WQ0038806_Sewer Extension Permit Status Update_20210713

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mcgill
LETTER OF TRANSMITTAL
DATE: July 9, 2021
TO: Collin Geersen
COMPANY: NCDEQ - WQPS - Municipal Permitting Unit RECEIVED
ADDRESS: 512 N. Salisbury Street, Suite 925, Raleigh, NC 27604 1 2 2021
PROJECT Polk County Permit No. WQ0038806 NCDEQ/DWR/NPDES
SUBJECT: Closeout Documents
WE ARE SENDING YOU THE FOLLOWING ITEMS:
X Attached Under separate cover via
# of Copies Date Description
1 7/9/2021 Sewer Extension Permit Status Update
1 7/8/2021 Fast Track Sewer Engineering Certification
9 g
1 7/8/2021 Sewer Record Drawing
THESE ARE BEING TRANSMITTED AS CHECKED BELOW:
X For Approval For your use As requested
For review For Bids due
Remarks:
Copy: Marche Pittman, Polk County (via email)
SIGNED: 7 _—
-
Bill Roark, PE
MCGILL A SSOCIATES 5400 TRINITY ROAD, SUITE 107, RALEIGH, NC 27607 /919 378.9111 /MCGILLASSOGIATES COM
1

Request for Engineering Certification Date of Letter: June 15,2021
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 14,2021
to the attention of Collin Geersen at the Division's Municipal Permitting Unit by the delivery method below:
NCDEQ/DWR
WQPS—Municipal Permitting Unit
By U.S.Postal Service: By Courier/Special Delivery: By Email:
1617 Mail Service Center 512 N.Salisbury St.Suite 925 Collin Geersen
Raleigh,NC 27699-1617 Raleigh, NC 27604 Collin.Geersen(a ncdenr.gov
Permit No.:WQ0038806 Permittee: Polk County
Project Name: Polk County Jail and Law Enforcement Center
Project Status (Complete Signature&Date section below. Check appropriate box tato indicate Permittee's response.)
Name&Title(print): Marche Pittman, County Manager
Signature: Q it Date: 7-9-2021
Comments:
SEWER NOT YET CONSTRUCTED
0 The Permittee certifies that the permitted project has 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
14 Engineer's Certification: The Permitted project has been constructed and the required Certification page and supporting
documents are being submitted to the Division with this form.
OWNERSHIP/NAME CHANGE
❑ The Permittee requests information 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 be constructed nor made operational. By signing below,we acknowledge that should we wish to operate a non-discharge sewer
system in the future,we shall 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: Polk County
PERMIT#: WQ0038806
PROJECT: Polk County Jail and Law Enforcement Center
ISSUE DATE: October 18,2016
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.
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.
,
Marche Pittman Q '''i j7,q _ 07/08/2021
Printed Name,Title Signature Date
ENGINEER'S CERTIFICATION
I, gst J. R01k ,as a dul registered Professional Engineer in the State of North Carolina,
having been authorized to observe ( periodically. ri weekly, I 1 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; 1SA 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:
C
•p. /• • r" Aik
Final Partial (include description)
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7'.
SEAL r'li
027788
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Certification Comments/Qualifiers(attach if necessary): tYYj•r
NC DWR—Water Quality Regional Operations Section Address City, NC Zip Code
Asheville Regional Office Phone: [phone] FAX:[phone]