fayetteville, NC 28301 Phone: (910) 486-1541 Fax: (910) 486-0707 Anson Moore Bladen Robeson Cumberland Richmond Harnett Sampson Hoke Scotland Montgomery Washington Regional Office WQ Supervisor 943 Washington Square Mall Washington, NC 27889 Phone: (252) 946-6481 Fax: (252) 946-9215 Beaufort Jones Bertie Lenoir Camden Martin Chowan Pamlico Craven Pasquotank Currituck Perquimans Dare Pitt Gates Tyrell Greene Washington Hertford Wayne Hyde Page 2 of 2 Mooresville Regional Office WQ Supervisor 919 North Main Street Mooresville, NC 28115 Phone: (704) 663-1699 Fax: (704) 663-6040 Alexander Lincoln Cabarrus Mecklenburg Catawba Rowan Cleveland Stanly Gaston Union Iredell Wilmington Regional Office WQ Supervisor 127 Cardinal Drive Extension Wilmington, NC 28405-3845 Phone: (910) 395-3900 Fax: (910) 350-2004 Brunswick New Hanover Carteret Onslow Columbus Pender Duplin