WQ0036769_Regional Office Historical File Pre 2018

EIPV
NCDENR
North Carolina Department of Environment and Natural Resources
Division OfWater Resources
Water Quality PmOg[a0G
Pat McCrory Thomas Reeder
GOVe[D0r Di[80k)r
Mr. Jimmy A.Clark, Public Works, Director
City ufConover
Post Office BnxS49
Conover, N[Z8613
Dear Mr. Clark:
John SkVa[a.III
Secretary
Subject.- Permit No. VVQ00}6769
VVahyreen»Stonz No, 15568Sevver Relocation
Wastewater Collection System Extension
Catawba County
In accordance with your application received October Q, I019, we are forwarding Permit No.
VVQ0036769, dated October 14' 2813 to City ofConover for the construction and operation of the
subject wastewater collection system extension, This permit shall beeffective from the date efissuance
until rescinded, and shall be subject to the conditions and limitations as specified therein, This cover
letter and supplement shall be considered a part of this permit and are therefore incorporated therein
by reference.
it shall be responsibility of City of Conover to ensure that the as -constructed project meets the
appropriate design criteria and rules. Failure to comply may result in penalties in accordance with the
North Carolina General Statute §143-215.64 through §143-215.6[ construction of additional or
replacement wastewater collection facilities, and/or referral of the North Carolina -licensed Professional
Engineer tothe licensing board.
if any parts, requirements, or limitations contained in this permit are unacceptable, you have the right
to request an adjudicatory hearing upon written request within 30 days following receipt of this permit.
This request must he in the form of written petition, conforming to Chapter 150Q of North Carolina
General Statutes, and filed with the Office of Administrative Hearings, 5714 Mail Service [enter, Raleigh,
NC37G99'6714. Unless such demands are made, this permit shall befinal and binding.
1617 Mail Service Comr, Camlinaz76n9-/0r
One
NortliCarofiiia
,Xahzralli,

irnrny A. Clark
t 0036769
If you need additional inforrnati n concerning this matter, please contact !'fir. Michael Parker at 704)
235-2194 or via e-mail at 1+ i"chael,[e-mail].
Division of Water Resources
cc: Michael D. Newman, R.E., (electronic copy)
Water Resources Central Files
PERCS (electronic copy)

STATE OFNORTH [ARGUNA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OFENVIRONMENT AND NATURAL RESOURCES
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
In accordance with the provisions of Article 31 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations, permission is hereby granted to the
City ofConover
Catawba County
for the construction and operation of approximately 340 linear feet of 8-inch gravity sewer and the
discharge of gallons per day of collected domestic wastewater into the [by of Newton Clark Creek
VVVVTp existing sewerage system, pursuant to the application received October 8' 2013' and in
conformity with 15A NCAC2l� the Division's Gravity Sewer Minimum Design Criteria adopted February
12' 1096 as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump
Stations and Force Mains adopted June I, 2000 as applicable; and other supporting data subsequently
filed and approved by the Department ofEnvironment and Natural Resources and considered part of
this permit.
This permit shall be effective from the date of issuance until rescinded and shall be subject to 'the
specified conditions and limitations contained therein,
^
issued this the 14"' day of October, 2013.
for Thomas Reeder, Director
Division of Water Resources
ByAuthority mfThe Environmental Management Commission
Permit Number: WQ0036769

SUPPLEMENT PERMIT COVER SHEET
City of Conover is hereby authorized to:
Construct, and then operate upon certification the aforementioned wastewater collection extemsk>n.
The sewage and wastewater collected by this system shall be treated in the City of Newton Clark Creek
Wastewater Treatment Facility (NPDES Permit No. NCO0]6196) prior to being discharged into the
receiving stream.
Permitting of this project does not constitute an acceptance of any part of the project that does not
meet 15A N[&C ZT; the Division of Water Resources' (Division) Gravity Sewer Minimum Design Criteria
adopted February 12, I996 as applicable; and the Division's Minimum Design Criteria for the Fast -Track
Permitting ofPump Stations and Force Mains adopted June l' 2000 as applicable, unless specifically
mentioned herein. Division approval is based on acceptance mfthe certification provided by North
Carolina -licensed Professional Engineer in the app|Ycahnn, lt shall be the permittee's responsibility to
ensure that the as -constructed project meets the appropriate design criteria and rules.
Construction and operation is contingent upon compliance with the Standard Conditions,
11. STANDARD CONDITIONS
L This permit bnot transferable. ;nthe event there isadesire for the wastewater collection facilities cuchange
ownership, or there is a name change of the Permiuee' a formal permit request shall he submitted to the
Div|siwn accompanied by documentation from the parties involved' and other supporting materials as may be
appropriate. The approvai of this request shall be considered on its merits and may or may not be approved
Z. This permit shall become voidable unless the wastewater collection fvo)hies are umnomcuzd in accordance
with the conditions of this permit, 15A NCAC 2T; the Division of Water Resuurces's (Division) Gravity Sewer
Minimum Design Criteria adopted February 12, 1996 e*app|oab|e,-the Division's Minimum Design Criteria for
the Fast -Track Permitting ofPump Stations and Fane Mains adopted June 1, 20gQvsmpp|icab|e,-and other
supporting materials unless specifically mentioned herein
3. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data.
4� The wastewater collection facilities shall he properly maintained and operated at all times. The Permiuee
shall maintain compliance with an individual system -wide collection system permit for the operation and
maintenance of these facilities as required by 15A N[4[ ZT 0403, If an individual permit is not required, the
following performance criteria shall bemet asprovided |nI5ANC4[JT�O4O3:
o The sewer systern shaU be effectively maintained and operated at all times to prevent discharge to Iand or
surface waters, and to prevent any contravention of groundwater standards or surface water standards,
bA map of the sewer system shall be developed and shall be actively maintained,
c An operation and maintenance plan including pump station inspection frequency, preventative
maintenance sc*eduie spare parts inventory and mverUwm/ response has been developed and
implemented,

d. Pumpgahunsthat ae not connected to a telemetry system shall be inspected every day (i.e. 365day
Pperyear), vmp stations that are connected to atelemetry system shall be inspected at least once per
"eek.
e. High -priority sewer lines shall be inspected at least once per every six -months and inspections are
documented,
f A general observation of the entire sewer system shall be conducted at least once per year.
8� Overflows and bypaseessha|f 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
§I43-215.l[.
h. A Grease Control Program is in place as follows:
l. For public owned collection systems the Grease [orund Program shall include at least tAounua|
distribution of educational materials for both commercial and residential users and the legal means to
require grease interceptors at existing establishments, The plan shall also include legal means for
inspections of the grease interceptors, enforcement for violators and the legal means to control
grease entering the system from other public and private satellite sewer systems,
2. For privately owned collection systems, the Grease Control Program shall include ucleast bi-annual
distribution of grease education materials to users of the collection system by the per,niuee or its
representative.
3. Grease education materials shall be distributed more often than required in Parts (l) and (2) of this
Subparagraph if necessary to prevent grease -related sanitary sewer overflows.
L R|#htof^ways and easements shall be maintained mthe full easement width for peoonmetand equipment
jDocumentation shall be kept for Subparagraphs (a) through (i) of this Rule for a minimum of three years
with exception ofthe map, which shall bemaintained for the life mf the system,
5. Noncompliance Notification:
The Pcrmittee shall report by telephone to a water quality staff member at the Mooresville Regional Office,
telephone number 704'663-1099' as soon as possible, but in no case more than 24 hours oronthe 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 WqckaQ* or
breakage, etc.; or
b. Any SSOand/or spill over 1,O00gallons; nr
c Any SSOand/or spill, regardless o/Volume, that reaches surface water
Voice mail messages or faxed information is permissible, but this shall not be considered as the initial verbal
report. overflows and spills occurring outside normal business hours may also be reported to the Division of
Emergency Management at telephone nombe/(8QO) 858-0368 or (9I9) 73]-3]00. Persons reporting any of
the above occurrences vhmU file a spill report by completing and submitting Part | of Form CS-SSD (or the most
current Division approved form) within five days following first knowledge of the occurrence, This report must
outline the actions taken or proposed to be taken to ensure that the problem does not recur. Part 11 of Form
CS-SSO (or the most current Division approved form) can also be completed to show that the S3Owas beyond

6Construction of the gravity sewers, pump stations, and force mains shall be scheduled so as not to interru
service by the existing utilities nor result in an overflow or bypass discharge of wastewater to the surface
waters of the State.
I per lSA NCA[ 2[0116, upon completion ofconstruction and prior to operation of these permitted facilities,
the completed Engineering Certification form attached tothis permit shall be submitted with the required
supporting documents tothe address provided onthe form. Acomplete certification isone where the form is
fully executed and the supporting documents are provided asapplicable. Any wastewater flow made tributary
to the wastewater collection system extension prior to completion of this Engineer's Certification shall be
considered aviolation u[the permit and shall subject the Permitteetoappropriate enforcement actions,
If the permit is issued to a private entity with an Operational Agreement, then a copy ofthe Articles of
Incorporation, Declarations/Covenants/Re5trictions, and Bylaws that have been appropriately filed with the
applicable County's Register of Deeds office shall be submitted with the certification.
A complete certification is one where the form is fully executed and the supporting documents are provided as
applicable. Supporting documentation shall include the following:
o� One copy of the project construction record drawings (plan & profile views of 5ewer lines & force mains)
of the wastewater collection system extension. Fina� record drawings should be clear on the plans or on
digital media (CD u/DVDdisk) and are defined asthe design drawings that are marked up or annotated
with after construction information and show required buffers, separation distances, material changes,
b� One copy of the supporting pump station design calculations (selected pumps, system curve operating
point, buoyancy calculations, available storage if portable generator(s) or storage greater than longest
past three year outage reliabdity option selected) for any pump stations permitted as part of this project,
c Changes tothe project that donot result innon-comp;ia^cewith this permit, regulations, orthe Minimum
Design Criteria should be clearly identified on the record d,awdngs, on the certification in the space
provided, or in written summary form.
Prior ,o Certification (Final or Parda|)� Permit modifications are required for any changes resulting in non-
compliance with this permit (iodudinOpipe length increases oflO%nrgreater, increased flow' pump station
design capacity design increases of 5% or greater, and increases in the number/type of connections),
regulations, or the Minimum Design Criteria. Requested modifications or variances to the ,minimum Design
Criteria will be reviewed on e case -by -case bads and each on its own merit. Please note that variances to the
Minimum Design Criteria should be requested and approved during the permitting process prior to
construction, After -construction requests are discouraged by the Division and may not be approved, thus
requiring replacement urrepair prior tocertification &activation.
8A copy of the construction record drawings shall be maintained on fi|c by the Permbtee for the life of the
wastewater collection facilities.
9� Failure to abide bythe conditions and limitations contained in this permit; lSA N[A[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 5mdmn and Force Mains adopted June I 2008 as applicable; and other
supporting materials may subject the Perrnittee,o an enforcement action by the Division, in accordance with
North Carolina General Statutes §143-2I16Athrough §I43'215.6C, construction of additional or replacement
wastewater collection facilities, and/or referral of the North Carolina -licensed Professional Engineer to the
licensing board,

In the event that the waste Alater collection facrlrtie ito perform satisfactorilw f including the creati an of
ante conditions, the Permittee shall take immediate corrective actioorr.. including those as may ,be required'
by this Division, such as the construction of additional or replacement facilities.
The issuance of this permit shall not exemptthe Permi tee from complying vv°ith;any and all statutes, ru€es,
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,
sedimentabon control requirements in 15A NCAC Ch, 4 and under the Division's General Permit NCGO10000,
and any requirements pertaining to wetlands under 15A NCAC 2t3 .0200 and 15A NCAC 2H :0500.

FAST TRACK ENGINEERING CERTIFICATION
Permittee: City of Conover Permit No. WQ00
Project: Walgreens Store No. 15568 Sewer Relocation Issue Date: 10/14/2013
Complete and submit this form to the permit issuing regional office with the following
• One copy of the project record drawings (plan & profile views and detail drawings of sewer lines) of the wastewater
collection system extension. Final record drawings should be clear on the plans or on digital media (CD or DVD
disk) in pdf format. Record drawings should indicate the design and the marked up changes during construction;
• 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. Modifications should be submitted prior to certification.
This project shall not be considered complete nor allowed to operate until the Division has received this Engineers
Certification and all required supporting documentation, Therefore, it is highly recommended that this certification
be sent in a manner that provides proof of receipt by the Division.
PERMITTEE'S CERTIFICATION
, the undersigned agent for the Permittee, hereby state that this project has
been constructed pursuant to the applicable standards & requirements the Professional Engineer below has
provided applicable design/construction information to the Permittee, and the Permittee is prepared to operate &
maintain the wastewater collection system permitted herein or portions thereof,
I Printed Name, Title Signature Date
ENGINEER'S CERTIFICATION
El
E Partial Final
I , as a duly registered Professional Engineer in the State of North Carolina,
having been authorized to observe (El periodically, Ei weekly, El full time) the construction of the subject 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 02T; the Division of Water Resources's Gravity Sewer Minimum Design Criteria adopted
February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump
Stations and Force Mains adopted June 1, 2000 as applicable, and other supporting materials,
North Carolina Professional Engineer's
Seal, signature, and date:
SEND THIS FORM & SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS
SURFACE WATER PROTECTION SUPERVISOR
MOORESVILLE REGIONAL OFFICE
610 East Center Ave., 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,

0
2
0
u.
z
—J
z
0
z
"--
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD Application Number:
(to be completed by DWR)
. Owner/Perm ittee:
la. City of Conover
Full Legal Name (company, municipality, I-10A, utility, etc.)
1 f)
Signing Official Name and Title (Please review 15A NCAC 2T .0106 lb) for authorized signing officials)
lc. The legal entity who will n this system is:
0 Individual 0 Federal MunicipalityE1 State/County 0 Private Partnership D Corporation 0 Other, (specify): _
1 d. 939 411' Street SW 11 e. Conover
Mailing Address City
if. NC 1 g. 28613
State I Zip Code
111. 828-464-4808 1 i. 28-464-5299 i1j. j mmy a k conovernc.gov
Telephone , Facsimile I E-mail
2. Protect (Facility) Information:
2a. Sewer Relocation for Walgreens Store#15568 2b, Catawba
Brief Project Name (permit will refer to this name) County Where Project is Located
3. Contact Person:
3a, Michael Newman
Name and Affiliation of Someone Who Can Answer Questions About this Application
3c. micha dven .co
3b. 704-400-1044
Phone Number
1. Project i Ii New EI Modification (of an existing permit)
E-m
If Modification, Permit Noe
2. Owner is Public (skip to Item B(3))
2a. If private, applicant will be:
0 Private (go to Item 2(a))
2b. If sold, facilities owned by a (must choose one)
El Retaining Ownership (i.e. store, church, single office, etc.) or 0 Public Utility (Instruction D)
0 Leasing units (lots, townhomes, etc. - skip to Item B(3)) Ej Homeowner Assoc./Developer (Instruction E)
Selling units (lots, townhomes, etc. - go to Item B(2b))
3. Ire.lLtrtv 4rrrfr '1144-it (1,,,ve, ,
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
l4a, J„erci feir i'm 1 e ,15: f 7 ,41D. AJ (I.cx-5
Name of WWTF WWTF Permit No.
5a. City of Conover b. 8-inch avity 5c.
Owner of Downstream Sewer Receiving Sewer Size Force Main
6. The origin of this wastewater is (check all that apply):
7,
0 Residential Subdivision
0 Apartments/Condominiums
Mobile Home Park
O School
0 Restaurant
Eli Office
Permit # of Downstream Sewer (instruction F
Retail (Stores, shopping centers)
Institution
0 Hospital
0 Church
El Nursing Home
0 Other (specify):
100% Domestic/Commercial
% Industrial
(Attach Description)
% Other
(Attach Description)
Volume of wastewater to be allocated or permitted for this particular project: 0 gallons per day
'Do not include future flows or previously permitted allocations
8. If the permitted flow is zero, indicate why:
0 Pump Station, Outfall or Interceptor Line where flow will be permitted in subsequent permits that connect to this line
0 Flow has already been allocated in Permit No.
Rehabilitation or replacement of existing sewer with no new flow expected
(see 15A NCAC 02T .0303 to determine if a permit is required)
FTA 08-13 APPLICATION
Page 3 of 6

Ines to be Permitted (attach additional sheets if necessa
LL
Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2T .0114 or
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 ,01 14 (f).
Existing Shopping Center space to be demolished is 35,000 SF. Proposed Retail -Pharmacy Store space is 14,550 SF.
There will be a net decrease in Store spaces with this proposed project, therefore no additional flow is being permitted as
part of this project.
Summary of Sewer
Size (inches)
Length (feet)
340
Gravity or Additional
Force Main.
Gravity
Summary of Pump Stations w/ associated Force Mains to be Permitted (attach additional sheets as necessary)
z
0 Pump Station Location ID:
0
*-- Longitude:
Z
0
}^
Q
cc
LL
Pump Station Location ID: (self chosen - as shown on plans/map for reference
elf chosen - as shown an plans/map for reference)
Design Flow
(MGD).
(
Operational Points
GPM @TDH
Latitude:
Power Reliability Option
- permanent generator w/ATS; Force Main Size Force Main Length
2 - portable generator w/MTS
;Longitude: Latitude:.
Design Flow ! Power Reliability Option
i Operational Point'
(MG]) permanent generator w/ATS;
i GPM {§TDH f 2 - portable generator w/MTS
Force Main Size Force Main Len
12. Will the wastewater flow in the proposed sewer lines or pump stations be able to be directed to another treatment facility?
01 Yes 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 Permitting of Pump Stations and Force Main
(latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC Chapter2T as applicable?
El Yes 0 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
F`IA 08-13 APPLICATION
Page 4 of 6

14. Have the following permits/certifications been submitted for approval for the system or project to be served?
Wetland"Stream Crossings - Genera! Permit or 401Certification? 0 Yes 0 No Ej
Sedimentation and Erosion Control Plan? 0 Yes 0 No El N/A
Trout Buffer Waiver? El Yes 0 No CZ] N/A
Stormwater? E: Yes 13, No Ej NIA
15. Does this project ncude includeany high priority lines (15A NCAC 02T ,040221) involve aenai lines, siph
manholes)? These lines be considered high priority and must be checked once eve
Check if Yes: 0 and provide details: N/A
1. OwneriPermit ee's Ce ' ation: ure of Signing Official and Project Name)
attest that this application for Sewer Relocation for \A/air:Fee
Project 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 tine not to
exceed S10,000 as well as civil penalties up to $25,000 per violation,
la.
Sign 0f5caLSinature
CO
0
I-- 2. Professional Engineer's Certification: (Signature of Design EngineerEngneer and Project Name)
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
Michael D. Newman „attest that this application for Sewer Relocation forWalqreens Stor #15568 Project 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 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 i7ot to exceed $10,000 as well as civil penalties idp to $25,000 per violation,
2a, Michael D. Newman
Professional Engineer Name
2e, MDV Engineering, RIC
Engineering Firm
2c. 215 Johnston St,
Mailing Address
2d,, Rock Hill
City
2e, SC 2 29730
State Zip
2g, 704-400-1044 2h, 803-325-525' rnichael mdver-!gc.om
Telephone Facsimile
NO PE Seal, Signature Dote
Fri\ l»t APPLICA.TIGN Page 5 of 6

14. Have the following permits/certifications been submitted for approval for the system or project to be served?
Wetland/Stream Crossings - General Permit or 401 Certification? 0 Yes 0 No N/A
Sedimentation and Erosion Control Plan? 0 Yes 0 No N/A
Trout Buffer Waiver? 0 Yes 0 No N/A
Stormwater? 0 Yes 0 No N/A
15, Does this project include any high priority lines (15A NCAC 02T .0402 (2)) involve aerial lines, siphons, or interference
manholes)? These lines will be cons tiered high Priority and mast be checked once every six months
Check if Yes: 0 and provide details: NIA
1. Owner/Permittee's Certification: (Signa(ure of Signing Official and Project Name)
97 1, it/ / attest that this application for Sewer Relocation for Walgreens Store#15568
Project has been reviewed by me a d 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 143-215.66, 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 000 as $10,Ilas ppOVISZI
eper violation,
la.
-
Date
ENGINEERING DESIGN DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL OF THIS
APPLICATION. THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR PROXIMITY
(i) TO OTHER UTILITIES, DESIGN CALCULATIONS, ETC. REFER TO 15A NCAC 02T.Q305
0
I.- 2. Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
1, Michael D. Newman ,attest that this application for Sewer Relocation for Waloreens Store#15568 Project 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. further attest that to the best of my knowledge the
proposed design has bean 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 143-215.68, 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. Michael D. Newman
Professional Engineer Name
2b. MDV Engineering, PLLC
Engineering Firm
2c, 215 Johnston St,
Mailing Address
2d. Rock Hill
City
2g. 704-400-1044 2h, 803-325-8257 2i. aemdven
Telephone Facsimile E-mail
2e. SC 2f, 29730
State Zip
NC PE Seal, Sirature & Date
ETA 08- 3 APPLICATION Page 5 of(

Division of Jatcr 17,c,,,otirces
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 08-13)
Project Applicant Name: City of Conover
Project Name for which flow is being requested: Sewer Relocation for Walgreens
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewater -
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name:
b. WWTP Facility Permit : t1r
c, WWTP facility's permitted flow
All flows are in MGD
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
.. Total actual and obligated flows to the facility
. Percent of permitted flow used
0 (no additional ow
It Complete this section for each pump station you are responsible for along the route of this
proposed wastewater flow.
List pump stations located between the project connection point and the WWTP:
(A) (B) (C) (D)=(B+C) (E)=.(A-D)
Design Obligateci,
Pump Average Daily Approx, Not Yet Total Current
Station Firm 'Flow" Current Avg, Tributary Flow Plus
(Name or Capacity,* (Firm / pi),. Daily Flow, Daily Flow,. Obligated Available
Number) MGD MGD MGD MGD Flow Capacity***
"--,,
Pi i ic-6, 1-2...clp 1.0 A C2' 0 . . - ..,,,„, ,,, , e°,',
* The Firm Capacity of any pump station is defined as the maximum pumped flow that
can be achieved with the largest pump taken out of service.
*"-' Design Average Daily Flow is the firm capacity of the pump station divided by a peaking
factor (p0 not less than 2.5.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the Available Capacity is < O.
Pate 1 of 6
FTSE 08-13

III. Certification Statement:
4.
I / „ttett-tt tt /71/ certify to the hest of my knowledge that the addition of
the volume of wastewater to be permitted in this project lias 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 OT overburden any downstream pump station
en route to the receiving treatment plant imder normal circumstances, given the irrmiernentation
of the plarmed improvements identified in the planning •assessluent where applicable. 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 I and Il
plus all attached planning assessment addendums for winch I am the responsible party.
Signature of this form indicates acceptance of this wastewater flow.
Signing 0 Ida Signature
Page 2 (31'6
FrsE OS- I 3

FTSE PLANNINGASSESSMENT ADDENDUM PAA)
Submit a plan ung assessrnent addendum for each pump station listed in Section 11 where Available
Capacity is 5 0.
Pump Station (Nance or Numbe
Given that:
a. The proportion and amount of Oblig t d, No Yet Tributary Daily Flow (C) accounts for
MGD of the Available Capacity (E) Pinup atatio
ad that
The rate of arty=atinaa: of this obligated, not yet tributary capacity is currently app. ate
per year; and that
c. A fended Capital Project that will provide the required planned capacity„
is in design or under cons
planned compl tion is ; and/or
d. The following applies:
aid
Therefore:
Given reasonably expected conditions and plannmg information, there is saffiient justification
to allow this flow to be permitted, without a significant likelihood of over -allocating capacity in
the system infrastructur .
understand that this does not relieve the collection system owner from complyingwith G.S.
143-215.67(a) which prohibits the introduction of any waste in excess of the capacity of the
waste disposal systems.
Date
Page of6
1 SE0 -1

Instructions for: Mow Tracking/Acceptance for Sewer Extension Permit Applications (FTSE) and
Planning Assessment Addendum (PAA)
Section I
a. WWTP Faci Naine: Enter the name of the WWTP that will receive the wastewater flow.
b. WWTP Facility Permit #: Enter the NPDES or Non -Discharge number for the WWTP receiving the
wastewater flow.
c. WWTP facility's permitted flow, MGD: From WWTP owner's NPDES or Non -Discharge permit,
d. Estimated obligated flow not yet tributary to the WWTP, 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 of January 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 Deceinber 31, Semi-
annual updates shall be submitted to the appropriate Regional Office by July 1.5 and January 15 of
each year.
Quarterly updates shall be required when the percent of permitted flow used reaches 80%. Quarters
are defined as Qtri (Jan -Feb -Mar); Qtr2 (Apr -May -Jun); Qtr3 (Jul -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 15 of each year.
e. WWTP facility's actual avg, flow. MOD: Previous 12 month average.
f. Total flow for this specific request, MGD: Enter the requested flow volume.
Total actual and obligated flows to the facility, MGD Equals [d + e + fl
h. Percent of permitted flow used; Equals [(g / 100]
Page 4 of 6
FTSE 08-13

For example:
On January 15 a POTW with a permitted flow of 6.0 MGD, reported to the Regional Office that there
is 0.5 MGD of flow that is obligated but not yet tributary. The annual average flow for 2007 is 2.7
MGD. There is a proposed flow expansion of 0.015 MGD.
The first Form FTSE submitted after January 15, 2008 may have numbers like this:
c. = 6.0 MGD
d. = 0.5 MGD
e. = 2.7 MGD
f. = 0.015 MGD
g. = 3.215 MGD
h. = 53.6 %
The next Form 171SE may be updated like this with a proposed flow expansion of 0.102 MGD:
c. = 6.0 MGD
d. = 0.515 MGD
e. = 2.73 MGD
f. = 0.102 .MGD
g. = 3.349 MGD
h. = 55.8 %
Each subsequent Form FTSE- will be updated in the same manner.
Section H
List the pump station name or number and approximate pump station firm capacity, approxitnate design
average daily flow (A) approximate current average daily flow (B), and the obligated, not yet tributary
flow through the pump station (C) for each pump station that will be impacted by the proposed sewer
extension project. Calculate the total current flow plus obligated flow (D=B+C) and the available
capacity (E=A-D). Include the proposed flow for this project with other obligated flows that have been
approved for the pump station but are not yet tributary (C).
Firm capacity is the maximum pumped flow that can be achieved with the largest purnp out of service as
per the Min itnurn Design Criteria.
Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor (pf) of
not less than 2.5.
If the available capacity (E) for any pump station is < 0, then prepare a planning assessment for that pump
station if the system has future specific plans related to capacity that should be considered in the
permitting process.
Firm
Purnp Station Capacity
(Name or Number) MGD
(A) (B)
Design
Average
Daily Flow
(Finn / pf)
Kaw Creek PS 0.800 0.320
Valley Road PS 1.895 0.758
Approx.
Current Avg.
Daily Flow,
MGD
(C) (D)=(B+C) (E)=(A-D)
Obligated,
Not Yet Total Current
Tributary Flow Plus
Daily How, Obligated
MGD Flow
0,252 0,080
0,472
0.332
0.135 0.607
Available
Capacity*
-0.012
0.151
Paae 5 of 6
FTSE 08-13

Planning Assessment Addendum Instructions
Submit a planning assessment addendum for each pump station listed in Section II where available
capacity is < 0.
A planning assessment for Kaw Creek PS (see example data above) may be .performed to evaluate
whether there is significant likelihood that needed improvements or reductions in obligated flows will be
in place prior to activating the flows from the proposed sewer extension project.
If the system decides to accept the flow based on a planning assessment addendum, it is responsible to
manage the flow without capacity related sanitary overflows and must take all steps necessary to
complete the project or control the rate of flow to. prevent sanitary sewer overflows.
The planning assessment may identify a funded project currently in design or construction, or a planned.
project in the future not yet funded but in a formal plan adopted by the system. The system should
carefully weigh the certainty of successful timely project completion for any expansion, flow
management diversion or infiltration and inflow elimination projects that are the foundation of a planned
solution to capacity tracking and acceptance compliance.
For example:
Given that:
a. The proportion and amount of obligated, not yet tributary flow accounts for 24 % and 0.080
MGD of the committed flow in Pump Station Kaw Creek; and that
b. The rate of activation of this obligated, not yet tributary capacity is currently approximately 0.01
MGD per year; and that
c. A funded capital project that will provide the required planned capacity, namely
is in design or under construction with
planned completion in ; and/or
d. The following applies:
ter an a d ten ar ca an contain recom ded sc and fundin for a ca
entitled Kaw Creek Pump Station iwgrade with fundino: planned in July 2014. This project is planned to
add 0.100 MGD to the firm capacity of the pump station by October 2015. Inclusion of this proposed
ca ro*e.ct as a condition of this Flow Trackin /Acce tance for Sewer Extension P rmit A " ation
elevates this project's priority for funding and construction to be im demented ahead of the activation of
obligated, not yet tributary flows in amounts that exceed the firm pump station capacities identified in
Section 11 above.
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification to allow
this flow to be permitted, without a significant likelihood of over -allocating capacity in the system
infrastructure.
Page 6 of 6
H SE 0

- CON
MST SW
6174 ST SW
Thsis
E 22ND sr'
(Ai.c. 6-ToPo 6-gAPHrc
Iv E-tAiroitiw ozopotzlbv&LE,
,scmt..L• " z 000'
peopos E. 0
sEt'Aiek
ExT Ews
E k

42 ' over Bhd Cor,NC 2861 - 729 on Yahoo! 1 iape,.. [)riving Dir diens and Traffic
of
426 Conover 1vd Conover,
aps. 'a oo &Inn/place?1 5 97051 on 1. 2457 1 426 206 novo°0?0 d% OW° 2.,.
77 01

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
()lois of Water Resources Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 08-1 3)
Project Applicant Name: City of Conover
Project Name for which flow is being requested: Sewer Relocation for Walgreens
More than one FTSE may be required for a single project if the owner of the WWTP is not responsiblefor all pump
stations along the route of the proposed wastewater/low
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: r
b. WWTP Facility Permit #: (y,7
c. WWTP faci1itys permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
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
Allflows are in MGD
0 (no additional flow
li. Complete this section for each pump station you are responsible for along the route of this
proposed. wastewater flow.
List pump stations located 'between the project connection point and the WWTP:
(A) (B) (C) (D),(B+C) (E)=(A-D)
Design Obligated,
Pump Average Daily Approx. Not Yet Total Current
Station Firm How** Current Avg. Tributary Flow Plus
(Name. or Capacity,* (Firm / pf), Daily Flow, Daily Flow, Obligated .Available
Number) MGD MGD MGD MGD Flow Capacity*"
.. . ,
The Firm Capacity of any pump station is defined as the maximum pumped flow that
can be achieved with the largest pump taken out of service.
Design Average Daily Flow is the firm capacity of the pump station divided by a peaking
factor (pf) not less than 2.5.
A Planning Assessment Addendum shall he attached for each pump station located
between the project connection point and the WWTP where the Available Capacity is < O.
Page I of 6
FTSE 08-13

e tification Statement:
srtify to the best of nay tenewledge that the addi
the vo ume wastewater to be permitted in this project has been evaluated along the route to t
receiving wastewater treatment facility and that the flaw from this project is not anticipated to
cause any capacity related ;sanitary sewer overflows or overburden any downstream p station
en route to the receiving treatment plant under normal circumstances, given the implementation
of the planned improvements identified in the planning assessment where applicable. This
analysis has been performed in accordance with local established policies arid procedures using
the best available data. This certification applies to those llerz s listed above in Sections I and it
plus all attached planning assessment addendums for which I am the responsible party.,
Signature of this form indicates acceptance of this wastewatez
Date
Page 2of6

FTSE PLANNING ASSESSMENT ADDENDUM (PAA)
Submit a planning assessment addendum for each pump station listed in Section II where Available
Capacity is < 0.
Pump Station (Name or Nutnber):
Given that:
a. The proportion and amount of Obligated, Not Yet Tributary Daily Flow (C) accounts for
and MGD of the Available Capacity (E) in Pump Station
and that
this obligated, not yet tributary capacity is currently approximately
D per year; and that
A funded Capital Project that will provide the required planned capacity, namely
is in design or under construction with
andlor
b. The rate of acti.v,
planned completion in
d.. The following applies:
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification
to allow this flow to be permitted, without a significant likelihood of over -allocating capacity in
the system infrastructure,
I understand that this does not relieve the collection system owner from complying with GS.
143-215,67(a) which prohibits the introduction of any waste in excess of the capacity of the
waste disposal system.
tiring Of i ign att
Page 3of6
,Fs-E. 08-13

Instructions for: Flow Tracking/Acceptance for Sewer Extension Permit Applications (FTSE) and
Planning Assessment Addendum (PAA)
Section I
a. WWTP Facility Name: Enter the name of the WWTP that will. receive the wastewater flow.
b. WWTP Facility Permit 41 1Enter the NPDES or Non-Discharg,e number for the WWTP receiving the
wastewater flow,
c. WWTP facility's permitted flow, MGD: From WWTP owner's NPDES or Non -Discharge permit,
d. Estimated oblieated flow_notyettributary to the WWTP. MGD: This includes flows allocated to
other construction projects not yet contributing flow to the collection system. Flows allocated through
intcrlocal 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 of January 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 sh.all 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 31. 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 Qtrl (Jan -Feb -Mar); Qtr2 (Apr-May-jun); Qtr3 (Jul. -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 15 of each year,
e. WWTP facility's actual avg. flow, MGD: Previous 12 month average.
f. Total flow for this specific request, MGD: Enter the requested flow volume,
g Total actual and obligated flows to the facility, MGD Equals [d ± e
h. Percent of permitted flow used: Equals [( / c)*100)
Page 4 of 6
FrsE 08-13

For example:
On January 15 a POTW with a permitted flow of 6.0 MGD, reported to the Regional Office that there
is 0.5 MGD of flow that is obligated but not yet tributary. The annual average flow for 2007 is 2.7
MGD. There is a proposed flow expansion of 0.015 MGD.
The first Form FTSE submitted after January 15, 2008,may have numbers like this:
c. = 6.0 MGD
d. = 0.5 MGD
e.= 2.7 MGD
f.= 0.015 MGD
3.215 MGD
53.6 %
The next Form FTSE may be updated like this with a proposed flow expansion of 0.102 MGD:
c. = 6.0 MGD
d. = 0.515 MGD
e. = 2.73 MGD
f. = 0.102 MGD
3.349 MGD
h 55.8 %
Each subsequent Form FTSE- will be updated in the same manner.
Sectioi
List the pump station name or number and approximate pump station firm capacity, approximate design
average daily flow (A) approximate current average daily flow (B), and the obligated, not yet tributary
flow through the pump station (C) for each pump station that will be impacted by the proposed sewer
extension project. Calculate the total current flow plus obligated flow (D=B+C) and the available
capacity (E=A-D). Include the proposed flow for this project with other obligated flowsthat have been
approved for the pump station but are not yet tributary (C).
Finn capacity is the maximum pumped flow -tat can be achieved with the Iargest. pump out of service as
per the Minimum Design Criteria..
Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor (pf) of
not less than 2,5.
If the available capacity (E) for any pump station is < 0, then prepare a planning assessment for that pump
station if the system has future specific plans related to capacity that should be considered in the
permitting process.
(A) (B) (C)
Obligated,
Design Approx. Not Yet
Firm Average Current Avg. Tributary
Pump Station Capacity Daily Flow Daily 'Flow, Daily Flow,
(Name or Number) MGD (Firm / pf) MGD MGD
Kaw Creek PS 0.800 0.320 0,252 0.080
Valley Road PS 1.895 0.758 0.472 0,135
(D)=(B+C) (E)=(A-D)
Total Current
Flow Plus
Obligated
Flow
0.33
Available
Capacity*
-0.012
0.607 0.151
Page 5 of 6
FTSE 08-1,3

Planning Assessment Addendum Instructions
Submit a planning assessment addendum for each pump station listed in Section II where available
capacity is < Q.
A planning assessment for Kaw Creek PS (see example data above) may be performed to evaluate
whether there is significant likelihood that needed improvements or reductions in obligated flows will be
in place prior to activating the flows from the proposed sewer extension project.
If the system decides to accept the flow based on a planning assessment addendum, it is responsible to
manage the flow without capacity related sanitary overflows and must take all steps necessary to
complete the project or control the rate of flow toprevent sanitary sewer overflows.
The planning assessment may identify a funded project currently in design or construction, or a planned
project in the future not yet funded but in a formal plan adopted by the system. The system should.
carefully weigh the certainty of successful timely project completion for any expansion, flow
management diversion or infiltration and inflow elimination projects that are the foundation of a planned
solution to capacity tracking and acceptance compliance.
For, example:
Given that:
a. The proportion and amount of obligated, not yet tributary flow accounts for 24 % and 0.0S0
MGD of the committed flow in Pump Station Kaw Creek; and that
b. The rate of activation of this obligated, not yet tributary capacity is currently approximately 0.01
MGD per year; and that
c. A funded capital project that will provide the required planned capacity, namely
is in design or under construction with
and/or
planned completion in
d. The following applies:
The ,master plan and ten. year capital plan contain recommended scope and funding for a capital project
entitled,Kaw Creek,Pump Station ,upgrade with funding planned in July 2014. This project is planned to
add 0.100 MGD. to the firm ,capacity, of the pump station by October 2015. Inclusion of this proposed
capital project as a condition of this Flow Tracking/.Acceptance for Sewer Extension Permit Application
elevates this ro'ect's riorit for fundin. and construction to be im lemented ahead of the activation of
obligated, not yet tributary flows in amounts that exceed the firm puif.p_station capacities identified in
Section II above.
Therefore:
Given reasonably expected conditions and planning information, there i sufficient justification to allow
this flow to be permitted, without a significant likelihood of over -allocating capacity in the system
infrastructure.
Page6of6
l081

4)6 Conove
d
\„
NC ? c co %a7ccMaps,(fit°i> aµ ci it an
d
42
r ve Blvd Conove NC 2861
2

DY
ngineering
215 Johnston Street
Rock Hill, SC 29730
[phone]
Naar: (803) 3 25-8257
September 17, 2013
NCDENR — Mooresville Regional Office
Division of Water Resources -- Surface Water
Sewer Extension. Permitting
61.0 E. Center Avenue, Suite 301
Mooresville, NC 28115
RE: Sewer Relocation for Walgreens #15568
Conover Marketplace Shopping Center
426 Conover Blvd. "W,, Conover, NC
To Whom It May Concern:
This cover letter is meant to provide with a brief description of the above referenced project.
The project is a redevelopment of a portion of the existing Conover Marketplace Shopping
Center. Two existing buildings will be demolished totaling approximately 33,500 square feet.
Then a new Walgreens retail -pharmacy store will be construction. There is an existing gravity
sewer main that is located under the proposed Walgreens building footprint. Therefore as part of
the Walgreens project this existing gravity sewer will be relocated so that it does not conflict
with the proposed Walgreens building. Please contact me if you have any questions.
Sincerely,
MDV Engineering, PLLC (P-088.3 )
Michael Newman, P.E.
President

Dv
Engineering
Letter of
Transmittal
To
NC'IFNR-Mooresville Regional Office
DWQ-Surface Water Protection
Date
Pro
10/4J
N"2012-107
reens #f 1' 568 - Fast -Track. App
61.0 E. Center St., Suite 301
& Plans
Mooresville, NC 28115
704-235-2107
sending you
These are transmitted
Under squaw. cover D Via Modem ® I -or your use
Attached l Via Courier 0 As requested
Via FedEs EJ Hand Deli Veled For approval
Via Maul ❑ Via _ Return for Corr ciions
Sign
Sewer Fast -Track Application. (FFA 08-13)
Plan & Profile Sheet C-301.
1 $480 review fee (Check #1002)
Remarks
Please revie
Thank you.
he attached permit application for approval. Let tree know if there is anything else tl rrt you need,
Copy
Signature Michael Newman
sures are not as noted, please no
Michael Newman
11 I)V Engineering
c/o AYER DESIGN GROUP
215 Johnston St
Rock Hill, South. Carolinas 29730
ncc. El no response as receivt°.d within 30 days the transmitted will he considered
ice 704, 00E1tt 4
fax 803,325.8257

Central Fees APS_
10/14/13
PPPTilt Number 0036769 Permit Tracking Slip
Program Category
Non -discharge
PermitType Fast Track
Gravity Sewer Extension Pump Stations, & Pressure Sewer
Extensions
Primary Reviewer
michaeltsarker
Coastal SW Rule
Permitted Row
0
Status Project Type
Active New Project
Version
1 00
Permit Classification
individual
Permit Contact Affiliation
Jimmy #2 Clark
PO Box 549
Conover
Facility
Facility Name Major/Minor
Sewer relocation for Walgreens Store #15568 Minor
Location Address
Owner
Owner Name
City of Conover
etas/Events
Ong Issue App Received Draft Initiated
10/14/13 10/08/13
Regulated Activities
Retail
Wastewater collection
Outfall NULL
NO 28613
Region
Mooresville
County
Catawba
Facility Contact Affiliation
Scheduled
Issuance
Owner Type
Government - Municipal
Owner Affiliation
Michael Lee Fax
PO Box 549
Conover
Public Notice issue
10/14/13
NC 28613
Effective Expiration
10/14/13
RecitiestediReceived Events
Additional information requested
Aciditona 1 information received
Waterbody Name Strearn Index Number Current Class Subbastri

CONOVER OULEVARD DEVELOPMENT, C.
1030 PHIL P ST„
NEW ORLEANS, LA 70130
Mem Serer Y lain Ilan Fee
Four Hundred Eighty and 00 0 Dollar
PAY
TO THE
ORDER North Carolina Depart art. of nvironment
OF d Natural Resources
TRUSTMARK NATIONAL ?NAL BANK
JACKSON, MS
65-27,65J
DATE AMOUNT
Oct t, 2013 4 0,0C

FAST TRACK ENGINEERING CERTIFICATION
Permittee: City of Conover
Project: Walgreens Store No. 15568 Sewer Relocation
Complete and submit this form to the permit issuing regional office with the following:
Permit No, WQ0036769
Issue Date: 10/1412013
One copy of the project record drawings (plan & profile views and detail drawings of sewer lines) of tthe wastewater
collection system extension. Final record drawings should be dear on the plans or on digital media (CD or DVD
disk) in pdf format, Record drawings should indicate the design and the marked up changes during construction.
• 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-compRance with this permit, renulations or
minimum design criteria. Modifications should be submitted prier to certification.
This project shall not be considered complete nor allowed to operate until the Division has received this Engineer's
Certification and all required supporting documentation, Therefore, It is highly d d that this certific
be sent in a manner that provides proof of receipt by the Division.
PERM1TTEE'S CERTIFICATION
(\r‘Olt a. c_LtizIL the undersigned agent for the Permittee, hereby state that this project has
been constructed pursuant to the applicable standards & requirements the Professional Engineer below has
provided applicable design/construction information to the Permittee, and the Permittee is prepared to operate &
maintain the wastewater collection system permitted herein or portions thereof.
ENGINEE CE CATION
0 Partial El Final
, Michael Newman_ , as a duly registered Professional Engineer in the State of North Carolina, having been
authorized to observe (4 periodically, El weekly, 0 full time) the construction of the subject 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 02T; the Division of Water Resources's Gravity Sewer Minimum Design Criteria adopted February 12,
1996 as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and
Force Mains adopted June 1, 2000 as applicable; and other supporting materials,
North Carolina Professional Engineer's
Seal, signature, and date:
I
SEND THIS FORM & SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS
SURFACE WATER PROTECTION SUPERVISOR
MOORESVILLE REGIONAL OFFICE
610 East Center Ave,, 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
cement actions.