WQ0039173_Sewer Extension Permit Status Update_20210706

1.11
Stanley D.Lindsey ,
and Associates,Ltd. v ,
July 1, 2021
Collin Geersen
NCDEQ Division of Water Resources
1617 Mail Service Center
Raleigh, NC 27699-1617
CHARLOTTE COUNTRY DAY SCHOOL LOWER LIBRARY & MATH/ I
PERMIT#WQ0039173 ' `�
JUL 0 7 2021
Subject: Engineer's Certification
NCDEQIDWRINPDES
Dear Collin,
Enclosed are (1) completed Sewer Extension Permit Status Update Form, (1) Engineering
Certification form, and (1) copy of the project construction record drawings. These items are
submitted as a complete final certification of the approved wastewater collection system extension
associated with permit number WQ0039173.
If you have any questions concerning this submittal, please do not hesitate to call.
Sincerely,
Steven H. Doe, PE
Stanley D.Lindsey and Associates,Ltd.
1347 Harding Place,Suite zoi Charlotte,NC 287o4
704 333 3122 www.sdlal.com
Nashville Atlanta Charlotte Tampa Orlando Louisville

Repuest for Ingrneenng Cert,hc.rtro', U.rte of tette, luny 15 is,.
Sewer Extension Permit Status Update
Please complete the applicable portion of this form for each permit and return this form and supporting documents by July 14.202.
to the attention of Collin Geersen at the Division's Municipal Permitting Unit by the delivery method below
NCDEQ/DWR
WOPS-Municipal Permitting Unit
tj U.S.Postal Service: By Courier/Special Delivery: BY Email:
1bI7 Mad Service Center 512 N Salisbury St Suite 925 Collin Geercen
Raleigh.NC 27699 1b17 Raleigh.NC 27604 • ,. •
Permit No. WQ0039173 Permittee: Charlotte Country Day School
Project Name:Charlotte Country Day School Lower Library& Math/Science Center
Project Status • '✓.
Name&Title(print)
Signature � Greg Walters Facilities Director
g /t 2 . Ys/4Ri4i�/71rs- Date 7///202•(
L"
Comments
SEWER NOT YET CONSTRUCTED
0 The Permittee certifies that the permitted project ha;not been constructed but shall be constructed in the future in conformity
with the approved Permit.project plans,specifications and supporting documents The Permittee understands that the
appropriate certification documents will need to be forwarded to the Division prior to operation Subject permit shall be
maintained in Active status NOTE:If sewer will never be built,please complete Permit Rescission Request section below
SEWER HAS BEEN CONSTRUCTED
Eli Engineer's Certification The Permitted project has been constructed and the required Certification page and supporting
documents are being suomitted to the Division with this form
OWNERSHIP/NAME CHANGE
0 The Permittee requests ntormahon to apply for ownership or name change Please provide email and phone number below for
follow-up
Permit Rescission Request
The Permittee requests that the subject permit be rescinded and certifies that the permitted sewer system has not been and shall
not he constructed nor made operational. By signing below.we acknowledge that should we wish to operate a non discharge sewer
system in the future we Shrill apply for and receive a new Wastewater Collection System Permit
Name&Title(Print):
Signature: Date.
Comments:
Contact Information Updates for Permittee
Updated Contact Person&Title(Print):
Updated Mailing Address
Updated Email Updated Phone:

FAST TRACK SEWER ENGINEERING CERTIFICATION
PERMITTEE: Charlotte Country Day School
PERMIT WQ0039173
PROJECT: Charlotte Country Day School Lower School Library and New Math&Science Center
ISSUE DATE: April 28,2017
This project shall not be considered complete nor allowed tb 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 ail 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,
PERMITTEE`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, and the Permittee is prepared to operate & maintain
the wastewater collection system permitted herein or portions thereof.
Greg Walters, Facilities Director /ILL iti•d&ad /Za
Printed Name,Title Slnature Date
ENGINEER'S CERTIFICATION
I, Jeffrey I. Smith, PE ,as a duly registered Professional Engineer in the State of North Carolina,
having been authorized to observe (LI(jperiodically, E3 weekly, L j full 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 ot 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:
,
El Final fl Partial(include description) -/0
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Certification Comments/Qualifiers(attach if necessary);
Statc of Noah Carolina Enwonnenial Quemy,%YAW Retourtes \lima Quallty kcipml Operamns
Moottsvalc Fict<rat Offkc 6 I 0 Ent Center Annue,Suite 30 I Motcisilk.No,n1 Carolina 28115