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WQ0029882_Regional Office Historical File Pre 2018
tvfichael Ir. Easley, Governor W1113 1311 3ROSS Jr Secretary North Caw t. lent of Environment anti Natural ReSOUFCC,ti Alan Klimek., PT. Director ntr" Water Qurtlity February 24, 2006 Mr, Rick Beasley, City Manager City of Conover PO Box 549 Conover, NC 28613 Subject: Permit No, WQ0029882 Cambridge Place City of Conover Wastewater Collection System Extension Catawba County, North Carolina Dear Mr, Beasley: In accordance with your application received on January 27, 2006, we are forwarding herewith Permit No. WQ0029882, dated February 24, 2006, to the City of Conover 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of the subject wastewater collection system extension, This permit shall be effective from the date of issuance until rescinded, and shall be subject to the conditions and limitations as specified therein, This cover letter shall be considered a part of this permit and is therefore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 2H .0227 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 2H ,0200; 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, \1,loresvlik kegioual Office 61 (.1 Fast Center Ave., Suite 301 Mooresvilie„ NC 28115 Phone: (704,1663-1699 kar(; (704)663-6040 flierriet. .6tAt.rw. newaterquaVy Om Customer Sery tee. 1-877-623-6748 Al Equal Opportunity/Affirregve Aclaxt Employer —50% Recycle,it10% Post Consumer Paper AettiCaralina „Naturally Mr Rick Beasley February 24, 2006 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 the City of Conover for the construction and operation of approximately 1,142 linear feet of 8-inch gravity sewer as part of the Cambridge Place project, and the discharge of 6,840 gallons per day of collected domestic wastewater into the City of Conover existing sewerage system, pursuant to the application received January 27, 2006, and in conformity with 15A NCAC 2H .0200; 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 Environment and Natural Resources and considered a part of this permit, The sewage and wastewater collected by this system shall be treated in the City of Conover WVVTP (Northeast NPDES No. NC0024252) prior to being discharged into the receiving stream. 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 Dee Browder at (704) 663-1699, Sincerely, r - Alan W. Klimek, P.E. cc: Catawba County Health Department Mooresville Regional Office, Surface Water Protection (WWTP Permit No. NC0024252) R. Carroll Williams, P.E. Surface Water Protection Central Files Marie Doklovic, 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 2H .0200; 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 2H .0227, lf an individual permit is not required, the following performance criteria shall be met as provided in 15A NCAC 2H .0227, 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.IC 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. 5 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 2H ,0220, 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 record 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 2H .0200; 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 2B .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 2B .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 (704) 663-1699, 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, line 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 () -0 or (919) 733-3300, Persons reporting any of the above occurrences shall file a :spill report by completing Part 1 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 -S (or the most current Division approved form) can also be completed to show that the SSO was beyond control. Per issued this the 24th day of February 24, 2006, NORTH CAROLINA ENVIRONMENTAL MANAGE a Alan W, Klimek, RE, Director Division of Water Quality By Authority of the Environmental anage en Comnission ENT COMMilt Per uif Number WQ0029882 Fast Track Emgineerinq Certification Permit No, VY0OO298O2 Complete and submit this form tothe permit issuing regional office with the following� ° One copy of the project record drawings (plan & profile views pfsewer lines) ofthe wastewater collection system extension • Supporting design calculations (selected pumps, system curve, operating point, available storage if portable genenatmr(a)orstorage greater than longest past three year outage reliability option selected) for any pump stations permitted u8part nfthis project * Changes hmthe project should be clearly identified onthe record drawings orinwritten summary form, Permit modifications are required for any changeonesu|dn minimum 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 bythe Division. Therefore, dishighly recommended that this certification be sent in a manner that provides proof oYreceipt by the Division. ENG|NEE�S{�E�RF|CAT0N � -- Partial Final [ as a duly registered Professional Engineer in the State of North Carolina, having been authorized to observe (|l periodically, El weekly, [:] full time) the construction of the Cambridge Place, a Catawba County project for the Pormittee.hereby state that, tothe best ofmyabilities, due care and diligence was used inthe observation mfthe construction such that the construction was observed hobebuilt within substantial compliance of this permit� 15A NC4C 2H 0280� the Division of Water C)ua|ih/'a (Division) Gravity Sewer Minimum Design CntehaadnptedFebnuary12.1Q80asappzab|e, 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 TOTHE FOLLOWING ADDRESS 88OORESV|LLEREGIONAL OFFICE SURFACE WATER PROTECTION S1OEAST CENTER AVENUE, SUITE 3O1 h8OORESV|LLENC 28115 The Pennittee is responsible for tracking all partial certifications up until afina| certification in 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 subjectthe Pamnittoetoappropriate enforcement actions. Central Fries: APS Perm it Number 002 882 Permit Tracking ti 02/24/0 i Program Category Status Project Type Non-dishard In revewar New Project Permit Type Version Gravity SewerExtension, Pump Stations, Pressure Sewer A Extensions Primary Reviewer dee,browder Permitted Flow 6840 Facilitv Facility Name Cambridge Place Location Address gwner Owner Name City of Conover Datear vent ctredul O i tssue App Received Draft Initiated l suafci 01f27106 Regulated Activities Apartment complex Condominium Wastewatet uttall NULL Permit Classification Individual Permit Contact Affiliation Major/Minor Region Minor Mooresville'; County Catawba Facility Contact Affiliation Owner Type Government - Municipal Owner Affiliation Lloyd PO Box 549 Conover Public N issue Beasley NC 28613 Effective Expiration Restuested/Reeied Events Additional information requested Additional information received Waterbody Name m index Number C rr nt Clas Subbasin Meino: PAY TO THE ORDER' OF HEDRICK CONSTRUCTION, INC. 4010 HWY 70 EAST PO BOX CLARES,1ON7 NO 25510 828.459-0710 Hun, : S3 ad,, 00,n` L'n op Bank t E-4967 31 534.88855BH DATE 2 0 5907 AMOUNT r +k$4 '}C' CC FA AC APPL "ATION'II©Ir t RAVXTY S W R . P` YMP STATIONS, AND 1 ORCE MAINS PAGE 3 SE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Owner: i -r 1 a. Full E:. al Name (company, municipality, HOA, 0 1 b. Signing 0 z 0 0 B. PERMIT Application Nurn (to be completed by MO Name and Title (Please review 1SA NCAC 2H .02fl8(b) for authorized signing officials!) lc. The legal entity who will own this system is: O Individual 0 Federal DiriAunicipality 0) St 1d. Mailing Address "po y�� 5U41 1f. State 1 h. Telephone 2. Project (Facility, 2a. CA c Brief Project Narne (permit will refer 3. Contact Person: 3a. h- Nc�o- Name and Affiliation 3b. Phone Number Project is &New For modifications, attach a separate sheet clearly explaining the reason for the modification (Le. adding another phase, changing line sixeilength, etc.). Only include the modified Information In this permit application - do not duptica project Information In 8(7) and B(10-11) that has already been included In the original permit. P o`Can Answer efCounty 0 Private Partnership 0 1g corporation 0 Other (specify): City Zip Code 2. Owner is Et/Public (skip to Item B(3)) 2a. if private; applicant will be: 0 Private (go to Item 2(e)) 2b If sold, faculties own O Retaining Ownership (i,e. store, church, single office, etc,) or O Leasing units (lots, townhomes, etc, - skip to Item B(3)) 0 Selling units (lots, townhomes, etc, - go to item fib)) y '�' �r 44,4 of Wastewater Treatment Fact 0 Public Utility (Instructldrn. Ill) 0 Homeowner Assoc./Developer (instruction IV) (VVVVTF) Treating Wastewater From This Project. 4b. N ton VVVVTF Permit No. igrn oftf 0 Residential Subcivision 0 Car Wash Apartments/Condominiums 0 Institution 0 Mobile Home Park 0 Hospital 0 School [] NursChurch e ng 0 Restaurant [,Q iHorn 0 Office 0 Other (specify): Volume of wastewater to be allocates( for this particular proj *Do not Include previously permitted allocations A If the permitted flow is zero, incate why: 0 Interceptor Une - Row will be permitted in subsequent permits 0 Flow has already been allocated in Permit No.. 0 Rehabilitation or replaiient of existing sewer with no new flow expected gallons per° day at connect t ine % Domestic/Commercial % Industrial % Other (specify): FTA 02103 - fix. 3 A15 FAST- ICA" ON for G RA" I y S RS, PUAT +(yam, AND FORCE PAGE 4 z Provide the wastewater flow calculations used in determining the permitted flow in ascot' ' nce with 15A NCAC 2H .0219(1) for Item B(7) or design flow for line or pump station sizing if zero flow in the space below. Values other than that in 15A NCAC 2H M0219(IX1-2) must be supported with actual water or wastewater use data in accordance with 15A NCAC 2H .0219(1)(3). l2 tat %-c5 4poien, "4 tk ©rLtwS x eiFtlib i, 10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary) Size (Inches) ENTER TOTAL LINE LENGTH IN MILES 0 Length (feet) 42w mary of Pump Stations to be Permitted (attach additional sheets as necessary) Location ID (self chosen - as shown on Design Flo plans for cross-reference) (MGD) Gravity or Force Main (use the pull down menu) RANI VT Power Re1labillty Optlo on Operational Point (1- dual line feed; 2- permanent generator w1ATS; 3- GPM TDH portable generator wftelemetry; 4-wet well storage) 2. 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 Desigt Criteria (latest version) and 15ANCAC 2H 0200 as applicable? i Er -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 permitstcertitittit r been submitted for approval? Wetland/Stream Crossings - General Permit or 401 Certification? ❑ Yes El No [aN!A Sedimentation and Erosion Control Plan? (Yes D No © N/A. Yes Cj No 0 N/A Stormwater ? 14. Does this project involve aerial lines or siphons? Check if yes. 0 fy/it These lanes well be considered hidit ononty and must be ctiecked once every six montYhs. 15, Does this project have gravity sewer lines designed at minimum slopes? Q Be aware that the Ciwsion win not accept nestalted lines more than 10% fatter than the minimum, slope. corrected prior to submitting the final engirreenng certification., outside this tolerance should be I-1 A 02/03 - Rev, 3 04/05 FA ATION fur GIAVITY SEWERS PUTMP STA ION FO10E MAINS PAGE 5 1, Use the Division's guidance document entitled, "DETERMINING STREAM CLASSIFICATIONS FOR FORM FTA 02103 , (FAST -TRACK SEWER SYSTEMS)" to collect and record the stream classification data below (attach adcitional 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 adttesses) OR indicate the following: 0 [if 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 a assification is not needed because the design does not depend on wet well storage as a power reliability opton for any pump station near a Class C down slope waterbody. Location ID on Map (seif chosen as shown on Name of maptor cross-reference) Waterbody County River Basin Index Classification 0 0 0 Waterbody Stream Waterbody Submit the 8.5" x 11" COLOR topographic map as required in instruction VI regardless of *tether a classification is provided! I. Applicants Certification: I, SIGNING OFFICIAL NAME attest that this application for PROJECT NAME has been reviewed by me and is accurate and complete to the best of my know$edge 1 understand that if all required parts of this application are not completed and that if all requinxi supporting documentation and attachments are not included, this applcation package is subject to being returned as incompiete. Note: In accordance with North Carolina General Statutes 143-215.6A and 143-21568, any person vvrio knowingly makes any false statement, representation, or certification in any application shall be guilty of a Class 2 misdemeanor which may inckide a fine not to exceed $10,000 ell a civil penalties up to $25,000 per violation, la, Signing Official Sign re 2 Professional Ent‘'neer's Certification- 2a - Date 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 best of my knowledge. I 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 Miiirrium Design Criteria for the Fast -Track Pemitting of Pump Stations and Force Mains adopted June 1, 2000 end 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 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 knowiigly 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. Engineering Firm 2c. # 24c, Mailing Address 2d. Vt. City '2g. - 5 r.-L4< 2h -19 2i. Telephone Facsimile E-mail Seal, Signature & Date .„. FTA R.Rev 3 04R5 County NC, Parcel Map and Report ounty i Page 1 Real ,Estate Map Server DISCLAIMER: This map product was prepared from the Catawba County, NC Geographic Information System, Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map. Catawba County promotes and recommends the independent verification of any data contained on this map product by the user, The County of Catawba, its employees, agents, and personnel, disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indire or consequential which arises or may arise from this map product or the use thereof by any person or entity. http://2t.211,226.33/website/Parcel/tools.html 1/1.6/2©©6 ne - The la's Topographic lap Page 1 of 1 0.3 0.6 0.9 1.2 1.5 km 0 t .1 0.2 0.3 0.4 0.5 mi Map center is UTM 17 481850E 3951402N (WGS84/NAD83) Newton quadrangle Projection is UTM Zone 17 NAD83 Datum http://www.topozone.com/print.asp?L-17&n=3951402.00©09495&e=481850&s=48&sizc—sa layer=... 1 /24/2006 \RI A Michael F Eastey, Governor William G. Ross Jr., Secretary North CaroUna Department of Environment and Natural Resources Alan W. Klimek, PE,, Director Division of Water Quality June 27, 2006 R. Carroll Williams, PE 4840 North Center Street Hickory„ North Carolina 28601 SUBJECT: Cambridge Place Permit No, WQ0029882 Wastewater Collection System Extension Final Engineering Certification Dear Perrnitee. The Division received a final engineering certification for the subject project on June 19, ,2006. A full review of the certification materials may or may not be conducted. It is assumed that receipt of this certification indicates compliance with all regulations, design criteria and the permit. Please be reminded that the Permittee is responsible for keeping a copy of the final record drawings for the life of the project. If you have not received a copy, please contact your consultant immediately to obtain a copy. You are receiving this letter because the Division has you listed as the responsible party. If this permitted system is no longer owned by you, please complete Form PNOCF-S CIS this permit is not automatically transferable, Form PNOCF-S can be downloaded from htto://h2oenr,„stale.nc.us/nolpuindpucipps.htmlitiSewer, lf you have any questions concerning this document or the completion of Form PNOCF-S if necessary), please contact Ms, Dee Browder at the letterhead address or via E-mail at dee,browder@nomail.net, inoerey, D. Rex Gleason, P.E, urfoce Water Protection Regional Supervisor Enclosure Cc: Surface Water Protection Section Central Files (Certification page only) Note: please send copy to Permittee One NorthCarolina )Vatu/w/fi,' Pretreatment, Emergency Response and Collection Systems Unit Internet httpl/h2o_enr..ric..state,usindpu 1617 Mali Service Center, Raleigh, NC 27699-1617 An Equal Opportunity Action Employer Telephone (919) 733-5083 Fax (919) 733-0059 50% recycled/10% post -consumer paper Fast Track Enp/neerinq Certification Permit No. VVO0029882 February 24,2808 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 oa|ou|obono (selected pumpo, system cume, operating pVint, available storage if portable generator(s) or storage greater than longest past three year outage reliability option selected) for any pump stations permitted aopart ofthis project � Changes tothe project shouild beclearly identified onthe record drawings orin written summary form. Permit modifications are required for any nhanAos nasu|timq in non-compliance with this permit, regulations or minimum design criteria - This p jc:tshaUnotbeoVnsidmredoom�lebano/aUowedtoopenahaumhU#h!s Engineer's Certification and all required supporting documentation have been received bythe Division, Therefore, itiohighly recommended that this certification be sent in m manner that provides proof of receipt by the Division. EN-,INEER'S CERTIFICATION ' Ell Partial Final Jas a duiyregisbened Professional Engineer |nthe State ofNorth Carolina, having been authorized to observe (lid/PehodicaUy. Fl weekly` D full time) the construction of the Cambridge Place, a Catawba County project for the Perm|ttee.hereby state that, tmthe best cfmyabilities, due care and diligence was used inthe observation of the construction such that the construction was observed tobebuilt within substantial compliance ofthis permit: 15ANCAC2HO2OO;the Division ofWater Quality's (Division)Gravity Sewer Minimum Design Criteria adopted February 12. 18BSasapplicable; the Division's Minimum Design Criteria for the Fast -Track Permitting o/ 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 ENTSTOTHE FOLLOWING ADDRESS JUN MQORESV|LLEREG|QNAL OFFICE SURFACE WATER PROTECTION =a� 610 EAST CENTER AVENUE, SU|TE3O1 K8OORESViLLENC 28115 The Permittee is responsible for tracking all partial certifications up un wastewater flow made tributary to the wastewater collection,Engineer's Certification shall be considered 4,,M,,,1 i rf"06f t�'Lh /a1inal certification is received Any priortocompletion of this subject the Permitteetmappropriate