WQ0036280_Regional Office Historical File Pre 2018

Water Resources
Environmental QuaItt
January 4, 2018
Mr. Adrian Miller, City Manager
City of Belmont
P.O. Box 431
Belmont, NC 28012
ROY COOPER
Governor
CHAEL S. REGAN
secretary
LINDA CULPEPPER
info int Director
Subject: Permit No. WQ0036280 MODIFICATION
City of Belmont
Mantcross Seniors
Wastewater Collection System Extension Permit
Gaston County
Dear Mr, Miller:
In accordance with your application received January 2,, 2018, we are forwarding herewith Perrnit No.
WQ0036280 MODIFICATION dated January 4, 2018, to City of Belmont (Perrnittee) for the construction
and operation upon certification of the subject wastewater collection system extension. This permit shall
be effective from the date of issuance until rescinded, shall void Permit No, WQ0036280 issued December
11, 2012, 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.
This permit was previously issued on December 11, 2012 for 1,181 linear feet of 8-inch gravity sewer and
17,280 gallons per day of domestic wastewater, This modification adds 24,000 gallons per day (66 one
bedroom apartments x 240 gpd/unit plus 34 two bedroom apartments x 240 gpd/unit) fora total of 41,280
gallons per day of domestic wastewater. No new sewer line is added.
Please pay particular attention to the following conditions contained within this permit:
Condition 11.1: This permit shall not be automatically transferable; a request must be made and
approved.
Condition
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.
It shall be the responsibility of the Permittee 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.
Mooressul
q Compares"
Carolina i Environmental Quaky ` Wat
i at r it oai 6Center Avenue, Suite 30I I M ores nile as h. Car©lima 281 l 5
'704 663 1699
Ely Regional Operations

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
or via e-mail at barry,[e-mail].
Sincerely°,
by W. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional Office
Division of Water Resources, NCDEQ
cc Anthony Brent Cowan,.R.E, (e-copy)
Regional Office Files
Water Resources Central Files
PERCS (e-copy}
Matte
pease contact Barry Love at (704) 35- 14

Environmental
Quality
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
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
City of Belmont
Gaston County
for the construction and operation of approximately 1,181 linear feet of 8-inch gravity sewer to serve as
part of the Montcross Seniors project, and the discharge of 41,280 gallons per day of collected domestic
wastewater into the City of Belmont existing sewerage system, pursuant to the application received
January 2, 2018, 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 Environmental Quality and
considered a part of this permit,
This permit was previously issued on December 11, 2012 for 1,181 linear feet of 8-inch gravity sewer and
17,280 gallons per day of domestic wastewater. This modification adds 24,000 gallons per day (66 one
bedroom apartments x 240 gpd/unit plus 34 two bedroom apartments x 240 gpd/unit) for a total of 41,280
gallons per day of domestic wastewater. No new sewer line is added,
This permit shall be effective from the date of issuance until rescinded and shall be subject to the specified
conditions and limitations contained therein,
by W. Corey Basi ger, Regional Su p+ rvisor
Water Quality Regional Operations Section
Mooresville Regional Office
Division of Water Resources, NCDEQ
Permit Number:
Permit Issued:
WQ0036280 MODIFICATION
January 4, 2018

�8U������������������U7������������
�^�~ � ���'~^��^�^ ^�~ PERMIT �����^��^ �''�����
City of Belmont is hereby authorized to:
Construct, and then operate upon certificationthe aforementioned wastewater collection extension. The
sewage and wastewater collected by this system shall be treated in the City of Belmont Wastewater
Treatment Plant inaccordance with Permit Number NC0U2118l.
Permitting of this project does not constitute an acceptance of any part of the projectthatdmosnotnneet
15A N[A[ZT;the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996, as
applicable; 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-ficensed 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,
Construction and operation is contingent upon compliance with the Standard Conditions and any Special
Conditions identified below,
1. SPECIAL CONDITIONS
1. No flow in excess of the quantity permitted herein, 41,280 GPD shall be made tributary to the subject
sewer system until an application for permit modification for an increase in flow has been submitted
to and approved by the Division. [lSA N[4C82T.8384(b)]
11. STANDARD CONDITIONS
l. This permit is not transferable, in the event there is a desire for the wastewater collection facilities
to change ownership, or there is a name change of the Permh1oe, m formal permit request shall be
submitted to the Division accompanied by documentation from the parties, involved, andether
supporting matrna|sasmay beappropriate. The approval of1�srequostsc ha|�be�nsi��re` on its
merits and may urmay not be approved. [15A WCAC82T.O%04; G.S 143-215.1(d3)]
2. This permit shall become vohjuh|e unless the wastewater collection facilities are constructed in
accordance with the conditions ofthis permit; I5A N[A[ 2T; the Division's Gravity Sewer Minimum
Design Criteria adopted February 12,I996,asapplicable; 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, i15AN[ACO2T.01IO1
l This permit shall beeffective only with respect tuthe nature and volume nfwastes described imthe
application and other supporting data, [I5AN[A[O2T.O11O\
4. 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 ofthese facilities asrequired bv15AN[4CZTI4U3. If, animdkvidua|
permit'is not required, the following performance criteria shall be met: [15A NCAC 02T .0108(b)]-
a. The sewer system shall be effectively maintained and operated at all times to prevent discharge
to land or surface waters, and to prevent any contravention of groundwater standards or surface
water standards,
b. A 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 schedule, spare parts inventory and overflow response has been developed and
implemented.
d. Pump stations that are not connected to a telemetry system shall be inspected everyday (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 -months and inspections are
documented.
A general observation of the entire sewer system shall be conducted at least once per year,
g. Overflows and bypasses shall bereported tothe appropriate Division regionaloffice |maccordance
with 15AN[AC28 OS06(a), and public notice shall be provided as required 6vNorth Carolina
General Statute g143-215'IC.
h, A Grease Control Program is in place as follows:
1. For public owned collection systems, the Grease Control Program shall include at Veast
biannual distribution of educational materials for both commercial and residential users and
the |cQa| means to require grease interceptors at existing establishments. The plan shall also
include legal means for inspections of the grease interceptors, enforcement for violato,rs 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 atleast bi-
anmwa� distribution of grease education materials to users of the collection system by the
permittec or its representative.
]. Grease education materials shall be distributed more often than required in Parts(1)and (2)
of this Subparagraph if necessary to prevent grease -related sanitary sewer overflows,
i. Right-of-ways and easements shall be maintained inthe full easement width for personnel and
equipment accessibility.
i Documentation shall be kept for Subparagraphs (a) through (i) of this We for a minimum of three
years with exception of the map, which shall be maintained for the life of the system.

5. The Pernittee shall report by telephone to a water resources staff member at the Mooresville
Regional Office, telephone number (704)663-l699,aosoon aspossible, but inmocase more than Z4,
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 650and/or spill over 1,OO8gallons; nr
c. Any SSO and/or spill, regardless of 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 number [phone] nr(g19) 7]3-]300.
Persons reporting any ofthe above occurrences shall file a spill report by completing and submitting
Part | of Form LS'SSO (or the most current Division approved form) within five days following first
knowledge ofthe occurrence. This report must outline the actions taken orproposed tobetaken to
ensure that the problem does not recur. Part ||ofForm CS'SSO(or the most current Division approved
form) can also be completed to show that the 6SQwas beyond control. [G.S. 143'215.1C(al)]
6. 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. [I5& MCAC 02T.0108(b)]
T 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 tnthe 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 a violation of the permit and shall subject the Parmi1t:e to
appropriate enforcement actions.
Ufthe permit ioissued toaprivate entity with amOperational Agreement, then acopy ofthe Articles
of Incorporation, 0edaratinna/Cmwmnents/Restr|cbnns, and Bylaws that have been appropriately
filed with the applicable CountysRegister ofDeeds office shall be submitted with the certification.
Acomplete certification is one where the form is fully executed and the supporting documents are
provided asapplicable. Supporting documentation shall include the following:
a. One copy of the project construction record drawings (plan & profile views of sewer lines & force
mains) of the wastewater collection system extension. Final record drawings should be clear on
the plans orun digital media (CD orDVD disk) and are defined asthe design drawings that are
marked up or annotated with after construction information and show required buffers,
separation distances, material changes, etc.
h. One copy of the supporting applicable design calculations including pipe and pump sizing,
ve|ocity, pump cycle times, and level control settings, pump station buoyancy, wet well storage,
surge protection, detention time in the wet well, and force main, ability to flush low points in
force mains with u pumpcycle, and downstream sewer capac�tyanalysis. If portable power

source or pump is dedicated to multiple stations, anevo|uation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, include travel
tinneh'ames,shall beprovided,
c Changes to the project that do not result in non-compliance with this permit, regulations, or the
Minimum Design Criteria should be clearly identified on the record drawings, on the certification
inthe space provided, nrinwritten summary form.
Prior toCertification (Final orPartlaH: Permit modifications are required for any changes resulting in
non-compliance with this permit (including pipe length increases of 1096 or greater, increased flow,
pump station design capacity design kncreesesof5%Vrgneater, and increases inthe number/type of
connections), regulations, or the Minimum Design Criteria, Requested modifications orvariances to
the Minimum Design Criteria will be reviewed on acasc'by-case basis and each on its own merit.
Please note that variances tothe 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 or repair prior to certification &
activation. (15A NCAC0lT .0116\
8. Gravity sewers installed greaterthan ten percent below the minimum required slope per the Division's
Gravity Sewer Minimum Design Criteria ohaO not be acceptable and shall not be certified until
corrected, if there is an unforeseen obstacle in the field where all viable solutions have been
examined, a slope variance can be requested from the Division with firm supporting documentation.
This shall bedone through apermit modification with fee. Such variance requests will beevaluated
onacase-bv- asebaxis.Neso|ubmonfsuch,eqvestshaUbeevidentphortocomp|etinQandsubmitting
the construction certification. [1SANCA[OZT.0lO5(n)]
9. Acopy ofthe construction reconjdrauinUsshaUbemaintonedon0ebvthePemmhteeforthe|ifeuf
IO. 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 l, 2000
as applicable; and other supporting materials may subject the Perrnitteelo anenforcement action by
the Division, in accordance with North Carolina General Statutes §149'J15.6Athrough §143-215,6[
construction of additional or replacement wastewater collection facilities, and/or referral of the North
Carolina -licensed Professional Engineer to the licensing board. [I5A N[A[ 02T �0104; 15A N[A[ 02T
11. 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.
lZ. The issuance ofthis permit shall not exempt the Pe,nmitteefrom complying with any and all statutes
rules, regulations, or ordinances that may be imposed by the Division any other Federal, State, or
Local government agencies which have jurisdiction or obtaining other permits which may be
required by the Division or any other Federal, State, of Local government agencies, [G.S. 143'

FAST TRACK SEWER ENGINEERING CERTIFICATION
PERM[T7EE.
PERMIT #:
PROJECT:
ISSUE DATE:
City ofBelmont
VVQ0036280MOD|F|CAT|0N
Montcrosa Seniors
January 4,ZO18
This project shall not be considered complete nor allowed to operate in accordance with Condition 7 of
this permit until the Division has received this Certification and all required supporting documentation. It
should be submitted in a manner that documents the Division's receipt. Send the required documentation
the Regional Supervisor, Water Quality Regional Operations Section at the address at the bottom,
Any wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Certification shall be considered a violation of the permit and shall subject the Permittee to
appropriate enforcement actions. The Permittee is responsible for tracking all partial certifications up
until a final certification is received. AFima| Certification shall be a complete set cfrecord drawings and
design calculations regardless of whether partials have been submitted.
PEnxnnTTsE'S CERTIFICATION
|, the undersigned agent for the Pnnnittee, hereby state that this project has been constructed pursuant
tothe applicable standards & requirements, the Professional Engineer below has provided applicable
design/construction information to the Permbtee,and the Permittee is prepared 1ooperate & maintain
the wastewater collection system permitted heroin o, portions thereof.
Printed Name, Title
Signature Date
EmG|mssn'S C1nnncATOM
|' __ _, as a duly registered Professional [ r in the State of North Carolina,
having been authorized to observe ( periodically,weekly,| |fu||timne) the construction of the
project name and location as referenced above for the above Permittee hereby state that, to the best of
my abilities, due cane 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; ISA NCA[ 02T; the
Division of Water Resources' (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 l, 2000' as applicable; and other supporting materials,
North Carolina Professional Engineer's Seal w/signature & date:
[—Fhna| / | Partial (include description)
Certification Comments/Qualifiers (attach if necessary):
State ofNorth Carolina |e"°m^m°ma]Quality | water n=w�acex|Water Quality Regional c*""uonu
Mom`na/rRegional offi=aoFast Center Avenue, Suite m1(mom~mme,North carerazmo
xw6au99

3. County where pc(
State of North Carolina
Department of Environmental Quality'
Division of Water Resources
ISA NC,AC: 02T ,0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Appli
n Number:
dt
be c(m)pkt'ed h DV R)
All items must he completed or the application will be returned
APPLICANT INFORMATION:
1, Applicant's name: City of Belmont. (company, nutrticipality. IIOA, uti
Applicant type: [l Individual
El Federal
Signature authority's name: Adrian
`title: City Ma{tam
(� (orporatiotm General Partnership
Ei State'Caurrt F l luni.i;ipal
filler per ➢ 5A N CAC 02"1 0106 )
4. Applicant's mailing address: 115 N. Main Street, P.O.. Box 431
City: Behnont State: North Carolina
5. Applicant's contact information:
Phone number: (7(4) 901-2067 hnail Address: 4rniJler(a.
II. P'IIOJECT INFORMATION:
1. Project name: i14onteross
2. Application/Project status:
If a modification, provide the existing
Zip: 28012-3041
0
org
Public Utility
iulOi91tt:` V L. E=. Etf (' Ic NAt..,0F .E CI=
Propo ed (New Permit) Z Existing Pernut Project
umber: WQ0036280 and issued dated December 1 12012
If new construction but part ol`a master plan, provide th
ated: Gaston
4. Approximate Co rdinates (Decimal Deg.e(
5, Parcel ID (if applicable): 221086
(or Parcel ID to closest downstream sewer)
e
nher: WQ00
tilude: 35 255" Longitude 8 I w()31
CONSULTANT INFORMATION:
1, Professional Engineer: Anthony Brent Coy;°°an
Firm: The Isaacs Group, P.C.,
Mailing address: 8720 Red Oak Blvd. Ste. 420
City: Charlotte State: NC Zip: 28217-
Phone number: [phone]
,e Number: 026462
Email Address: bccwanr` oaacsgrp.corrr
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. facility Name: Cite of Belmont Permit Number: NC002.1 1.81
Owner Name: City of Belmont
RECEIVING DOWNSTREAM SEWER INFORMATION (It' different than WWTF):
l Permit Number(s): WQ0036280 Downstream (Recetvit }Sewer Size: 8 inch
System Side Collection System Permit Numbers) (if a'ppls'ctrble): QCS_
Owner Name(of Belmont
FORM: FTA04-16 Pa*e 1 of 5

I.PIPPIPPIP;If
FRe:\LFREQI'IREN ,NTS
Applicant is a Privately -Owned Pu
If the Applicant
If the Applicant
Utility, has a Certili
❑ Yes ❑No
a Developer of lots to be sold, has a Developer's t )I r zt
❑ Yes ❑No ZNFA
a I lomz/Prope.rt Ov nears sr c i zt€can
❑ Yes No
Origin of wastewTa'ter: (check all t
❑ Residential Owned
Residential
School preschool / day care
0 Food and drink facilities
❑ Businesses offices factories
5. Nature of wastew°titer : 100 % Dome
app
❑ Retail (stores, c
❑ Retail with food prepara
0 Medical dental ' vetcrin
❑ Church
Nursing It.
;,'Comet
of Public Convenie
NIA
jjoitaf Agreement_
N
`.' a Conunercial
% Industrial (See I A NC .R` C 0' I ..010 (20))
-- 1 t tere a Pretreatment Procram in effect"r
oreduction been approved under I SA NCAC 021. 0114j 1)? ❑ Yes
es, provide a copy of flow reduction approval letter
S ummariz
water generated by project.
Establishment Type (see 02`h.0114(f))
One bedroom Apartment
bedroom.Apartrnent
Dailyr Design Flow
No
and Necessity' been attached"?
been attached'
MRM ,,,11C)Am) been attached".'
'ash
andlor Motels
ing Pool =Clubhouse
Pool Filter Backwash
-xplain in Attachment)
Flow
240 gal,'tatait Erb 15,840 GPI)
240 gal.'unit
34 8,160 GPI
GPD
GPI)
GPL)
GPD
Tot(l 24,000 GPD
tier 1 t1,Fvt mmt1? d)1 4 )) d , () 1) andlcl(21 for caveats to wastewater design flow rates (i.e., per
dwtilling;proposed unl nowrt non-residential development uses; public access facilities located near high public u e areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
itt 42A_4).
b Per 1..5A NCAC 02T .0114(c), design flow rakes for establishments not identified gin table 1 S'1 NCAC 02T.01141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data..
°'ante °titer generated by project: 24.000 GPI) (per 1.5A_NC ' C)__' 1..Q 1_I4,)
Do not include future flows orpreviously permitted allocations
permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow -will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitat,or
❑ Other (Explai
eplacement of existing sewer with no new flow expected.
FORM: 'FTA 04-16
Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Soyers):
1. Summarize gravity sewer to be -permitted.
Size les)
Length (feet) Material
Section II & 11.1 of the MDC for Permitting of Gravity Sewers contains information related to design criteria
• Section 111 contains information related to minimum slopes for gravity sewer(s)
• Oversiiing lines to meet: minimum slope requirement is not allowed and a violation of the NIDC
VHF PUMP STATION DESIGN CRITERIA (If Applicable) — 02T & MDC (Pump Stations/Force 'Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
Puinp station number or .name:
2. Approximate Coordinates (Decimal Degrees): Latitude: , Longitude: -
3. Design flow of the pump station: millions gallons per day (firm capacity)
4. Operational point(s) of the pump(): gallons per minute at feettotal dynamic head (TDIT)
5. Summarize the force main to be permitted (for this Pump Station),
Size
s)
6, Power reliability in accordance with 15A NCAC 02 1 .0.305fhla):
Standby power source or pump with automatic activation and telemetry - I 5A NCAC 02T .0305(1)(1 )(B):
Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
Must be permanent to facility
Or lithe pump station has an average daily flow less than 15,000 gallons per day:
El Portable power source with manual activation, quick -connection receptacle and telemetry 1 5.A NCAC 02T
.0305(1)(1)(C)
or
El Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T ,0305(h)(1)(C):
• it shall be demonstrated to the Division that the portable source is own.ed or contracted by the applicant (draft agreement)
and is compatible with the station,
If the portable power source or pump is (dedicated to multiple pump stations, an evaluation of all the pump stationsstorage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, hall be provided
in the case of a multiple station power outage.
FORM: 1LA 04-16 Page 3 of 5

Pry
X. SETBACKS & SEPARATIONS — (02B .0200 & 15A, NCAC 02T .0305(0):
Does the project comply with all separations found in 1 5A„NCAC 021 .0305(1) &
.15A NCAC 02T,0305(f) contains minimum separatmnthat shall be provided for sewerystenis:
Setback Parameter* Separation Re
24 inches
Storm sewers and other utilities not listed below (vertical)
Water mains (vertical-wate over sewer includingin benched trcnches'
Water mains (horizontal)
Reclaimed water lines (vertical - reclaimed OVer sewer)
Reclaimed water lines (horizontal - reclaimed over sewer)
Any private or public water supply source, including any wells. WS-I waters of Class 1 o
Class JIimpounded reservoirs used as a source of drinking water
terclassified WS (except WS-I or VS-V), B. SA, ORW, HQW, or SB from normal
high water (or tide elevation) and wetlands (see item IX.2)
t,.. .
ditches
Any building foundat
Any basement
r stream, lake, impoundment, or ground water lowering and surface drainage.
Top, slope of embankment or cuts of .2 feet or n
Drainage systems and interceptor drains.
Any swimming pools
Final earth grade (vertical)
re vertical heiuht
18 inches
10 feet
18 inches
2 feet
re
100 feet
50 feet
:feet
5 feet
10 feet
10 feet
fcct
10 feet
36 inches
5A NCAC 02 r.0305(g) contains alternatives where separations in 02.LQ3Q5(t) cannot be achieved.
**Stream classifications can be identified using the Division's NC Surface Water Class; fications webpage
if noncompliance with 021,0305(florkg), sec Section X of this application
2 Does the project comply with separation requirements for wetlands? (50 feet of separation.)
See the Division's draft separation requirements for situations where separation cannot be meet
• No variance is required if the alternative design criteria specified ts utilized in design and construction
As built documents should reference the location of areas effected
EA Yes
3, Does the project comply with all setbacks found in the river basin rules per 15AX:AS.131213_.0200? El Yes
• This woukl include Trout Buffered Streams per 15,A NCAC 213.0202
No
No
4., Does the project comply with an individual 404 Permit or any. 401 Certification! Yes No
• Wetland -related permits shall he requested, obtained, and adhered to for projects that impact Wetlands or surface waters
Information can be obtained from the 401 & Buffer Permitting Branch
5.„ Does project comply with 15A NC Af 021,0105(46) (additional permits/certifications)? Z Ye LJ No
Per 15A NCAC 02r0l 051401 directly related environmental .permits or certification. applications are being prepared, have
been applied for, or have been obtain.ed. Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stonnwater management plans, etc:).
6. Does this project include any sewer collection lines that are deemed -high-priorW"
Per 15.A NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon,.. sever
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
El Yes No
If yes, include an attachment with details for each line, including type (aerial. line, size, material, and location).
,Eligh priority lines shall be inspected hy the permittee or its representative at least once every six -months and inspections
documented per 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the MinitnuirLDesign Criteria_for the_Pertnitting ofPtimp.Stations
and Eorce Mains (latest version), and the Gravity Sewer Ni Minium Desiiin Criteria (tatesr version) as applicable'?
[El Yes 11 No
If No, complete and submit the VariancelAltemaie Design Request application (VADC 10-14) and supporting documents for
review, Approval of the request is re uired prior to suhniittal of the Fast Track Application and supporting documents,
Professional Engineer's Certificuton.
attest that this applic
Profesiona1 Engineer's name from Appheation Item 1111.1)
has been reviewed by me, and i.s accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of lily 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 (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version), 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 —iri accordance s th General Statutes 1.43-215.6A and I.43-21.5.6B, any person who knowingly makes any false
statement, representation, or certification in any application package 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,
North Carolina Professional Engineer's seal, signature, and date:
.3, Applicant's Certification per 15A NCAC 021 ,0106(b):
A kr eV' M
(Signature Authority's name & title fitApplication item 1,3,)
has, been rev ewed. by me and is accurate and complete to the hest 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 returned as incomplete, I understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result i„n an immediate enforcement action that may include civil penalties,
injunctive relief, and or criminal prosecution, 1 will make no claim against the Division of Water Resources should a condition
of this permit be violated. I. also understand that if all required parts of this application package are not completed and that if
all required supporting information and attachments are not included, this application package wil.lbe returned to me as
incomplete,
NOTE -- In accordance with General Statutes 143-21.5.6.A. and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package 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 S25.000 per violation,
Sigoature
'Date:
FORM: FTA 04-16
Page 5 of 5

Goa Maps

Name: MT HOLLY
Date: 9/4/2012
Scale: 1 inch equals 2000 feet
Location: 035°15' 20,1" N 081 ° 01' 54.9" W
Caption: Montcross Senior Site
Belmont, NC

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: City. of Belmont
Project 'Name for \vhich flow is being requested: Montcross Seniors - Loftin Apts Phase 2
!Ire than one FTSE be required for a single project if the owner
stations along the route of the proposed wastewater flow.
'the (11177) is not responsible JOr all pump
Complete this section onlyit you are the owner of the wastewater treatment plant,
a. WWTP Facility Name: City of 'Belmont WWTP
b. \VWTP Facility Permit 4: NC0021 181
Allflo are in MGD
c. WWTP facility's permitted now 5.0000
d. Estimated obligated flow not yet tributary to the WWTP 1.2102
e. WWTP facility's actual avg. flow
Total flow for this specific request
g. Total actual and obligated flows to the facility
h. .Percent of permitted flow used
1.6490 (2016 Average)
0,0240
7.883)
58°4)
II. Complete this section for each pump station you are responsible for along the route of this
proposed vvastewater flow.
List p
stations located between the project coflflectiofl point a
(A) (H) (C.)
Design Obligated,
TP:
(D)=(3-(C) (E) A-D)
Pump Average Daily Approx. Not Yet Total Current
Station Firm Flow** Current Avg. Tributary How Plus
(Name or Capacity, * (Firm 1 pt), Daily How, Daily Flow, Obligated Available
Number) MGD MGD MGD MCiD Flow Capacity***
* The Firm Capacity of any pump station is defined as the maximum pumped flow that
can he 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 be attached for each pump station located
between the project connection point and the WWTP Nv here the Available Capacity is <
Downstream Facility Name (Sewer):
Downstream Permit. Number:
Page 1 7
FT,Sti',, 04-16

'ertifcation_taternet
Adrian `I'. Miller, C
Yoltrrite ot
-astewater tr`e
cause any capacity related sari
en route to the reeei in treats ent plan
the planned Improvements identified in
has been performed in accordance
available titttti. This certification applies
attached plan
indicate
ties'
a hg
perm'
Tac'
d iir this pr
and that tl
le best of d e that the addition cat`
ras beevaluated along the route to the
from this project is not antia:if-iated t
erllouvs or overburden any downstream pump station
rider normal circumstances„ jai e the implementation of
he planning assessment sliere applicable. This analysis
ocal established policies an d t rocedures usingt 7e best
those
mg assessment addendttt -ts for which
acceptancetof this wastew ater flow
tcd .......... ection l arnd. fl
the responsible party,. Sit�atttre tt

PLANNING ASSESSMENT ADDENDUM (PAA)
Submit a planning assessiticnt addendum for each pump station listed in Section 11INhere Available
Capacity is si O.
Pump Station (Name or Number):
Given that:
a, The proportion and amount of Obligated, Not Yet Tributary Dail) Floiv (( ) accounts for
% and IVIGD of the Available Capacity (E) in Pump Station
and that
'Ile rate of activation of this obligated, not yet tributat,capacity is currently approximately,
M(i!) per 3:ear, and that
c. A funded Capital Project that 1A-ill provide the required planned capacity, namely
is in design or under construction with
and/or
h.
planned completion in
d. The following applies:
Therefore:
Given reasonably expected conditions and planning infortriation. there is sufficient Justification to
allow this flow to be pennitteck without a significant likelihood of over -allocating capacity in the
system infrastructure.
I understand that this does not relieve the collection system owner front complying with G.S. I 43-
215.67(a) avhielt prohibits the introduction of any waste in excess of the capacity of the waste
disposal s.) stem.
Signing Official Signwure Daie
Page.3ul6:

Instructions for Flow Tracking/Acceptance form (FTSE) and Planning Assessment Addendum (PA)
Section I
a. WWTP Facility Name: nter the name of the WWTP that ill receive the wastewater Dev,
b. WWTP Fact lits Permit #: Enter the NPDES or Non -Discharge nutriber for the WWFP recut in the
wastes\ ater flow.
c. VVWTP ficilitklsperniitted flow. PVIGD: broil) WNlir FP owner's NPDES Or Non -Discharge pennit.
d. Estimated obligated floNv not yet tributary to the IllirWTP, MGD: This includes flotivs allocated to other
construction projects not yet contributing flow to tile collection system. Flows allocated through
interlocal agreements or other contracts not yet contributing flow to the collection system are also
included. For 1101"Ws that implement a pretreannent 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 11011 tributary to your WWTP.
As of January 15. 2008 the POTW should have reviewed flow allocations made over the last bivo 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 NV \VIP, in accordance xvith local policies and
procedures employed by the reporting entity.
e. \VW IP facility s aelital avg. flo‘s. NIfil): Previous 12 month averagc,.
g•
h,
Totul Ilow for this specific. request. MCI): Enter the requested floss volutric.
otal actual and obligated flows to the facility, MCI) Eipials Id 1 e fl
Percent of perrnitted flow used: Equals I(g c)t 100
Flor "example:
Oil Jailkiar: 15 a POTW With a permitted flow of 6.0 MCI). reported to the Regional Office that there
is 0.5 MCI) of floss that is obligated but not yet tributary-. The annual as erage floss for 2007 is 277
MGD.'Inure is a proposed flo:o expansion of 0.015
`the first Forirt FUSE submitted after Januar 15, 2008 rnay have numbers like this:
c. --- 6.0 MGD
d. ---- 0.5 MCI)
c. 2,7 MCI)
11 = 0.015 MCI)
e, = 3.215 MCI)
h. = 53.6
I he next Form 171 SE limy be updated like this viith 11 prof)osed flow expansion of 0102 MCI)
e. 5- 6.(1. MCI)
d.= 0.515 M(d)
e.— 2.73 MGD
= 0.102 MCI)
g. = 3.349 MCI).
h.- 55.8
1 ach subsequnt 1 1 51 lorni w itl he updated in the:::sgthe..:014n.tiot;
Page 4 of
1ISE 04-16

rther and appro iniate pump station firm c
ge daproxirrrate current a\=erase rail) flow (B), and the abl
gh the pump tatron (C) for each purnp station that will be impacted b
project. Calculate the tcatrt1 current flow- plus obligated flow (D—B4 C) and t
Include the proposed flow for this project wvith;other obligated flows that
station but arc not het tributary'
per th
the rrra
n Design C°ri
p.rrnlecl t7crvw that can
Average Daily F1ovv is the firm c:
1.5.
apa
tern has future~
pro e ess.
Pit
(Name
p
r Nun-)l
ek PS
firm
Capacity
rty.
MGD
aeit}, appro. iarate des
ated, not yet tri utarti° f lOvv
proposed sew\ er exte
a lahle capacity,. (E---A
wed for the pump
largest li)uorut of :ser°\ i
pump station tr ded by-
rp sta.tion is dry' fl, t1
lairs relate c1 ter capa
Desist
v erage
c()00.32
0.758
pealing factor
spars a plannint
that,huu1I be eat
Appro..
Current Avg,
Daily Flow,
MGD
0472
(C)
Oblinated,
Not Yet
"tributary"
Daily, Flow,
MGD
Shier]
red ir'
(pf)
r(t
Or that punzl
perrnitti
Total C"u
Flow
Oblrg
Capacity
)12
Page5olt
)4 1t

PIannine Assessment Addendum Instructions
Suhmit a planning assessment addendum for each pump station listed in Section 11here aaUah1e capacit\
'is O.
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 he 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 inay 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 systetn. 1 he 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 1oundation of a planned solution to capacity
tracking and acceptance compliance„
For example:
Given that:
a. The proportion and amount of obligated, not ).,et tributary flow accounts for 24 % and 0,00
I\4GD of the committed flow in Pump Station Ka w Creek, and that
b. The rate of activation of this obligated, not yet 'tributary capacity is currently approximately0.
d.
MG D per year, and that.
A funded capital project that will provide the required planned capacity, namely
is in design or under construction with
planned completion in ; and/or
The 'following applies:
'the masteLplan and ten year capital _plan contain recommended scope and funding for a capital project
entitled Ka w Creek Pump Station u „ 0.rade with funding planned in July 2014. ThisTroject is_planned to
add 0.100 MGD to the firm capacity of theTunip station by October 2015. Inclusion of this_prowsed
capital_pimjecf as a condition of this Flow Tracking/Acceptance for Sewer Extension Permit Application
elevates this project's priority for funding and construction to be implemented ahead of the activation of
vet tributary flows in amounts that exceed the firm sta n ca aci. "es identified in
obligated
Section 11 oho\ e.
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification to allow
this flow to be permitted, Wi th out a significant likelihood of over -allocating capacity in the system
infrastructure,
Page 6 of 6
FT'S E 04-1 6

IsAAcC")
'S
N N N &LAC 5uRvEyiNG
E720 RED OAK BOULEVARD,. STE, 420
CHARIJIPT, N.C. 28217
PHONE [phone] FA:x [phone]
Project Narrative
Loftin Phase 2 (Montcross Seniors)
City of Belmont, Gaston County, North Carolina
This permit submission is for a modification to Permit No. W00036280 (Montcross
Seniors) to add flow for a new phase 2 apartment building. The project site is located
in the City of Belmont, Gaston County, N.C. and consists of 5 tax parcels (214376,
214375, 214374, 221086 and 221089) that total 6.66 acres. The development is
located on the south side of Hawley Avenue and is approximately 1,750 l.f. west of the
intersection of Hawley Avenue and Hwy 273. Phase 1 was permitted on Dec. 11,
2012 under permit number WQ0036280 and consisted of one apartment building with
24 two bedroom units and 48 one bedroom units. This submission is for a permit
modification to the original permit to add flows from a new phase 2 building that
consists of 34 two bedroom units and 66 one bedroom units.
Originally permitted flow was 24 x 2 bedrooms x 120 god/bedroom + 48 x 1
bedroom x 240 gpd/unit = 17,280 gpd
New flow to be added to original permit is 34 x 2 bedrooms x 120 gpd/bedroom
+ 66 x 1 bedroom x 240 gpd/unit = 24,000 gpd
Total flow from phs 1 and phs 2 = 17,280 + 24,000 = 41,280 gpd
The sewer collection system within the project site will be provided by a series of
public 8-inch gravity lines that are owned and maintained by City of Belmont. The
sewer system installed under phase 1 permit connects into an existing downstream 8-
inch sewer lines owned by the City of Belmont and will be treated at the City of
Belmont Waste Water Treatment Facility (WWTF NC0021181), which is owned by the
City of Belmont.
Date: 10/04/17
PAActive Projects \ WG M. Design \Loftin Phase 2 I 61.43Trigineering\ Applications\ nedwq SS\tollin 2 Sewer Cover
Letter doe

SAACS
NGINEERING DESIGN & LAND SURVEYING
8720 RED OAK BOULEVARD, STE, 42C, -C3
CHARLOTTE, N,C, 28217
PHONE_ (704) 527.--3„440 FAX (-704) .527-5,52,5
TO North Carolina Dept. of Envir. Quality
610 E. Center Avenue
Mooresville, NC 28115
WE ARE SENDING YOU El Attached
LI Shop drawings H Prints
E Copy of letter LI Disk
LETTER OF TRANSMITTAL
DATE: 12126/2017
JOB NUMBER: 16143
ATTENTION: Div, of Water Resources
RE: Loftin Phs 2
Sewer Fast Track Submission
Modification to permit WQ0036280
Lil Under Separate cover via
E Plans
El Applications
the following items:
Specifications
COPIES
DATE
NO.
DESCRIPTION
2
Application Packages (1 orig. plus 1 copy) inlcuding the following
Fast Track Application
Cover Letter / Pro), Narrative
8:5x11 colorusgs map ti-lEcLivhuiNc,t.TNi.
8.5x11 color street level map
Original permit WQ0036280
PlowTraCking application FTSE 04- 6
v rOORC-S;Vi' ' i: RF-rICINI
1
$480.00 check for review fee
THESE ARE TRANSMITTED as checked below:
E For approval
P1 For your use
E As requested
LI For review and comment
REMARKS
Li Approved and submitted
E Approved as noted
P1 Returned for corrections
Resubmit
El Submit
rj Return
copies for approval
copies for distribution
corrected prints
Enclosed find items listed above necessary for your review. Please call 704.227.9402 or email
[e-mail] if you have any questions or need any add'I information to proceed with review.
COPY TO
SIGNED Brent Cowan
OF,PtCE

Central Files: APS SWP
1/4/2018
Permit Number WQ0036280 Permit Tracking Slip
Program Category Status Project Type
Non -discharge Active Major modification
Permit Type
Gravity Sewer Extension, Purnp Stations, & Pressure Sewer Extensions
Primary Reviewer
earrylove
Coastal SWRuIe
Permitted Flow
41,280
Facility
Version Permit Classification
1.10 Individual
Permit Contact Affiliation
Facility Name
Montcross Seniors
Location Address
Own
MajoriNlinor Region
Minor Mooresville
County
Gaston
Facility Contact Affiliation
Owner Name
City of Belmont
Date vents
Owner Type
Government - Municipal
Owner Affiliation
Adrian T. Miller
PO Box 431
Belmont
NC 28012
Orig Issue
12/11/2012
App Received Draft Initiated
1/2/2018
Regulated Activities
Scheduled
Issuance Public Notice Issue Effective Expiration
Apartment complex
Condominium
Wastewater collection
Outfall
1/4/2018 1/4/2018
Requested /Received Events
Additional information requested
Additional information received
Waterbody Name Streamindex Number Current Class Subbasin