WQ0039510_Regional Office Historical File Pre 2018

r Resources
Envarcrtxnten 9J Quality
October 5, 2017
Mr. Adrian Miller; City Manager
City of Belmont
115 N. Main Street
Belmont, NC 2801.2
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. JAY ZIMMERMAN
Director
Subject: Permit No. WQ0039510
City of Belmont
The Conservancy 2
Wastewater Collection System Extension Permit
Gaston County
Dear Mr. Miller:
in accordance with your application received September 26, 2017, we are forwarding herewith Permit No.
WQ0039510 dated October 5, 2017, to City of Belmont (Permittee) 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from the date of issuance until rescinded and shall be subject to the conditions and limitations as specified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 the following conditions contained within this permit:
Condition Ili.: This permit shall not be automatically transferable; a request must be made and
approved.
Condition 91.4: 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.
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.
othing
State of North Carolina j Envirewalrty. i 4r$aLer k esouro I Wale r S ualif E Regal Operations
Mooresville Regional OfTh e i 610 East Center Avenue, Suite 301 I Mooresville, North Carolina 28115
7 04-663- 1699

If you need additional information concerning this matter, please contact Barry Love of 04)235-2143
or via e-mail at barryiov°e@ncdenr. v,
.Sincerely,
by W. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional Office
Division of Water Resources, PCDEQ
cc: Scott Doerr, P,E: (e-copy)
Regional Office Files
Water Resources Central Files
PERCS Cc -copy)

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 3,865 linear feet of 8-inch gravity sewer, to serve the
The Conservancy 2 project, and the discharge of zero additional gallons per day (flow previously allocated
in WQ0037537) of collected domestic wastewater into the City of Belmont existing, sewerage system,
pursuant to the application received September 26, 2017, 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 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 Basinger, Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional Office
Division of Water Resources, NCDEQ
Permit Number: WQ0039510
Permit issued: October 5, 2017

�&U��0����K�l7�������Ul�������������
~,��o�w~o~m�v"_v�v n�� PERMIT n����u.on °»uo^.m.n
City of Belmont is hereby authorized to:
Construct, and then operate upon certification the aforementioned wastewater collection extension. The
sewage and wastewater collected bythis system shall be treated inthe City nfBelmont Wastewater
Treatment Plant lnaccordance with Permit Number NC002l181.
Permitting of this project does not constitute an acceptance of any part of the project that does not meet
ISA NCAC ZT; the Division's Gravity Sewer Minimum Design Criteria adopted February lZ, 1996, as
applicable; and the Division's Minimum Design Criteria for the Fast -Track Permitting ofPump 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 Caro lina-licensed Professional Engineer in
the application. It shall be the Penn|1tee"s responsibility tuensure 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.
|. SPECIAL CONDITIONS
1. No flow in excess of the quantity permitted herein, zero GPD (flow previously allocated in
VVQ08376]7) shall be made tributary to the subject sewer system until an application for permit
modification for an increase in Movv has been submitted to and approved by the Division. [15A N[AI
11. STANDARD CONDITIONS
,
�
l. This permit is not transferable, In the event there is a desire for the waatenwate, collection facilities
to change ownership, or there is a name change of the PennUtne, 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 ormay not beapproved, [15ANCA[0IT.01O4;G,S143-215.1(d3)]
2. This permit shall become voidable unless the wastewater collection facilities are constructed in
accordance with the conditions of this permit; 254 NCA[ 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 nfPump Stations and Force Mains adopted June 1,2ODO,asapplicable; and
other supporting materials unless specifically mentioned herein. [15AN[A[03T.0110l
}. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data. [1SAN[4COZT.Dl1Ol
4. The wastewater collection facilities shall be p,mppdv maintained and operated atall 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 NCACZT�03� |fanindividual
permit |snot required, the following performance criteria shall bemet: [15AN[A[0IT.0108(b)):
a. The sewer system shall be effectively maintained and operated atall times tnprevent 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. Anoperation 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 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.
n. High -priority sewer lines shall be inspected at least once per every six -months and inspections are
documented.
[ 4general observation of the entire sewer system shall beconducted atleast once per year.
g. overflows and bypasses shall bereported tothe appropriate Division regionalofficeinaccmrdance
with 15A NCAC 2B D506(a), and public notice shall be provided as required by Worth Carolina
General Statute §143'Z15.IC.
h. AGrease Control Program is in place asfollows:
1 For public owned collection systems, the Grease Control Program shall include at least
biannual distribution of educational materials for both cornnucrda| 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 tocontrol 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-
annual distribution of grease education materials to users of the collection system by the
pernmitteeorits representative.
3. 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 in the full easement width for personnel and
equipment accessibility.
i. Documentation shall be kept for Subparagraphs (a) through (i) of this Rule for a minimum of three
years with exception of the map, which shall be maintained for the life of the system.
5

5. The PennitteeyhaU report by telephone to awater resources staff member at the Mooresville
Regional Office, telephone number (704)563'1699,assoon axpossible, but innocase more than I4,
following the occurrence or first knowledge of the occurrence of either of the following:
a. Any process unit failure, due toknown orunknown reasons, that renders the facility incapable
of adequate wastewater transport, such as mechanical or electrical failures ofpumps, line
blockage orbreakage, etc;or
b. Any 560and/or spill over 1,OUOgallons; or
c Any 5S{Jand/or spill, regardless ofvolume, that reaches surface water
Voice mail messages or faxed information is permissible, but this shall not be considered as the initial
verbal neport. Overflows and spills occurring outside normal business hours may also be reported to
the Division of Emergency Management attelephone number(800) 858'0368 or (919) 733'3300.
Persons reporting any of the above occurrences shall file a spill report by completing and submitting
Part | of Form CS-S5O (or the most current Division approved form) within five days following first
knowledge ofthe occurrence. This report must outline the actions taken urproposed 1obetaken to
ensure that the problem does not recur, Part ||ofForm [S-55O(or the most current Division approved
form) can also be completed to show/ that the 55Ovvas beyond control. [G.S. 143'315.1[/a1\l
6. Construction ofthe gravity sewers, pump stations, and force mains shall be scheduled soasnot to
interrupt service by the existing utilities nor result in an overflow or bypass discharge of wastewater
7. Upon completion of construction and prior to operation of these permitted facilities, the completed
Engineering Certification form attached tothis permit shall besubmitted with the required supporting
documents to the address provided on the form. Acnmpiete 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 Permittee to
appropriate enforcement actions.
t[the permit isissued twmprivate entity with em Operational Agreement, then ecopy mfthe Articles
of Incorporation, Deo|mratim nantsJRmstrict|uns, and Bylaws that have been appropriately
filed with the applicable Countys Register of Deeds office shall be submitted with the certification.
Acomplete certification is one where the form |sfully executed and the supporting documents are
provided asapplicable. Supporting documentation shall include the following:
a. One copy Vfthe project oomo ructionrecorddrawin8s(p|an&urof|eviewsofsewerHnes&force
mains) ofthe wastewater collection system extension. Final record drawings should be clear on
the plans or on digital media (CD orDVD disk) and are defined as the design drawings that are
marked up or annotated with after construction information and show required buffers,
separation distances, material changes, etc.
b. One copy of the supporting applicable design calculations including pipe and pump sizing,
velocity, 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 a pump cycle, and downstream sewer capacity analysis. If portable power
6

source or pump is dedicated to multiple stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, include travel
t|rneframe»,shall beprovided.
Changes tnthe project that donot result innon-compliance with this permit, regulations, cnthe
Minimum Design Criteria should be clearly identified on the record drawings, on the certification
|nthe space provided, or|nwritten summary form,
Prior tmCertification (Final orParba|): Permit modifications are required for any changes resulting in
non-compliance with this permit (including pipe length increases oflO% or greater, 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 omacase-bv'casebasis 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 orrepair prior to certification &
activation. [l5AN[A[O2T.U1lGl
6. Gravity sewers installed greater than ten percent below the minimum required slope per the Division's
Gravity Sewer Minimum Design Criteria shall 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 be done through a permit modification with fee. Such variance requests will be evaluated
onacaye-bv~casebasis. Resolution of such request shall be evident prior to completing and submitting
9. A copy of the construction record drawings shall be maintained on file by the Permittee for the life of
18. Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 2T; the Division's
Gravity Sewer Design Criteria adopted February IJ, 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 [oro||ma General Statutes §143-215.6Athromgh §143'215.6C,
construction of additional or replacement wastewater collection facilities, and/or referral of the North
Carolina -licensed Professional Engineer tothe licensing board. \1SAW[ACO2T.01O4;1SAN[A[0ZT
12- 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.
12. 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 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-
7

FAST TRACK SEWER ENGINEERING CERTIFICATION
City nfBelmont
VVQ0X039510
The Conservancy 2
October 5,2017
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 besubmitted 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 Permhtep to
appropriate enforcement actions. The Pernnittee is responsible for tracking all partial certifications up
until afinal certification lsreceived, AFinal Certification shall beacomplete set pfrecord drawings and
design calculations regardless ofwhether partials have been submitted.
PERw[rTEE'S CERTIFICATION
|, the undersigned agent for the Permittee, 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 Permittee, and the Permittee is prepared to operate &maintain
the wastewater collection system permitted herein orportions thereof.
Printed Name, Title
Signature Date
ENGINEER'S CERTIFICATION
,aoaduly registered Professional
U rin1heStatenfNo�Carolina,
having bepn authorizedauthorized|o observe (| periodically,periodically,D weekly, �U 1hnu) the construction of the
project name and location as referenced above for the above Permittee hereby state that, tVthe 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; 25A N[A[02T; the
Division of Water Resources' (Division) Gravity Sewer Minimum Design Criteria adopted February lJ,
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, w/signature & date:
l
IRr�| /Partia| description)
CertificationComments/Qualifiers if necessary):
State v/murihcaiuhn^|cu=o""ciatalVlUdlty|w3ttTmMvUTCe"/W°teTV"aitynegi"na/nr°rAhOn,

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number:
o be completed by DWR)
All tems rnust be completed or the application will be returned
I. APPLICANT INFORMATION:
1. A.pplicant's name: City of Belmont (company, municipality, HOA, utility, etc.)
2. Applicant type: E Individual Corporation [11 General Partnership El Privately -Owned Public Utility
[1] Federal State/County L Municipal El Other
3. Signature authority's name: Adrian Miller per I5A. NCAC 02T f11.00,0I
Title: City Manager
4. Applicant's mailing address: 115 N. Main Street
City: Belmont State: NC Zip: 28012-
5, Applicant's contact information:
Phone number: [phone] Email Address: amiller@eityofbelmontm;
IL PROJECT INFORMATION:
I Project name: The Conservancy 2
2. .Application/Project status: E] Proposed (New Permit) [1] Existing Permit/Project
If a modification., provide the existing permit number: WQ00 and issued date:
if new construction but part of a master plan, provide the existing permit number WQ00
3. County where project is located: Gaston
4. Approximate Coordinates (Decimal Degrees)' ude: 35. 1.620' Longitude: -81,0498"
5. Parcel ID (if applicable): 3.582608343
(or Parcel ID to closest downstream sewer)
HI. CONSULTANT INFORMATION:
1.. Professional Engineer: Scott Doerr License Number 29933
Fimi: Merrick & Compnay
Mailing address: 1001. Morehead Square -Drive, Suite 530
City: Charlotte State: NC Zip: 28203-
Phone number: [phone] Email Address: scott.doerr@merrick..com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORN1ATION:
I Facility Name: City of Belmont WWTP .Permit Number: NC0021.181
Owner Name: City of Belmont
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1 Permit Number(s): WQ0037612 Downstream (Receiving) Sewer Size: 8 inch.
System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s): City of Belmont
FORM: FTA 04-16 Page 1 of 5

VI. GENERAL REQUIREMENTS
.1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
El Yes ONo ZN/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational A.greementAFOR , EY) been attached?
0 Yes 0No ZN/A
3. If the Applicant is a Flome/Property Owners' Association, has an Operational Agreement. (FORM:H.0A) been attached?
0 Yes ZNo ZN/A
4. Origin of wastewater: (check all that apply):
[Z] Residential Owned
El Residential Leased
School / preschool / day care
E Food and drink facilities
El Businesses / offices / factories
El Retail (stores, centers, malls)
El Retail with food preparation/service
Medical / dental / veterinary facilities
LI Church
LI Nursing Home
5: Nature of wastewater: 100 % Domestic/Commercial
% Commercial
E Car Wash
El Hotel and/or Motels
LI Swimming Pool /Clubhouse
El Swimming Pool/Filter Backwash
E] Other (Explain in Attachment)
% Industrial (See 15A. NCAC 02T .0103(2_.(1))
1--0. Is there a Pretreatment Program in effect? E Yes
6; Has a flow reduction been approved under 15A NCAC 02T ,Q.,114(f)? El] Yes E No
If yes. provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
0 No
Establishment Type (see 02T.01141(0)
Residential - 4 Bed Rooms
Daily Design Flow `01
No. of Units
Flow
120 gal/Day
92
gal/
44,160 GPD
GPD
gal/
GPD
gal/
gal/
GPD
GPD
gali
GPD
Total 44,160 , 60 GPD
a See 15A NCAC 0217 .0114(b),_(0),_(e)(1) and teL)L2) for caveats to wastewater design flow rates (i.e, minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in (i,S,42A...-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified {in table 15A. NCAC 02T.01141 shall be
determined using availlibTaltrwistata, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 0 GPD)per 15A. NCAC 02T .01 14)
Do not include future flows ol„preViously permitted allocations
If permitted'flow-is-zeto, indicate why:
[1] Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to .this line
E Flow has already been allocated in Permit Number: WQ0037537
0 Rehabilitation or replacement of existing sewer with no new flow expected
LI Other (Explain):
FORM; FTA 04-16 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC fGravitv Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
8
8
Material
3,8 I 5
50
PVC
DIP
▪ Section 11 & HI of the MDC for Permitting of Gravity Sewers contains information related to design criteria
• Section ITT contains information related to minimum slopes for gravity sewer(s)
'0•'• Oversizing lines to meet minimum slope requirernent is not allowed and a violation of the MDC
VHI. PUMP STATION DESIGN CRITERIA (If Applicable) — 02r .0305 & MDC (Porno Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
I. Pump station number or name:
1 Approximate Coordinates (Decimal Degrees): Latitude: Longitude: -
3, Design flow of the pump station: millions gallons per day (firm capacity)
4. Operational point(s) ofthe pump(s): gallons per minute at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
6. Power reliability in accordance with 15A NCAC 02T A)305111111(1):
Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(B)i.'
.1i>. 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 if the pump station has an average daily flow less than 15,000 gallons per day:
I Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCA.0 02T
,0305(h)(1)(C)
or
El Portable pumping unit with plugged emergency pump connection and telemetry - 15.A NCAC 02T .0305(h )( 1)(C):
▪ It shall be demonstrated to the Division that the portable source is owned 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 stations' storage
capacities and the rotation schedule of the. portable power source or pump, including travel timeframes, shall be provided
in the case of a multiple station power outage..
FORM: FTA 04-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & I5A NCAC 02T .0305(f)):
1 Does the project comply with all separations found in .15.A, NCAC 02T .0305(1) &Lig)
> 1.5A NCAC 02T.0305(f) contains • 'n um separations that shall be provided for sewer_systems:
Setback Parameter*
Storm sewers and other utilities not listed below (vertical)
ains (vertical -water over sewer including rn benched trenches)
ter mains (horizontal)
Reclaimed water lines (vertical - reclaimed over sewer)
Reclaimed water lines (horizontal - reclaimed over sewer)
Z Yes EliNo
Separation Required
24 inches
inches
10 .fect
*Any private or public water supply source, including any wells, WS-. waters o C
Class 1.1 impounded reservoirs used as a source of drinking wat
18 inches
**Waters classified WS (except WS-1 or WS-V), B, SA, ORW, HQW, or SB from normal
high water (or tide elevation) and wetlands (see item IX.2)
2 f.
100 feet
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
Any building foundation
An basement
10 feet
ee
10 feet
To s o e of embankment or cuts of 2 feet or more vertical height
es stems and interceptor drains
n pools
Final earth grade (vertical)
0 fect
fee
0 feet
36 inches
• 15A NCAC 02T.0305(g) contains alternatives where separations, in 02T„0.30.510 cannot be achieved.
• **Stream classifications can be identified using the Division's NC Surface Water Classifications webraze
• If noncompliance with 02TA)305(flswlg), see 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 is utilized in design and construction
As built documents should reference the location of areas effected
3. Poes the project comply with all setbacks found in the river basin rules per 4.5.A,„:
• This would include Trout Buffered Streams per 15A. NCAC 211.0202
02B .0200?
Yes 11 No
Yes 1 INo
4. Does the project comply with an individual 404 Permit or any 401 Certifications? [I] Yes No
Wetland -related permits shall be 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 'I5.A NCAC 02T,0 05(c)(6) (additional permits/certifications)? L Yes No
Per 15ANCAC 02T,0105(c)(6), directly related environmental permits or certification applications are being prepared, have
been applied for, or have been obtained.. Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormwater management plans, etc..),
6, Does this project include any sewer collection lines that are deemed "high -priority?"
Per I 5A, NCAC 02.T„0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to strearnbanks that is subject to erosion that undermines or deteriorates th,e sewer,
Ej Yes JNo
If -yes, include an attachment with details for each line, including type (aerial line, size, material,and location).
High priority lines shall be inspected by 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

CERTIFICATIONS:
1. Does the submitted system comply with 1.5.A NCAC 02T, theDesign Criteria tbr the Permitting of Puma...Stations
and Force Mains (latest 'version), and the Gravity Sewer :Minimum Design CriteriaRatest, version) as applicable?
0 Yes 0 No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-1.4) and supporting documents for
review. Approval ofthe request is required prior to submittal of the Fast Track Application and supporting documents.
Professional Engineer's Certification,
SCOtt C. Doerr, PE
(Professional Engineer's name from Application Jteni IIL .)
attest that this application for
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. 1 further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (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 - In accordance with General Statutes 143-215,6A and '143-215.6B, any person who knowingly makes any -false
statement, representation, or certification in any application packa,ge shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed S10,000, as well as civil penalties up to S25.,000 per violation,
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(h):
1, Cr-
(
Signature Authority's name & title fro.
pplication Item L3.)
attest that this application for
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 returned as incomplete. I understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, andlor criminal prosecution. I 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 arc not completed and that if
all required supporting information and attachments are not included, this application package will be returned to me as
incomplete,
NOTE — In accordance with General Statutes i43216 and 1.43-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 -misdemca,nor, which may
include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature.
FORM: FTA 04-16
Page 5 of 5

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 which flow is being requested: McLean - The Conservancy Phase 2
for than one FTSE may be required Ibr a single praieci tithe owner of the 1,VITI7- is not responsible /or all pli
stations along the route of the proposed wastewater flow,
. Complete this section only ifyou are the owner of the wastewater treatment plan
a, WWTP Facility Name: City of Belmont WWTP
b. WWTP Facility Permit #: NC0021181
A II flows are in MGJJ
c. WWTP facility's permitted flow 5.0000
d. Estimated obligated flow not yet tributary to the WWTP 1.0760
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
1.64.9.0 (2016 Average)
0.0000 (In .WQ0037818)
g. Total actual and obligated flows to the facility 2.7250
h. Percent of permitted flow used 55%
11. 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:
Pump Sation
(Name or
Number)
Conservancy
McLean PS
Moans PS
Firm
Capacity, *
MGD
(A)
Design
Average Daily
Flow**
(Firm pi),
GI)
0.2880 0.1154
0.9360 0.3744
1:7280 0.6912
(B)
Approx..
Current
Avg. Daily
Flow, MGD
0.0022
0.0096
(C)
Obligated,
Not Yet
Tributary
Daily How,
MGD
0.0988 0,_
(D)=-(13+C)
Total Current
Flow Plus
Obligated
Flow
(E)—(A-D)
Available
Capacity***
54 0.0000
0 0,2006 0.7354
0.4519 1.2761
* 'file 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 (pfl 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.
Downstream Facility Name (Sewer): Conservancy/McLean/Morgans Branch
Downstream Permit Number:
WQ0037818/WQ0037537/WQ0037000
Page 1 of 6
ErsF 04-16

111: Certification Statement:
1 Adrian T. Miller, City Manager certify to the best of my knowledge that the addition of
the volume of wastewater to he permitted in this project has been evaluated along the route to the
receiving wastewater treatment facility and that the flow from this project is not anticipated to
cause any capacity related sanitary sewer overflows or overburden an downstream pump 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 and procedures using the best
available data. This certification applies to those items listed above in Sections I and It plus all
attached planning assessment addenduins for which I am the responsible party. Signature of this
loan indicates accep nee of this wastewater flow.
Signing Official Signature
Date
Page 2 of 6

P
itff 4,444 ,4.i 447 4 1 Ki1i16:tih. 4,441 AND NM i Ftxk §tb'r. Jx Nt
#'tYtih "c 4,444 4 4,44 KS-454 xq'&z,K;
` 444PI 44.4‘14,.*144.444444 4,414,444444.4Mi n4 SEIM44
454.44_0
m'+?tit91 <'ROt4x(S'w,n *iAA 41 i 44,4€ 41.R4k
K 4414t4NE. kB SI KH, 414 4444,44444 PF 94(

0• ERRICK
000
hlertik & Company
1001 k orehead Square Dr , Suite 530
Charlotte, NC 28203
Tel [phone]
Fax: +1 '704-522-0882
www.merrick.com
The Conservancy 2 at McLean
NCDEQ — QWR Fast Track Application for Gravity Sewers, Pump Station & Force Main.
Project Narrative:
This application is to cover the gravity sewer as part of the second phase of The Conservancy at McLean, a single
family subdivision located in the City of Belmont, Gaston County, NC. The entire phase includes 92 single family
residential 4 bedroom homes.
The gravity system permitted will include 3,865 linear feet of 8" sanitary sewer and 16 manholes,
Enin Architecture °esl d Surveyetg Planning Landscape Arc e GeoS:

00 MERR CK
COMPANY
TRANSMITTAL
To: NCDEQ - Water Quality Section
c/o Barry Love
610 E. Center Avenue, Suite 301
Mooresville, NC 28115
[phone]
Date: September 25, 2017
Document: FTA Sewer Ext Application
Ref.: The Conservancy 2
Job #. 65117825-11
Sent Via: Courier
Quantity Description
2 FTA Sewer System Extension Application
1 Application fee of $480.00 (1714)
Remarks
Please find attached FTA submittal for The Conservancy Phase 2 gravity sewer, part of the McLean Masterplan
in Belmont, NC. If you have any questions, please feel free to call me 7044-612-0702 or send an email,
[e-mail]. I appreciate your time!!
Respectfully submitted,
Merrick & Company Received by
By; !! 'op%
J °McDonald, El — Ci 1 En:ineer I
Date: Time:
Merrick & Company — Charlotte
1001 Morehead Square Drive
Charlotte, NC 28203
704-529-6500

CentralFil.es APS SVVP
10/412017
Permit Number W00039510 Permit Tracking SIM
Program category Status Project Type
Non -discharge Active New Project
Permit Type Version Perrrat Classification
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions 100 Individual
Primary Reviewer
berry love
Coastal SA/Rule
Permitted Flow
0
Facility
Permit Contact Affiliation
Facility Name
The Conservancy 2
Location Address
Owner
Major/Minor Region
Minor Mooresville
County
Gaston
Facility Contact Affiliation
Owner Name Owner Type
Chly of Belmont Government - Municipal
Owner Affiliation
Adrian Miller
Dates Events
PO Box 431
Beintont
NC 28
Schedu led
Orin issue App Received Draft Initiated issuance Public Notice Issue
Effective Expiration
1013/2017 9/26/2017 10/512017 1015/2811
Regulated Activities
Subdivision
Wastewater collection
Outfit&
Requested /Received Events
Additional Otformation requested
Additional Otforniation received
Waternody Name
Strearnindex Number Current Class Subbasin

PrFAST TRACK SEWER ENGINEERING CERTIFICATION
PERMITTEE:
PERMIT tf:
PROJECT:
ISSUE DATE:
City of Belmont
WQ0039510
The Conservancy 2
October 5, 2017
E NC N FaMP,
8 1018
M RESV Pa, E REG 0 iNiAt,„ (;)14' 1 GE
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. A Final Certification shall be a complete set of record drawings and
design calculations regardless of whether partials have been submitted.
PE EE'S CERTIFICATION
I, 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, an,� the Permittee is prepared to operate & maintain
the wastewater collection system permitted here portions thereof.
MY.;..t d
Printed Name, Title Signature Da
ENGINEER'S CERTIFICATION
I, Scott C. Doerr, P.E. as a dyy registered Professional Enjneer in the State of North Carolina,
having been authorized to observe ( periodically, D weekly, U fu!I time) 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 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(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 w/signature & date:
Finat 0 Partial (include description)
Certification Comments/Qualifiers (attach if necessary):
00"11"1,i,
State of Nonti Carolina Environmenial Qualnyl Water Kesootco Water Qtralli) Itcgicnal Operations
Kir,Aille 1,4 ewkrotal Cares 610 r Cenicc AverVtle... SIAM, 301 Noah Carolina 28115

ERRICW
TRANSMITTAL
To; Barry Love, NCDEQ
Mooresville Regional Office
610 East Center Avenue, Suite 301
Mooresville, NC 28115
Quantity Description
2 Record Drawings
2 Certification Letter
2 Testing Reports
Remarks
Barry,
Date: 9,27.2018
Document: WQ0039510
Ref,: Conservancy 2 Final
Job #: 65117825-05
Sent Via: FedEx
Attached are the certification doctnients for a final sewer certification for Conservancy
know if you have any questions. Thank you.
Respectfully submitted,
Joshua Motes
errick & . ompan
By:
Pr.ject Manager— Merrick & Company
Received by
Date: Time:
errick & Company Charlotte
1001. Morehead Square Drive
Charlotte, NC 28203
704-529-66500

01
COMMENTS
000
0 0
000
Job Marne: `on,s =°w
Contractor. eier$a P,,
PHASE FROM 7O PIPE LENGTH
MH MH SIZE
2 1
2
2
2
8'
SEWER TEST R_E•SUk.Ta
Wdtnessecf B'r van H riso
DaW 6t11/20
PRESS iE AIR T
'2
PVC 'STARTING ENDING P
OR DIP PRESSURE ' PRESSURE D
Ps"9 pig
7 02 PVC 5 0 5.6
PVC
PVC
PVC
E AIR PASS
DATE
I?ur�
7 d71,
ASSING DATE
4,0 '.
PVC 4 0 4„0
212
,1
.4 "av6 PVC 4 0 - 4.0
7
PVC 40 3.0
PVC
PVC
40
PVC 4.,C
2 i7 14 193,tCg ' PVC 4.0
2 14 15 '➢ PVC,
4,7
'2C

SEWER MANHOLE VACUUM TEST RESULTS
Job Name: Conservancy Phase 2
Contractor: Horsepower
rvoi
10
12
14
Witnessed By: Bryan Clark
Date: 6/25x/2018
******"""VACUUM TE
STARTING ENDING
VACUUM VACUUM
H9 In Hg
10.0
10.0
10.0
10,0
10.0
10.0
10.0
10,0
10, 0
10.0
10.0
10,0
10,0
10.0
10.0
10.0
*Time duration for testing pe
T:�rt���araar�f ■��w�
VACUUM PASS
DROP DATE
In Ht
9.5 0,5 6/25/2018
9.9
9,6
0.1
6/25/2016
0 1 6/25/2018
0,4
0,5
6/25/2018
'2018
0.2 6/25f2018
9.8 0,2 6/25/2018
10,0
9,9
10.0
9.6
a4
9,2
y of Belmont,
0.0 6/25/2018
0,1 6/25/2018
0.2
05
0.4
0.8
612512018
6125/2018
125/2018'
6/25/2018
25/2018
6/25/2018
COMMENTS
d Development Standards Manual, Appendix B-4