WQ0031372_Regional Office Historical File Pre 2018

Michael F„Easley, Governor
ifl G. Ross Jr., Secretary
North Carolina Department of.ERVironment and Natlial Res{,inrces
Alan \VKInn P E,
Division Of Warcr Quality
February 27, 2007
Mr, Rick Howell, City Manager
City of Shelby
300 South Washington Street
Shelby, NC 28150
SubjectPermit No, WQ0031372
Crystal Estates
Wastewater Collection System
Cleveland County, North Carolina
Dear Mr, Howell,
In accordance with your application received on January 29, 2007, we are forwarding herewith
Permit No, WQ0031372 dated February 27, 2007, for the construction and operation of the subject
wastewater collection system extension, This permit shall be effective from the date of issuance until
rescinded, and shall be subject to the conditions and limitations as specified therein, This cover letter
shall be considered a part of this permit and is therefore incorporated therein by reference,
Please pay particular attention to Permit Condition 3 which requires that the wastewater
collection facilities be properly operated and maintained in accordance with 15A NCAC 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 610 East Center i\ e Sue 301 McKyress Ole, NC 28115
Intemer www.iicumaterquality,org Custosner Service 1-877-623-6748
An Equal OpportunityrAffirmae Action Employer - 5)Y Recycfed/10% Pot Consumer Paper
Phone r70,S) 6.63-1699 ktx: 004) 663-6040
NZhcarol.
Naturally

!Ip
Mr HoweH
Page 2
February 27, 2007
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North
Carolina as amended, and other applicable Laws, Rules, and Regulations, permission is hereby
granted to the City of Shelby for the construction and operation of approximately 1,536 linear feet of 8-
inch gravity sewer and the discharge of 23,040 gallons per day of collected domestic wastewater into
the City of Shelby's existing sewerage system, pursuant to the application received January 29, 2007,
and 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 Shelby's
VVVVTP (NPDES No, NC0024538) prior to being discharged into the receiving stream
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the
right to request an adjudicatory hearing upon written request within 30 days following receipt of this
permit. This request must be in the form of a written petition, conforming to Chapter 150B of North
Carolina General Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service
Center, Raleigh, NC 27699-6714 Unless such demands are made, this permit shall be final and
binding.
If you need additional information concerning this matter, please contact Dee Browder at (704)
663-1699
Sincerely,
or Alan W. Klimek, P.E.
cc: Mooresville Regional Office, Collection System Permit Files
David Odom, Odom Hollifield & Assoc., 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:
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.
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
.0401
a. The sewer system shall be effectively maintained and operated at all times to prevent
discharge to land or surface waters, and any contravention of the groundwater standards in
15A NCAC 2L .0200 or the surface water standards in 15A NCAC 2B 0200,
b. A map of the sewer system shall be developed and shall be actively maintained,
c. An operation and maintenance plan shall be developed and implemented.
d. Pump stations that are not connected to a telemetry system shall be inspected every day (i.e,
365 days per year), Pump stations that are connected to a telemetry system shall be
inspected at least once per week,
e. High -priority sewer lines shall be inspected at least once per every six-month period of time.
f. A general observation of the entire sewer system shall be conducted at least once per year.
g. Inspection and maintenance records shall be maintained for a period of at least three years.
h. Overflows and bypasses shall be reported to the appropriate Division regional office in
accordance with 15A NCAC 2B .0506(a), and public notice shall be provided as required by
North Carolina General Statute §143-215.1C

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.
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 [phone] or
(919) 7;-0. Persons reporting any of the above occurrences shall file a spill report by
completing Part l of Form - (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 11 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 27th day of February 2007,
NORTH CAROLINA A N IR NMENTAL MANAGE
ar Alan W Klimek, . . , Director
Division of Water Quality
By Authority of the Environmental Management ComComm s ion
ENT COM ISSION
Per ft Number ber0031 7

Fast Track Engineering Certification
Permit No, WQ0031372
February 27, 2007
Mr. Rick Howell, City Manager
City of Shelby
300 South Washington Street
Shelby, NC 28150
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, Permi
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 all
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.
ENGINEER'S CERTIFICATION
Partial
Final
, as a duly registered Professional Engineer in the State of North Carolina, having been
authorized to observe (Ell periodically, rjj weekly, Ej full time) the construction of Crystal Estates, a Cleveland 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,

PIPIF
-TRACK APPLICATION for GRAVITY SEWERS, P
I I
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number:
(to be completed by DWQ)
s/ L.
1. Owner
la. City of Shelby
Full Legal Name (company, municipality, HOA, utility, etc,)
lb. Rick Howell -City Manager
Signing Official Name and Title (Please review 15A NCAC 2H .0206(b) for authorized signing officials!)
0
z
0
lc. The legal entity who will own this system is:
Individual 0 Federal Municipality 0 State/County Ell Private Partnership El Corporation Li Other (specify);
Id. 300 South Washington Street
Mailing Address
lf. NC
State
lh, 704-484-6801 704-484-6871
Telephone Facsimile
2. Project (Facility) Information:
2a. Crystal Estates
Brief Project Name (permit will refer to this name)
3. Contact Person:
3a. David Odom
le. Shelby
City
1g, 28150
Zip Code
11 rick.howell@ciofshethycorn
E-mail
2b. Cleveland
County Where Project is Located
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b, 828-247-4495 3c. davidodom@odomen ineering,corn
Phone Number E-mail
1. Project is E New 0 Modification (of an existing permit) If Modification, Permit No.:
TATIONS, AND FORCE MAINS PAGE 3
For modifications, attach a separate sheet clearly explaining the reason for the modification (Le. adding another
phase, changing line size/length, etc.). Only include the modified information in this permit application- do not
duplicate project infonnation in B(7) and B(10-11) that has already been included in the original permit.
2. Owner is Public (skip to Item B(3)) 0 Private (go to Item 2(a))
2a. If private, applicant will be: 2b. If sold, facilities owned by a (must choose grip)
0 Retaining Ownership (i.e. store, church, single office, etc.) or El Public Utility (Instruction III)
D Leasing units (lots, townhomes, etc. - skip to Item B(3)) I: Homeowner Assoc./Developer (Instruction IV)
El Selling units (lots, townhomes, etc. - go to Item B(26))
3, City of Shelby
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
4a. City of Shelby NC0024538
.... Name of WWTF WWTF Permit No.
U. 5a. City of Shelby 5b. 8" 7 Gravity F,5c.
Z Owner of Downstream Sewer Receiving Sewer Size Iiii Force Main Permit Number of Downstream Sewer (if known)
--i
.„.„.._.
6. The origin of this wastewater is (check all that apply):
0 Residential Subdivision 0 Car Wash
Apartments/Condominiums 0 Institution
0 Mobile Home Park 0 Hospital
[lj School 0 Church
Ei] Restaurant El Nursing Home
El Office 0 Other (specify):
7. Volume of wastewater to be allocated for this particular project: 23,040 gallons per day
*Do not include previously permitted allocations
8. If the permitted flow is zero, indicate why:
O Interceptor Line - Flow will be permitted in subsequent permits that connect to this line
El Flow has already been allocated in Permit No.
01 Rehabilitation or replacement of existing sewer with no new flow expected
% Domestic/Commercial
% Industrial
% Other (specify):

TRACK APPLICATION for (;RAvITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 4
0.1•111%.
0
9, Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2H
.0219(1) for Item B(7) or the design flow for line or pump station sizing if zero flow in the space below, Values other than
that in 15A NCAC 2H .0219(1)(1-2) must be supported with actual water or wastewater use data in accordance with 15A
NCAC 2H 0219(I)(3).
64 3 bdr Condominiums Units @ 120 gpd = 23,040,gpd
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches)
8" SDR-35 PVC
Length (feet)
1,536,16
ENTER TOTAL LINE LENGTH IN MILES 0.29
. Summary of Pump Stations to be Permitted (attach additional sheets as necessary)
Gravity or Force Main
(use the pull down menu)
Gravity
Location ID Power Reliability Option
(self chosen - as shown on Design Flow Operational Point (1- dual line feed; 2- permanent generator w/ATS; 3-
plans for cross-reference) (MGD) GPM @ TDH portable generator wItelemetry; 4-wet well storage)
12. 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 2H .0200 as applicable?
Yes E3 No If no, please reference the pertinent minimum design criteria or regulation and indicate why a
variance is requested. SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS
PERTINENT TO THE VARIANCE WITH YOUR APPLICATION
13. Have the following permits/certifications been submitted for approval?
Wetland/Stream Crossings - General Perrnit or 401 Certification? El Yes No [1:1 N/A
Sedimentation and Erosion Control Plan?
Stormwater?
14, Does this project involve aerial lines or siphons? Check if yes: 0
These lines will be considered hiah priority and must be checked once every sox months
16. Does this project have gravity sewer lines designed at minimum slopes? 0
Be aware that the Division will not accept installed lines more Than 10% flatter than the minimum slope, Lines installed outside this tolerance should be
corrected prior to submtino the final enoineering certification,.
Yes DI No Ej N /A
Yes El No N/A

cc
-TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS
PACE 5
1. Use the ivision's guidance document entitled, "DETERMINING STREAM CLASSIFICATIONS FOR FORM FTA 02/03
(FAST -TRACK SEWER SYSTEMS)" to collect and record the stream classification data below (attach additional sheets as
necessary). This document is available from our web site or by contacting the appropriate Division of Water Quality
regional office (see instructions for addresses) OR indicate the following:
A Stream Classification is not needed because all parts of the project are at least 100 feet away from any down slope
waterbody; AND,
0 A Stream Classification is not needed because the design does not depend on wet well storage as a powereli
option for any pump station near a Class C down slope waterbody,
Location ID on Map
(self chosen - as shown on Name of
map for cross-reference) Waterbody
County
Waterbody Stream Waterbody
River asin Index Classification
Submit the 8.5" x 11" COLOR topographic map as required in Instruction VI
regardless of whether a classification is provided!
1. Applicant's Certification:
1, Rick Howell, attest that this application for Crystal Estates has been reviewed
by me and is accurate and complete to the best of my knowledge. 1 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 retu ed as incomplete. Note. In accordance with North Carolina General Statutes 143-
215.6A and l4t2l5,GB, any pe on who knowingly makes any false statement, representation, or certification in any
app1icat,onjdI be guilty of a fIass 2 misdemeanor which may include a fine not to exceed $10,000 as welt as civil
penaftie�yto$25,0 n.
la,
Sign ng 0 al ignature
2. Professi al Engineer's Certification:
Date
I attest that this application for Crystal Estates has been reviewed by me and is accurate,
complete and consistent with the information in the engineering plans, calculations, and all other supporting documentationl
to the best of my knowledge. I further attest that to the best of my knowledge the proposed design has been prepared in 11
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 certain portions of this submittal
package may have been developed by other professionals, inclusion of these materials under my signature and seal
signifies that if 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 tine not to
exceed $10,000 as well as civil penalties up to $25, 000 per violation,
2a. David Odom
Professional Engineer Name
2b. Odom Hollifield & Assoc, Inc.
Engineering Firm
2c_ 152 E. Main Street
Mailing Address
2d, Forest pity 2e. NC 2f, 28043
City State Zip
2g. 828-247-4495 2h, 828-247-4498 2i davidodomRodomengineering
Telephone Facsimile E-mail Seal, Signature & Date

Permit Number WQ0031372
Centrai Fees: APS SAP
02126107
Permit Tracking Slip
trograrn Category
Non-thscharge
Permit Type ed mk
Gravity Sewer Extension, Pump Stations, & Pressure Sewer
Extensions
Primary Reviewer
dee browder
Permitted Flow
23040
f acility
Facility Name
Crystal Estates
Location Address
Owner
Owner Name
City of Shelby
Ptes/Events
Ogg issue pp Received
02/26/07 01/29/07
Status Project Type
Active New Project
Version Permit Classification
1 ttO Individual
Permit Contact Affiliation
Major/Minor Region
Minor Mooresville
County
Cleveland
Facility Contact Affiliation
Owner Type
Government - Municipal
Owner Affiliation
Jay Stowe, PE
PO Box 207
Shelby
NC 281510207
Scheduled
Draft Initlated Issuance Public Notice Issue Effective Expiration
02/26/07 02/26/07
Regulated Activities iR
Apartment corepIed Additional information requested
Condorrurs um
Veastewater collection
Outten Ntild
Waterbody Name
Additional Information received
Stream Index Number
Current Class, Subbasin

PAY TO THE
ORDER OF
ODOM, HOLLIFIELD & ASSOCIATES
ENGINEERING, INC.
[phone]
FAX [phone]
152 EAST MAIN STREET
FOREST CITY, NC 28043
1CLIENR - D',1='Q
Four Hurt lred and 00/10
NCDENR
61.0 East Center A
Mooresv 11e, NC 281.15
CAROLINA FIRST BANK
FOREST C6TY, NC 28043
67-219/539 1427
8620
/2007
$ "4O0 00
D©LLAoS
MEMO
Fi'00B6 20' t.05111 2 Li9?I:? Loo 2 105411'

\,Nl A F Easley iil,kiivierroi,
G Ross Jr , Secretar7
North Carolina D.epailment of Environrrien an.d Natural Resources
February 27, 2008
Mr, Rick Howell, City Manblger
City of Shelby
300 South Washington Street
Shelby, North Carolina28150
SUBJECT:
Dear Perm
Crystal Estates
Permit No, WQ0031372
Wo.stewater Collection System .Exterifision
Final Engineering Certification
eoleen. Sullins Director
Divisicin of lidVater Qoality
The Division received a final engineering certification for the subject project on January 11, 2008, A
full review ci)f the certification materials may or may not be conducted, It is assumed that receipt of
this certification indicates compliance with all redufationsi design criteria and the permit, Please be
reminded that the Per mittee is responsible far keeping a copy of the final record drawings for the
life of the project, If you have not received a copy, please contact your consultor mmediately to
obtain a copiy,
'iou are receiving this letter because- the Division has yOU listed as the responsible party, If this
permitted system is no longer owned by you, please complete Form PNocF-s as this permit i5 not
automatically transferable, Form PNOCF-S can be downloaded from
ib:I/h2oienrista einciinapuinapijapps,html#Sewer,
you have questions concerning this document or the completion of Form PtiitOCF-S rf
necessand„ please contact Ms, Dee Browder at the letterhead iadaress or via E-mail at
dee..browdec@nomalll,net.
iiobert Krebs
'ace Water Protection Regional Supervisor
Enclosure
Cc: David Odom
Sorf ace Viiiater Protection Seciiiion Central Files page only)
NYth
Carolina
1111V4
Pretreatment, Emergency Response and Collection Systems Unit
1617 Mail Service Center, Raleigh, NO 27139:9-16.17
Telephone 1,915) '133-5083 Fax il916l 733-G059
interact http ern- no„state usindpir
An Equal Oppoillinity Action Employer
50% recydedil10% post -,con 5,,,irner paper

Fast Track Engineering Certification
Permit No WQ0031372
February 27, 2007
Mr. Rick Howell, City Manager
City of Shelby
300 South Washington Street
Shelby, NC 28150
Complete and submit this fo
of
suing regional office with the following.
• One copy of the project record drawings (plan & profile views of sewer lines) of the westewa
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. Prrn
modificaticns are required for any changes resetting in non-compliance with this permit, regulations or
minimum design, criteria.
n
This project shall not be considered complete nor allowed to operate until this Engineers Certification and all
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.
ENGINEER'S CERTIFICATION
0 Partial Final
�� 0 , as a duly r istered Professional Engineer in the State of North Carolina, having been
a on o obs a periodically, weekly, EI full time) the construction of Crystal Estates, a Cleveland County
project for the Permittee, hereby state tha , 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 -Tr c � � of
Stations and Force Mains adopted June 1, 2000 as applicable; and other supporting m
North Carolina Professional Engineer's
seal, signature, and date'
WITH R
SEND THIS FORM & SUPPORTING
UIRED ATTACHMENTS TO THE FO
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.