WQ0033720_Regional Office Historical File Pre 2018

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
February 11, 2009
Mr, Mick Berry, City Manager
City of Hickory
76 N. Center Street
Hickory, NC 28601
Subject: Permit No, WQ0033720
Hampton Inn
VVastewater Collection System Extension
ounty, North Carolina
') Ci
Dear Mr, Berry,
In accordance with your application received on February 3, 2009, we are forwarding herewith
Permit No, W00033720 dated February 11, 2009, to the City of Hickory 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date of issuance until rescinded and shall be subject to the conditions and limitations as specified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 fetter shall be considered a part of this permit and is therefore incorporated therein
by reference.
Please pay particular attention to Permit Condition 3 which requires that the wastewater
collection facilities be properly operated and maintained in accordance with 15A NCAC 2T .0403 or any
individual system -wide collection system permit issued to the Permittee.
Permitting of this project does not constitute an acceptance of any part of the project that does
not meet 1) 15A NCAC 2T; 2) the Division of Water Quality's (Division) Gravity Sewer Minimum Design
Criteria adopted February 12, 1996, as applicable: 3) and the Division's Minimum Design Criteria for
the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000, as applicable,
unless specifically mentioned herein. Division approval is based on acceptance of the certification
provided by a North Carolina -licensed Professional Engineer in the application. It shall be the
Permittee's responsibility to ensure that the as -constructed project meets the appropriate design criteria
and rules. Failure to comply may result in penalties in accordance with North Carolina General Statute
§143-215.6A through §143-215.6C, construction of additional or replacement wastewater collection
facilities, and/or referral of the North Carolina -licensed Professional Engineer to the licensing board.
Mooresville Regional Office
Locabon: 610 Fast Center Ave., Suite 301 Mooresvifie., NO 28115.
Phone [phone], Fax [phone] Customer Service: '1-877-623-6748
Rnternet www,newater u
An EtjF Oppot-Woiv 1,AffUfrative Acticn Emoiover SO% Recvdediio% Posr. Consumer ,oaDeT
NOrthCafoiina
Vittilany

rilir Mr, Berry
Page 2
February 11, 2009
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations, permission is hereby granted for the
construction and operation of approximately 299 linear feet of 8-inch gravity sewer and the discharge of
15,015 gallons per day of domestic wastewater into the Town of Mooresville existing sewerage system
in conformity with 15A NCAC 2T; the Division's Gravity Sewer Minimum Design Criteria adopted
February 12, 1996, as applicable: the Division's Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains adopted June 1, 2000, as applicable, and other supporting data
subsequently filed and approved by the Department of 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 Hickory
VVWTP (NPDES Permit No, NC0040979) prior to being discharged into the receiving stream,
Assessing subsequent impacts to the downstream collection system and treatment
facility is the complete responsibility of the City of Hickory. Hickory must utilize whatever
tracking tools necessary for planning additions of sewer flow in order to maintain compliance
with the VVVVTP permitted limits and the collection system permit WQCS00020,
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,
Coleen H. Sullins
cc: Mooresville Regional Office, Collection System Permit Files
Mathew Edwards, Kimley-Horn and Associates, Inc,
Surface Water Protection Central Files
PERCS

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
This permit shall be effective from the date of issuance until rescinded and shall be subject to the
following specified conditions and limitations,
1, This permit shall become voidable unless the wastewater collection facilities are constructed in
accordance with the conditions of this permit; 15A NCAC 2T; the Division of Water Quality's
(Division) Gravity Sewer Minimum Design Criteria adopted February 12, 1996, as applicable; the
Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force
Mains adopted June 1, 2000, as applicable; and other supporting materials unless specifically
mentioned herein.
2. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data.
3. The wastewater collection facilities shall be properly maintained and operated at all times The
Permittee shall maintain compliance with an individual system -wide collection system permit for the
operation and maintenance of these facilities as required by 15A NCAC 2T ;0403. If an individual
permit is not required, the following performance criteria shall be met as provided in 15A NCAC 2T
.0403.
a. The sewer system shall be effectively maintained and operated at all times to prevent
discharge to land or surface waters, and any contravention of the groundwater standards in
15A NCAC 2L .0200 or the surface water standards in 15A NCAC 2B .0200.
b A map of the sewer system shall be developed and shall be actively maintained.
c. An operation and maintenance plan shall be developed and implemented.
d. Purnp stations that are not connected to a telemetry system shall be inspected every day .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 §143-215.1C.

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 2T .0116, upon completion of construction and prior to operation of these
permitted facilities, the completed Engineering Certification form attached to this permit shall be
submitted with the required supporting documents to the address provided on the form. A complete
certification is one where the form is fully executed and the supporting documents are provided as
applicable.
7 A copy of the construction 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 2T: the
Division's Gravity Sewer Design Criteria adopted February 12, 1996 as applicable; the Division's
Minimum Design Criteria for the Fast -Track Permitting of Pump Station and Force Mains adopted
June 1, 2000 as applicable; and other supporting materials may subject the Permittee to an
enforcement action by the Division, in accordance with North Carolina General Statutes §143-
215.6A through §143-215.6C.
9. In the event that the wastewater collection facilities fail to perform satisfactorily, including the
creation of nuisance conditions, the Permittee shall take immediate corrective action, including
those as may be required by this Division, such as the construction of additional or replacement
facilities.
10. The issuance of this permit shall not exempt the Permittee from complying with any and all
statutes, rules, regulations, or ordinances that may be imposed by other government agencies
(local, state and federal) which have jurisdiction, including but not limited to applicable river buffer
rules in 15A NCAC 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 [phone], as soon as possible, but in no case more than
24 hours or on the next working day, following the occurrence or first knowledge of the occurrence
of either of the following:
a, Any process unit failure, due to known or unknown reasons, that renders the facility incapable
of adequate wastewater transport, such as mechanical or electrical failures of pumps, 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 8 -0 a or
[phone]. Persons reporting any of the above occurrences shall file a spill report by
completing Part I of Form -SS (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 -" (or the most
current Division approved form) can also be completed to show that the SSO was beyond
control.
Permit issued this the 1 1 th day of February, 200
NORTH CAROLINA ENVIRONMENTALMANAGEMENT COM SION
fi r Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental an gement Commis i n
mit Number ‘8,'Q0033720

Fast Track Engineerin
Permit No, WQ0033720
February 11, 2009
Owner/WQCS
Rob Neill, Manager
Primax Properties
1065 East Morehead Street
Charlotte, NC 28204
Certification
WArTP/VVQCS
Steven Hussman, Town Manager
Town of Mooresville
413 N. Main Street
Mooresville, NC 28115
PE
Mathew Edwards
Kimley-Horn and Assoc. Inc,
4651 Charlotte Park Dr, Suite 300
Charlotte, NC 28217
Complete and submit this form to the permit issuing regional office with the following:
• One copy of the project record drawings (plan & profile views of sewer lines) of the wastewater collection
system extension
• Supporting design calculations (selected pumps, system curve, operating point., available storage if portable
generator s) or storage greater than longest past three year outage reliability option selected) for any pump
stations permitted as part of this project
• Changes to the project should be clearly identified on the record drawings or in written summary form. Permit
modifications are required for any changes resulting in non-compliance with this permit, regulations or
minimum design criteria.
This project shall not be considered complete nor allowed to operate until this Engineer's Certification and ail
required supporting documentation have been received by the Division. Therefore, it is highly recommended
that this certification be sent in a manner that provides proof of receipt by the Division.
ENGINEERS CERTIFICATION
Partial 0 Final
as a duly registered Professional Engineer in the State of North Carolina, having been
authorized to observe (0 periodically, Eli weekly, 0 full time) the construction of Hampton Inn, a Catawba County
project for the Permittee, hereby state that, to the best of my abilities, due care and diligence was used in the
observation of the construction such that the construction was observed to be built within substantial compliance of
this permit; 15A NCAC 2T, the Division of Water Quality's (Division) Gravity Sewer Minimum Design Criteria adopted
February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump
Stations and Force Mains adopted June 1, 2000 as applicable, and other supporting materials.
North Carolina Professional Engineer's
seal, signature, and date:
SEND THIS FORM & SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS
MOORESVILLE REGIONAL OFFICE
SURFACE WATER PROTECTION
610 EAST CENTER AVENUE, SUITE 301
MOORESVILLE NC 28115
The Permittee is responsible for tracking all partial certifications up until a final certification is received. Any
wastewater flow made tributary to the wastewater collection system extension prior to completion of this
Engineer's Certification shall be considered a violation of the permit and shall subject the Permittee to appropriate
enforcement actions.

USE THE TAB KEY TO MOVE FROM FIETO FIELD!
Owner/Permittee:
la,. City of Hickory
Full Legal Name (company, rnonioit,tatity HOA utility, etc.)
lb, dick W •
Berry, City Cylan aa er
Apptic tion Number:
(to be completed by t)WQ)
Signing Official Name and Title (Please review 15A NCAC 2T 0106 (b
lc, The legal entity who will own this system is:
[� individua[ 0 Federal Municipality 0 State,'County Li Private Partnership El
1 d. 76 N. C
Astalllnct Adt'tre
NC
State
1 h. 828 ;1°2 f-7=t27
Telephone
7. Project (Facility
2a. Hampton Inn
Brief Project Name (permit will refer to this name)
3, Contact Person:
3a. Matthew A. Edwards P.E.Kimley-Horn artd Ass
Name a et Affiliation of Someone Who Can Answe
3b. (704) 554_7493
Phone Number
1, Project is i New
2.. Owner is ® Public (skip
Facsirrlle
PCrn:
thor i'zed signing officials!)
lloration [] Other (specify):
ie. Hickory' _
City.
1g. 28601
Zip Code
kgreer(ulci.hir.kory,.nc.us
E-mail
Catawba County__
County Where Project is Located
s, tncmm.
stions About this Application
3c, ftl tf.edwards@kirrriey-hcr'.un gat
2a. If private, applicant. will be:
Retaining Ownership (i.e, store, chura:h, singe office„ etc,
Leasingunfits (lots, townhomes, etc. - skip to Item B(3))
0 Selling units (kris, townhornes, etc. - go to Item B(2b))
3. City of Hickor
Owner o
4a, Henry Fork Waste
Name of WW'TF
5a., City of Hickory
Owner of Downstream Sewer
er Tr
nt Fac
ent F
5b. 8 inch
eiving Se%
E-mail
cation, Permit No.:
eni 2(a))
2h. If solo), f
ned by a (must choose one
Ej Public Utility (Instruction C)
10 Homeowner Assoc./Developer (Instruction D)
wrWTF) Treating Wastewater From This Project
ity 4b NC0040797 ..
VTF Permit No.
Size
The origin of this wastewater is (check all that apply):
• Resirtentias Suhd°^,tision
• Apartments/Condominiums
U Mobile Home Park
• School
Cl Restaurant
I[) Office
Gravity
Force. Main
n Retail (Stores sh
Q Institution
[j Hospital
[� Church
[1 Nursing Home
El Other
(specify): Hotel .w�..._r-s ...
7. Volume of wastewater to be allocated or perrnitte
*Do not include future flows or previously per
6 If the permitted flow is zero, iindic.ate why:
Pfai
.enters)
this particular project: 15,01
d allocations
0 Pump Stat#on, Outfall or Interceptor Line where flow will he pern
[1 Flow nos already been allocated in Permit No,
• Rehabilitation or replacement of existing sewer with no new fVrarn
permit is required)
Downstream Sewer (Instruction E)
100 `F Domestic/Commercial
Industrial (attach
description.)
(RO: contact your Regional Office
Pretreatment staff)
% Other (spec
allons per day
fy):
suhsealuent permits that connect to this line
5A NCAC 02T ,6303 to determine if a

2
0
u.
9, Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2T .0114 for
the value in Item B(7) AND/OR the design flow for line or pump station sizing if a reduced or zero flow is being requested in
Item B(7). Values other than that in 15A NCAC 2T .0114 (b) and (c) must be supported with actual water or wastewater use
data in accordance with 15A NCAC 2T .0114(0.
Please see attached,
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches) Length (feet)
8
New Gravity or Additional
Force Main
299 Gravity
11, Summary of Pump Stations w/ associated Force Mains to be Permitted (attach additional sheets as necessary)
Pump Station Location ID (self chosen - as shown on plans/map for reference)
Design Flow
(MGD)
Power Reliability Option
Operational Point
1 - permanent generator w/ATS;
GPM @TDH
2 - portable generator w/MTS
Force Main Size Force Main Length
Pump Station Location ID
Design Flow
(MGD)
Operational Point
GPM @TDH
(self chosen -
Power Reliability Option
1 - permanent generator w/ATS;
2 - portable generator w/MTS
as shown on planslmap for reference)
Force Main Size
Force Main Length
ce Pump Station Location ID
ILLI
a. Design Flow
(MGD)
(self chosen - as shown on plans/map for reference)
Power Reliability Option
Operational Paint ..
permanent generator w/ATS; Force Main Size Force Main Length
GPM @TDH
2 - portable generator w/MTS
12. Will the wastewater flow in the proposed sewer lines or pump stations be able to be directed to another treatment facility?
[I] Yes El No If Yes, permit number of 2nd treatment facility
(RO — if "yes" to B,12 please contact the Central Office PERCS Unit)
13, Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force
Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC Chapter 2T as
applicable?
El Yes El 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
FTA12/07

14. Have the following perrnits/certifications been submitted for approval for the system or project to be served?
Wetland/Stream Crossings - General Permit or 401Certification? El Yes 0 No [3] N/A
Sedimentation and Erosion Control Plan? E] Yes LI No [1] N/A
Stormwater? Yes 0 No El N/A
15. Does this project include any high priority lines, [see 15A NCAC 02T .0402 (2)] involve aerial lines, siphons, or interference
manholes)? These lines will be considered high priority and must be checked once every six months
Check if Yes: D and provide details
la.
Owner/Permittee's Certification: (Signature of Signing Official and Project Name)
I, Mick W. Berry , attest that this application for Hampton Inn 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 Genera/ Statutes 143-
215,6A 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.
Signing Official Signature
/2 ,
Date
ENGINEERING DESIGN DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL OF THIS
APPLICATION, THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR PROXIMITY:
TO OTHER UTILITIES, DESIGN CALCULATIONS. ETC. REFER TO 15A NCAC 02T .0305
CO
I 2
2, Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
uj
0
0
/, Matthew Edwards , attest that this application for Hampton Inn 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 1 further attest that to the best of my knowledge the proposed
design has been prepared in accordance with the applicable regulations, Gravity Sewer Minimum Design Criteria for
Gravity Sewers adopted February 12, 1996, and the Minimum Design Criteria for the Fast -Track Permitting of Pump
Stations and Force Mains adopted June 1, 2000 and the watershed classification in accordance with Division guidance.
Although other professionals may have developed certain portions of this submittal package, inclusion of these materials
under my signature and seal signifies that I 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 143-215.6B, 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 civil penalties up to $25, 000 per violation,
2a. Matthew A. Edwards, P.E.
Professional Engineer Name
2b. Kimley-Horn and Associates, Inc.
Engineering Firm
2c, 4651 Charlotte Park Drive, Suite 300
Mailing Address
2d Charlotte
2e NC 2f, 28217
City State Zip
21. mattedwards@kimley-
2g, [phone] 2h. [phone] horn.com
Telephone Facsimile E-mail
NC PE Seal, Signature & Date
FTA I 2/07

Department of Environ
State of North Carolina
nt and Natural Resources
Division of Water Quality
Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE - 10/07)
Project Applicant Name: City. of Hickory
Project Name for which flow is being requested: Hamptot lnn
More than one FTSE- 10/07 may he required for a single project if the owner of
pump stations along the route of the proposed wastewater flow.
VIP is not responsi
e
all
1.. Complete this section only if you are the owner of the wastewater treat
a. WW'fP Facility Name: Henry Fork Waste Water Treatment Plant
b. WWTP Facility Permit #::NC0040797
c. WWTP facility's permitted flow
d. Estimated obligated 'flow not yet tributary to the WWT'P
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
1,3254
2.48
0.015015
3.820415
42.45 %
nt plant.
s are ut MGD
MGD
MGD
MGD
MGD
MGD
Complete this section for each pump station you are responsible for along the route of this
proposed wastewater flow.
;t pump stations located bettiveen the project connection point and the WWTP
ntp Station Name
Clark Creek
Sandy Ford
Approx. Capacity, MGD
(Firm Design)
1.92 MGD
2,30 MGD
Approx. Current Avg.
Daily Flow, MGD
0.68 MGD
0.95 MGD
III. Certification Sta
I, Mick W. berry, City IV1anaer, certify that, to the best of my knowledge, the addition of the vlunte
ofwastewater to be permitted in this project has been evaluated along the route to the receiving
wastewater treatment facility and that the flow from this project is not anticipated to cause any capacity
related sanitary sewer overflows or overburden any downstream pump station en route to the receiving
treatment. plant under normal circumstances. This analysis has been performed in accordance with local
established policies and procedures using the best available data, This certification applies to those items
listed above in Sections 1 and 11 for which 1 am the responsible party. Signature of this form indicates
acceptance of this wa
Signing OJfic tat
/2 9,
Date

instructions for: Flow TiaCking/Acceptance for SewerExtension Pennit
Applications (FTSE —10/07)
Section I
a. WWTP Facility Name: „Enter the narne of the WWTP that will rceiv&. thc atewater flow.
b. WWTP FaciWPermit #: Enter the NPDES or Non -Discharge number for the WWTP receiving the
wastewater flow,
c. facility"s permitted flow, MGD: From WWTP owner's NPDES or Non -Discharge permit.
d. Estimated oblizated flow: not vet tributary to the WWIT_MGD: This includes flows allocated to
other construction projects not yet contributing -flow to the collection system. Flows allocated through
interlocal agreements or other contracts not yet contributing flow to the collection system are also
included. For POTWs that: implement. a pretreatment program, include flows allocated to industrial
users who may not be using all of their flow allocation. Please contact your Pretreatment Coordinator
for information on industrial flow tributary to your WWTP.
As olJanuary 15, 2008 the POTW should have reviewed flow allocations made over the last two
years and reconciled their flow records, to the best of their ability, so it is known how much flow has
been Obligated and is not yet been made tributary to the WWTP, in accordance with local policies and
procedures employed by the reporting entity.
The obligated flow not yet tributary plus actual flow. will be reconciled annually for systems at less
than 60% of permitted flow used. Annual updates shall be submitted to the appropriate Regional
Office by January 15 of each year and cover the previous calendar year.
Semi -Annual updates shall be required when the percent of permitted flow used reaches 60%. Semi-
annual time period are defined as January 1 through June 30 and July 1 through December 3 I. Semi-
annual updates shall be submitted to the appropriate Regional Office by July 15 and January 15 of
each year.
Quarterly updates shall be required when the percent of permitted flow used reaches 80%. Quarters
are defined as Qtr 1 (jan-Eeb-Mar); Qtr2 (Apr -May -Jun); Qtr3 (Rd -Aug -Sep); Qtr4 (Oct -Nov -Dec).
Quarterly updates shall be submitted to the appropriate Regional Office by April 15, July 15, October
15 and January 1.5 °leach year.
WWTP facility's. act g, flow 'a Previous 12 month average.
:. Total flow for this specific request, TVIG-D: Enter the requested flow volume.
g. 'Iota' actual and oblizated flows to the facility. MGD Lquals [(.1 e + 11
h. Percent ofpermitted flow used: Equals Rg / c)*1.001

For example:
On January 15 a POTPOTW with a permitted flow of 6,0 MGD, reported to the Regional Office that there
is n, 5 MOD of flow that is obligated but not yet tributary. 'The annual average flow for 2007 is 2,7
MOD.
The first 10 i 11 SE-10107 subraaitted after January 15. 2008 may have numbers
6.0 MOD
d. --- 0.5 MCiD
ems- 2.7 MCi
0.015 MCI)
-= 3,215 Mil
53,6 %
"fhe next Form " 'S1E - /07 roar° he updated like thi
= 6.0 MOIL
t .515 M I)
3D
= 2.73
- 0.102 [
g. 3,349 MG1.9
b. = 55. 'a
k
this:
Each subsequent Fo F "SF 10/07 will Ite updated in the same ma
n 1
e naraac, pltrcavinaate pump station tirni (design) capacity and appru insete eurrerot avvee #Jove
(previous 12 rnoraths) through the pump station for each pump station that s i11 be impacted by, the
proposed sewer extension project. Include the proposed flow for this project and other flows that have
been approved for the pump station hut are not yet tributary,
(design) capacity is the design average daily tlois of the pump station as ealculated by the design
,iraeer or the station capacity with the largest pump out of service as per the Minimuaaa Design Criteria
ht designipacity is unknown.
Section
FUSE SF 10/117 rases
e s
ed by" the appropriate ()litchi aas per iA NF'AC 0'l .0106.

TOPC..)! map prInted on 01/05/09 from "Unttlecl,tpo"
0
81'20, 000W
0-;
81°20,000' W
MNTN
7°
4
000 w 0 0 0
• :'•.;*,,si•
81°19000 W
WGS84 81°18.000' W
0 MILE
0 1(I00 'i'E E I 0-
-8--7.--—,9 (-----.•--------T-==-----,R
Map mated with TOPOICI ©2003 National Geographic (wv/w.nationalgeographir. coraftopo)
MI ITFIS

Hampton Inn, Hickory
Subject: Hampton Inn, Hickory
From: <Matt.Edwards@kim!ey-horn.com>
Date: Tue, 10 Feb 2009 17:06:49 -0500
Ta: <[e-mail]>
CC: <Beverly.Rosenbloom rzkimley-horn.corn>
Dee,
Per your request, attached are our sary eav'er flow calculations. Let us know if you need any additional information. Thanks,
Matthew A. Edwards, P.E.
Project Manager
Kimley-Horn. and Associates, Inc.
Suite 300
4651 Charlotte Park Drive
Charlotte, NC 28217
Ph:704-954--7493 Fa : 704-333-0845
Content -Description: Hampton Inn Sanitary Sewer loadings 11-24-08.pdf
pt©n Inn Sanitary Sewer loadings 11-24-08.pdf Content -Type: applicati.onlpdf
Content -Encoding: base64
1of1 2110/20095:13PM

PROJECTED FLOWS TABLE
Project Name: Hampton Inn, Hickory, NC
Projected Flows Per NC DENR, Title 15A
fat
Ret
Al
A2
Type of Establishment
Motel
ttout
n-rocl
Hatel wth In -room a
cooking facil
skin fact
ales
12
Hydraulic
Loading
120
175
Total
ADF
3,440
r
575
15015
gpd
gpd
ggd
Peak C ally Flog 4 l i to E fisting reef Sewer 37,538 gpd

Suite
rlKimley-Horn
and Associates, Inc.
i 1'(113sJ71lital
Date: January +, 2( 09 Job Number: 0
Project Name: Hampton I.n.n, llic.koryt NC
To: Dee Browder
Division of Water Quality
610 E. Center Avenue
ooresville, NC.:
704-663-1699
ending threw by'
L
U.S. Mail
Other:
46SI CI
28217
a
North Carolina
b'd i_ 71)4 3,33 5131
f..X )4 333 084
Hand Deliver
We are sending V t
® Attached
Shop Drawings
E Other:
Date
r" Under separate cover via.
Prints/Plans
Samples
Description
the following items:
Specitications hane Orders
Fast Track Sewer Application
Cheek fir S4810 payable to NCCDENR
Thee are transmitted as chec t'd beh
EKFor your use C Approved as submitted
,s requested n A:pproved as noted
For review and comn4en
Dee,
We trust t1
Arne
ections
Resubmit
Submit
R.eturo
(Copies for appro 1
Copies for distribution
ted prints
eeds tit this tit le but please let us know ifyctu nee rt °t}zing else,
Thanks, Beverly Rosenbloom.
704.319.7699
Copy to:
ed Beverly .Rosenbloom
Page 1

Central Fifes: APS SWP,
Pert°nit Number
Q00 Permit Tracking Slip
02/10/09
Program Category
Non -discharge
Status
in review
Project Type
New Project
Permit Type I a, l Track Version Permit Classification
Gravity Sewer Extension, Pump Stations, r Pressure Sew A Individual
Extensions
Primary Reviewer
dee, brewder
Permitted Flow
15015
F
Fac
Name
Hampton Inn
Permit Contact Affiliation
cation Address
er
Owner Name
City of Hickory
Major/Miner
Minor
Orig Issue Ann Received Draft lnitia
02/11 / 9 01 //06/09
euiated Activities
rtotetsroatel'
Wastewater sae ion
Gutfll NULL
t*Vaterbcdy Name
Region
MooresviI
County
Catawba
Facility Contact Affiliation
Owner Type,
Government u Municipal
Owner Affiliation
Mick Berry
PO Box 398
ctreduled
d Issuance
Hickory
Public Notice
NC 286010398
Issue Effective
02/1 0/11,r09
este /_ t, eived
Additional infoabort requested
Additional inform aticn received
Stream Index plumber
Expi
02/03/09
02/11/09
Current Cis5ubbasin

HA PION INN, HICKORY II, LC
225HWY. 70 SE, SUITE 101
HICKORY. NC 28602
Four Hundred Eight
PAY
1 ) THE
ORDER
r
NN.
0 00 2
DCD. A U A$ kICPIOPFUNTIIYO
WA H )VIA
KUHY, NC 28601
00-1 6/5."1
16 08 10024$ *** *480.0
E EWEa'OP MIS DCCU 1 ,`1 CLUDEALAN AA CIAL A m`11 D AT AA ANSI TO VI
200004 091, cie

Fast Track Engineering Certification
Permit No. WQ0033720
February 11, 2009
Owner/WQCS
Rob Neill, Mag,ager
Primax p2rfeities
1065 t Morehead Street
Ototte, NC 28204
WiATTP/WQC
Steven HL
Town
413
Mr. Mk Ferry,
C; 4,j cyc I:Lko-y
4-6 Ai Cealet
Ki ZE3601
PE
,man, Town Manager
idoresville
ain Street
resville, NC 28115
pr
Mathew Edwards
Kimley-Horn and Assoc. Inc
4651 Charlotte Park Dr, Suite 300
Charlotte, NC 28217
Complete and submit this form to the permit issuing regional office with the following:
• One copy of the project record drawings (plan & profile views of sewer lines) of the wastewater collection
system extension
Supporting design calculations (selected pumps, system cure, operating point, available storage if portable
generator(s) or storage greater than longest past three year outage reliability option selected) for any pump
stations permitted as part of this project
• Changes to the project should be clearly identified on the record drawings or in written summary form. Permit
modifications are required for any changes resulting in non-compliance with this perrnit, regulations or
minimum design criteria
This project shail not he considered complete nor allowed to operate untii this Engineer's Certification and ail
required supporting documentation hae been received by the. Division. Therefore, it is highly recommended
that this certification be sent in a manner that provides proof of receipt by the Division.
ENGINEER'S CERTIFICATION
El Partial Final
as a duly regstered Professional Engineer in the State of North Carolina, having been
authorized to observe periodically, weekly, 0 full time) the construction of Hampton Inn, a Catawba County
project for the Permittee, hereby state that, to the best of my abilities, due care and diligence was used in the
observation of the construction such that the construction was observed to be built within substantial compliance of
this permit 15A NCAC 2T,' the Division of Water Quality's (Division) Gravity Sewer Minimum Design Criteria adopted
February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump
Stations and Force Mains adopted June 1, 2000 as applicable; and other supporting materials.
flb44ww 4. Elk;
North Carolina Professional Engineer's
seal, signature, and date:
•
4. • •
11 A
f 7.154)q
SEND THIS FORM & SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS
MOORESVILLE REGIONAL OFFICE
SURFACE WATER PROTECTION
610 EAST CENTER AVENUE, SUITE 301
MOORESVILLE NC 28115
The Permittee is responsible for tracking all partial certifications up until a final certification is received. Any
wastewater flow made tributary to the wastewater collection system extension prior to completion of this
Engineer's Certification shall be considered a violation of the permit and shall subject the Permittee to appropriate
enforcement actions.

Kimley-Horn
and Associates„ in
° r ansm ttal
Date: December 1 /, 2009 Job Number 0 429001
Project Name: Hampton lnn, l-lickorNC
To:
Suite 300
4651 C:ltar}trftc Parr} Can v
Charlotte, ?tic rrft f aralina
282}
TEL 10433
FAX 7 433:3
, Coleen Sullins
NC :11 1 Division vision of Water Quality
Mooresville Regional Office
610 East Cent
Suite al
Mooresville, NC 2(
We are 'ending r
u.S, mad
Other`
rending you
Attached
Shop Dr :
122/
5
FedExc
Under separate c
,^Plans
via
Del^er
apes
Speecaticrnss
the flitr�ri
Change Orders
/09
7109
12117^+09
Description
Fast -Track Engineering Certification t sitter
Fast -Track Engineering Certification
Fox Survey Company — As -built Survey
3Cirrrley Horn Lrtility Plan
These are transn ed 17S c°:ir ?ckedhefo t.
For your use 0 Approved as subrttitted
ElAs requested piApproved as noted
ElFor review and ctarnrncnt Returned for co
Copy to:
Resubmit
Submit
Return
Copies iar appros
Signed l tatt Edwards, P
distribution
Page 1

ey-Horn
and Associates. hr.
the
Qua].i
lia.
co n rasa
Public
utilities
construe
Please
Pau
act. anin-in
Per i tnNot Q00 3720
1-1gantpatan lraa
Wastewaters
1 +4) 00"1
Sullins:
tensi
ll cal4 illy "its' cal lli kor , this
laic "
kl�at Ilic, caa�sttttticatt ai` tic sawNit),;
0( oinpletc lgar the subject
ecl Feb
(704) ::13 S 13:i °i.
. .l:d aardS.0. ,
r 1) ti ihaati« at laa.
1919S
Chatibilei Hut
282034778.
19% a aplalicab
:Water
Petit
h•
itth
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siArdi
SLtk'a t'
E AL
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ii44 70413 t}?1t
Fla 704744049778.

Shrum Acres sewer extension plan construction certification —
Plan designed by R. Carroll Williams, PE 3202, Engineer now retired
Hickory, NC
f, G. Cecil Clark, as a duly registered Professional Engineer in the State of
North Carolina, having been authorized to observe periodically the testing of
approximately 3503 linear feet of 8" SDR 35 PVC sewer line and 22
manholes..
I hereby state that, to the best of my abilities, due care and diligence was
used in the observation of the testing such that the project was observed to
be built within substantial compliance and intent of the approved plans and
specifications, and other supporting materials.
S ignature
Date
Registration No. 5156