WQ0012826_Application (FTSE)_19960822

F !Z c
MEMO TO: State Review Group Division of Water
Quality
FROM: Kitty Kramer � Vi`
Environmental Technician
SUBJECT: Procedure Four (4)
WQ0012826
EPA SuperFund/Cape fear Woods
Sewer Extension - Public
PWC/City of Fayetteville
Cumberland County
Fayetteville Regional
Office
8/29/96
Date
State Review Group Review
Engineer Randy Kepler
Regional Office
Contact Kitty Kramer
1) Name of wastewater treatment plant to receive the wastewater:
PWC of Favetteville - Rockfish Creek Wastewater Treatment Plant
2) WWTP design capacity 12.0,MGD
3) NPDES Permit No.: NC0050105 Expiration Date: 5/31/96
4) Compliance Information:
Present treatment plant performance
for previous 1Z months - beginning 7/95
(See attached self -monitoring data)
5) Quantity and type of wastewater from proposed sewers: .144.00Q GPD
domestic ; industrial 100E ; other
6) Volume from previously approved projects not yet tributary to
WWTP N/A GPD
7) Regional Recommendations: Approval
AKK/akk
Enclosure
X Denial

* - x ,
DF03650I SESSION READY FOR INPUTGKEX88/MP.
COMPLIANCE EVALUATION ANALYSIS REPORT
PAGE i
PERMIT--NCO050i05 PIPE--00i REPORT PERIOD: 9507-9606 LOC--- E
FACILITY--PWC/FAYETTEVILLE-ROCKFISH CRK DESIGN FLOW-- 12.0000 CLASS--4
LOCATION--FAYETTEVILLE REGION/COUNTY--06 CUMBERLANB
50050 003i8 00538 006% 31616 50060 00300 TGP3B
MONTH Q/MGD BOD RE%/T%% NH3-N FEC COLI CHLORINE DO CERI7DPF
LIMIT F12.8000 F 6.00 F 30.0 F i.00 F 200.0 NOL NOL
95/07 .8.2483 2.44 i.0 .84 i0.i 235.750 8.70
95/08 7.6000 2.97 i.i .05 11.4 i88.03 8.39
95/89 7.5608 3.34 i.3 .07 48.5 20.500 8.75
LIMIT F12.8008 F 6.00 F 30.0 F 1.00 F 200.0 NOL NOL NOL
95/i0 8.0096 3.17 i.3 .07 4.0 00.454 8.83 i
LIMIT F12.8008 F 12.00 F 30.0 F 2.00 F 200.0 NOL NOL NOL
95/ii 7.5700 3.35 i.6 .05 8.3 234.750 9.40
9502 7.1806 4.00 i.4 .08 4.7 213.421 9.63
96/0i 7.3096 4.06 i.6 .08 4.4 i94.047 i0^0i i
96/02 .835i 2.68 i.4 .85 2.8 261.666 9.68
96/03 8.0741 3.72 i.3 .05 6.4 202.380 9.60
LIMIT F12.0000 F 6.80 F 30.0 F i.08 F 200.8 NOL NOL NOL
96/04 8.3266 3.63 i.7 .43 i0.7 222.6i9 9.i6 i
96/05 8.2000 3.05 i.6 .07 15.2 207.954 9.i2
96/86 8.0766 2.84 1.2 .06 22.6 219.250 9.i6
AVERAGE 7.i825 3.27 1.3 .09 12.4 226.892 9.20 i
MAXIMUM 12.i0OO 7.90 3.2 3.60 700.0 545.000 ii.00 i
MINIMUM .0080 i.40 .4 .03 LE%%THAN 40.000 8.i8 i
UNIT MGD MG/L MG/L MG/L 4000ML UG/L MG/L PA%%/FAI

, <E:X88r`MF'
COMPLIANCE EVALEiATIQP'( ANALYSIS REPORT
b87( 9"f 9A
PAGE
PERiMIT__.NCOOS0105 PIPE'-_.001 REPORT PERIOD 9507-9606 L_OC-__E
F t^CILI't'Y__P C. / t"•YEi EVILL..E-ROCKF I Ei C•RI< DESIGN FLOW-- 12.0000 CLASS-4
LOCATION-FAYETTEV!L_LE REGION/ COUNTY___O6 CUMBERL..ANLD
00010 00400 00600 00665 01042 01051
MONTH TEMP PH TOTAL N PHOS-TOT COPPER LEAD
LIMIT
NOL 9..0 6..0 NOL NOL NOL NOL
95/07 26.10 7.4-6.7 12.900 1.6600 .0000 .0000
9 5 / 0 9
r_ 12.800 i .8800 .:;Y0.:):.� .0000
i "}8>s10 . �}000 .0000 .
�i f'? . 40 i . ai "" C.+ .. E:7 16. ,.91:} C:y . . l: +..
r:
NOL NOL NOL NOL NOL..
LIMIT� .::} f3.:�
::).:> 2.7300 4.0000 .0000
LIMIT NOL 9.0 6.0 NOL NOL. NOL NOL
C ''i .' ; f .. ai....6. 3 14.100 1.4700 5..):;300 .0000
8 17.800 1,8700 9.0000 .3000
96/02 r.- r„ 0 '+. `+ 18.600 1.4300 5.0000 .2000
14.360 i. :[}40: 4.5000 .4500
LIMIT NOL 9,0 6.0 NOL. i'40i... NOL NOL
96/04 02- + 8 16.600 1.4100 5.0000 .2000
96/05 21.81 i .,ia__fi.Z+
-i .4.400 1 .4300 .0000 .0000
96/06 t, 15.2. 0 1.9400 .0000 .0, 00
AVERAGE 20.99 15.491 1.8108 2.8750
.0875
MAXIMUM 28..00 8,000 18.600 2.7300 6.0000 0;;}00 .3000
MINIMUM Ii"iUM 6.80 6.300 12.800 1.4100 4.0000 .2000
UNIT DEG.C: SU MGri... MG/L. UG/L.. UG/L

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E. Director
AT:7'1:4A
�HNF=1
August 22, 1996
MR. VICTOR GANJEHSANI
PWCJFAYE f 1'EVILLE
PO BOX 1089
PAYE I hVILLE, NORTH CAROLINA 28302
Dear MR. GANJEHSANI:
-AUG 27 1996
ENV. MANAGEMENT
FAYETTEVILLE REG. OFFICE
Subject: Application No. WQ0012826
EPA Superfund/Cape Fear
Sewers -Public
Cumberland County
The Division's Permits and Engineering Unit acknowledges receipt of your permit application and
supporting materials on August 21, 1996. This application has been assigned the number listed above.
Your project has been assigned to Randy Kepler for a detailed engineering review. Should there be any
questions concerning your project, the reviewer will contact you with a request for additional
information.
Be aware that the Division's regional office, copied below, must provide recommendations from the
Regional Supervisor or a Procedure Four Evaluation for this project, prior to final action by the
Division.
If you have any questions, please contact Randy Kepler at [phone] extension 544. If the
engineer is unavailable, you may leave a message on their voice mail and they will respond promptly.
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAKING
INQUIRIES ON THIS PROJECT.
Sincerely,
C Supervisor, State Engineering Review Group
cc: Fayetteville Regional Office
OHM Remediation Services, Corp
01
D. Mcaskill
Pollution Prevention Pays
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

State of North Carolina
Department of Environment, Health and Natural Resources
Division of Environmental Management
Non -Discharge Permit Application
(THIS FORM MAY BE PHOTOCOPIED FOR USE AS AN ORIGINAL)
GRAVITY SEWER EXTENSION
PUMP STATIONS, AND PRESSURE SEWERS
L GENERAL INFORMATION:
1. Applicant's name (please specify the name of the mnniripslity, caperaticn, individual. et:.): Publ i c
Commission of the City of Fayetteville, NC
Works
2. Print Owners or Signing =e:ars name and title (the person who is legally responsible for the facility and its a plurr-).
Victor GanJehsani-Chief Water Resource Engineer t.
3. Main a:ddStsm P.O. Box 1089
City: Fayetteville
Telephone Number ( 910
s(a•e NC zip: 28302-1089 .)
483-1401
4. Project Name (please specify the name of the rubdivision, facility, or establishment - should be consist= with pcjeu
name on plans, specifications, letters of flow accep(ance, Operational Agreements, etc.): r-
Former CapeFear Wood Preserving site - EPA Superfund Project -�
S. Applkasion .DaL May, 1996 a Fee submitse z$ 200
6. County w herep-o jcct u bcisrd: c um b e r land
II_ PERMIT INFORMATION:
1. Application No. (wlil be cbmtletcd by DEM):
2. Specify whethcprojectis: X Dew•
modifreadon.
3. If this application is being submitted as a result of a modification to an existing p rant, please cotnplct.-:
existing permit numb.:, and the issue dam
4. Spr ry whthe apps=nti public cs x Frivasr,-USEPA-Remedial Action
1n. INFORMATION ON WASTEWATER:
1. Nan.ce of Wasewat_. % DonnesticrCommercial ; 1 0 0 96 Industrial,;
% Other waste (specify);
2. Please provide a one ex two word description specifying the origin of the wastewatu. such as s:.hool, subdivision:, hospital,
commercial, induszial,apa;unents,e:c. fiind Site NPL Listed
3. Induct any prametrr(s) (and their cornent±ation) that will be greater than normal domestic level.v Non°
�. it warr.water is not dormesde in nature, what level of prr.cucnrtthas been provided to ensure protection of t_h
wastewater c-c-aanent facility? Carbon Absorbtion _q
FORM; GSPSA. 11!93 " . Page 1 of i_'
FEgtqc
rAUG 27 1996
ENV. MANAGEMENT
FAYETTEVILLE REG. OFFICE

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s.. Maxim= sewer =do Length between !armholes N / A linear lav-
e. This sewer line segment ot=s between taanhole ao. and manhole no.
7. Dons the ov+ne:/opeaus have the stalky so clean this length? X Yes No. For sewer reach lengths grew=
than 425 feet, please pr nel& a Lena from the ownalop=ator. sating the ability to clean the speoified reach and include the
equipment rp-f-fsev?ipeis.
8.' •Sens= subject to curing a planned uafEe bearing kinds?
so enable the newer to withstand the ;cads?
X Yes No. If yes, what me:stars are being tsf—i
9_ Outside d.-op manholes ten provided who.: invert sepxc-sdans a=d: N / A feet (provide far xq.araaons > ce-= 2_5)
10. Identify (by rrIzrthe,le murabes) those ! nh•oies that taut drop eacs-seafoer N / A
II. ).4arcirmua allowable infilt:adon/crilcstioo testratr.: 100 GPD/pipe die.meta inchftniie of pipe_
NOTE: Must not et f -e-t 100 GPD/pipe diameter inehfmtlt of pipe.
12. Minimum separation distances as shown on the plans or addressed in the apu ifications. If a, b. or c below is no, explain
is an attachment (This =don mu= be compJPt.-d far all eolleaioo systems irscIudiog fora mains and p esstn= sewers):
a) 100 ft. horizontal separation Croat wells or oche it supplies? Yes X No
b) 12 in. vertical separation foal stoner sewn or fe.7ous pipe cantr.r7 sewer speollkd? X Yes -__•_No *
• 10 ft. bariz, rep. from water mains cr 18 in vcieni rep. (water ova newer) or fezras pipe speziueri? X Yes _No *
13. Arc manholes mbja:t to flooding? :tea X No. 1t yes, are manhole rim elevations 1 foot above 104-yea flood
level, (100 year flood elevion should be indicated on plans) Yes No: Or, are manholes watertight and vented 1
foot above the 100-year flood elevation ( should be shown on plans k Yes No
14. Identify (by manhole numbs) those manholes that are vcat
15. Dots this projct involve any stream crossings? Ya X Na. If yes, what prrecsutions or speciAl features have
trilTz-d to ensues prmadoa of the sower line and not restrict swum flow? Identify t?ac sheet of the plans and station
numb= whcr su.arn =sings sre kr..ated:
Please Dote: The Division recommends all stream crossings be located three (3) feet below the stream bed or fore s
material pipe be spifned. In addition, all aerial stream c-ossings most be located above the 25-year flood elevation. Both
the 25-year flood elevation and the 100-year flood elevation should be indicated on the plains.
16. Sewers IIrao gat be List:led it WS-I wet: rsheds. Are any of the" subject wastewater eallection systems located in a F 5-1
watershed? Yes X No.
17. liti=ejancouscomrn-= Except for under Cliff .ale Ave.
FORM: GSPS.'', 11./9::t
Pet g a

V. PITMP STATION INFORMATION Wood Preserving Site
I. puism Starke No. err NarD=Fprmer Cape Fear • (A =part= sheet 4 of 8 should be submitted for each pconp =edam)
Na=e of closest down/102c srrf, vsurs Unnamed tributary to Beaver C
3- Cia-ri5 tioa of closes< d rwrIslope staiac wa.= "C" (as established by the Enviroamemal M=fig
Commi.ssioa St sp=:fied oa sheet S of 8 of tills application)
4. In accordance with ISA NCAC 2.13.0219 (h)(3). dtsmite the mean= that are being implemented to prevent impacts ocz
Qoarnsiape turf= wat.'-s, should a power fail tot Dear at this pump station. NOT'.: A1te-satire pourer MUST be
addressed for every pump non in ace rd nor with the above rri!adon. N/A
5. ut rizz pu=psalzp dcd: 3" duplex Barnes GPM; and bowzas:ty? 50 GPM x 2 pumps
6. What is the d=ign total dye+-+m;- bead? 100' tea.
7 Hew many pumping cycles wilt ocelot at average: daily flow? 2.0 . cycles per hour:
NOTE: ISA NCAC 213.0219 (h)(2) requite 2 to 8 pumping cycles per hour be achieved at average daily Sow.
8. The following items ire typically required in the design far pump =dons. Check the appropriate blank to signify that
these itetT1e balm hcca provided is the design pl ns/s {cam ion=
Alternate Power Sac
We: Well Vented with Screen
Fillets in wet Well x
Check Valves and Crate Valves
Security Fcn ng
7 n4.161c Wet Wr31 Cone
Area Light
110V Elee.:ical Convenience Outlet
Ed/Buoyancy Ptatecdcrt
High Water Alan-rn (cue choir may be Sp:titled) X AntEble and Visual
N/A
x
mare of for::: main to be tted. by diameter size and pipe my -mill:
Auto Dialer
Diartu..a
. Length
(liocer feet)
Pipe
Material
liigh
Elevation
(ft)
Low
Eevador.
(h)
Minimum
Veledry
(fes)
Maximum
Velocity
(fps)
Minimum 1
Cover (in) I
( _
q
4
4,800
SDR 21
233.0
226.0
2.5
2.85
36
10. Are air release valves provided at *11 high points along the force main (must be provided where the elevation
exrMlit 10 feet)? yc DO /
•
11. Ispump station subject to flooding? yes x no. If yes, what meastr= toe being taken to protect against f,00d;1g?
1'? Z�ssb .;., to floodi;,g, the 1C0-,: a. flood eievatioc:
13. Arz L"^� � X S V i o: plar.neG pump p s'.3ciors cC this s'a:]c-cYCs X No. Lr yes, the c.T1
e-'/`111..1"1Le the .biii % o: Lose pump s'tv.5,::.'1t. c le-g122! i f „?^, _ � � C)�t CkI t h elude Luwit CV:.,;, ..Li. . .
ff 3 7.. &-a-11 LrS,.
ntLo1.S3y2Lir- ri
FORM: GSPS!. 11/93 •..a;, t)r

This form oust be completed by the appropriate, DEM ,regional office and included as a part of tht project
submittal beformation.
"NSTRUCTIONS TO NC PROFESSIONAL ENGINEER:
The classification of the dowaslope tut ace waters (the surface waters that any overflow from the facility would flow toward)
in which these sewers wviIl be ccusauctcd must be dm:mincd by the appropriate DEM rgional office. Therefore, you are
required, prior to submittal of the application package, to submit this C. +rich items 1 through 7 completr.4 to
the appropriate Division of ironmea a1 Management Regional Water Quality Supervisor (see page 8 of 8). At a
minimum, you must include an 8.r by 11" copy of the portion of a 7.5 minute USGS Topographic Map which shows the
location of these =wets and the downslope surface waters in which they will be Located. Identify the closest downslope
surface waters on the attached map copy. Once the regional oftice has completed the classification.
reincorporate this completed page and the topographic snap into the complete application form and
submit the application package.
1.
Applicant (sprcCfy aa:uc of the ratri.-z unity. wrparant 1, individual, etr.) RP rh r e 1
2. Namedteactplctcaddressofenginemingflan: OHM Remediation Services, Corp.
5335 Triangle Parkway, Suite 450,.Norcross, GA 30092
Telephone number. ( 770 ) 729-3900
3. PPojectn.imc F_prmPr Cape Fear World Preserving Site
4. Name ofnlosestdowrulopeiznfrewit= TTnna*npd
S. County(s) where; sewers and surfs= wasers ar Boated:
6. natm.eand dt See Attached
7. NCPzofessionai Engineer's Seal, Signanae, and Dote:
TO:
rr-iht,rary rn Beaver
Cumberland
('reek
(.
�
1,,1,,...,,,,,,
:,IAA' AR02 . .
: • SEAL i
's 19B66 ' 4
+,4iJJJ11i11
REGIONAL WATER QUALITY SUPERVISOR
Please provide me with tlx cLLrifi=aon of the wait 'get.--_ thou✓ sewers will be c r s :zed, as identified on the ast.whe4
map scgrncnt
Name of i ✓face war=
1.
Unrlctmed - ibcu--cary -�b OeAjer Ctsee-V-
Classification (as esnblirbed by the Environmental Management Commission):
Pzoposcd classification, if applicable: AI /A
Signature of regional office personnel: .,r
(All ara;hrrtens muss be s:gn4)
. G SPSA 1 1l9
D tc -/3 - i L,

ir11,1 triuist1111ut1 memo 7671
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3.
THIS APPLICATION PACKAGE VCTLL NOT BE ACCEPTED BY THE DIVISION OF ENVERONMElrTAL
MANAGEMENT UNLESS ALL OF THE APPLICABLE ITEMS ARE
INCLUDED WITH THE SUBMITTAL
Req dred nears
at. One original sod one copy of the completed and appropriately executed application fcsr:. If modificadorLs to the fort; are
required as a result of additional information requests by the Division, the additional izforrnation must be transmitted under
the signature of the applicant and the actual modification must be initialed by the NC Prof msional Engineer.
b. Two (2) sets of detailed plans and signed rid sealed by a Ncrth Carolina Professional Enginea. The plaits must
include a general location map, a plan view of the sewer extension, a profile of the sewer extension, and must show the
proximity of the sewer extension to other ctilides and natural features. Specifications may be omitted for delegated
authorities. Each she of the plans and the first page of the specifications must be signed and sealed. Two (2) copies of the
existing permit if a modification. The plats and specifications must not contain phrases (such as: FOR REVIEW ONLY,
NOT FOR CONSTRUCTION, etc.) that indicate that they are anything ether than final plans and specifications. However,
tlse plans and specifications may contain: FINAL DESIGN - NOT REL.ASED FOR CONSTRUCTION.
c. Two copies of all ealcula:ions, including pump election, friction calculations, cycle ti.oe, pu.-np turves ('including syr.etn
craves applicable with one pump running, two pumps running, three pumps running. etc.), and evaluation of downstream
pump stations. These items mast be submitted under the signantrt and seal of the NC Professional Engineer.
d. The appropriate permit processing fee, in accordance with 15A NCAC 2H .0205(c)(5). The fee for sewer extensions for
nondelegated municipalities is S40O. The fee for sewer extensions for delegated municipalities (applies only to those
=overumental jurisdictions that have specific delegation review authority. as granted by the Environmental Management
Commission) is S200. Name changes without other modificarioas are S10Q.
e. If the owner/authority of the wastewater treatment facility (WV(TF) the: will be =ept ng the wastewater flow from this
project is different from the applicant of the project, then a lute must be provide; from the owner/authority of the WWIF
specifying the volume of flow that will be accepted. The lean should he a recent learn anti should refer to the project by the
same name as that identified on the application and the plansispecifications.
f. If the application is being submitted in the name of a privately owned public utlity, eviduice mu-. be xubrirtd burn the
Utilities Commission which demonstrates that the utility is authorized to hold the franchise for the area to be served. In the
ease of contiguous service areas, evidence -must be provided from the Utilities Commission acknowledging these areas __
covered under an existing franchise.
A properly executed 0*xrational Agreement (original and txic espy - fo :n provided by DEM.) must be submited if the sewer
extension w-iU' be serving single family residences, condominiums, :noble hoes, c: t w house and if the subject sew=
extension is owned by the individual residents, a homeowner; association, a a devciops-.
h. 'The downsIope surface waters classification must be det rmined by the appropriate DEM regional office, using page 5 of 8 of
this form, prior. to the. submittal of the application package to the Watt: Qua.ity Permits and Engineering Unit_ Once the
regional office has completed the classification, page 5 of 8 should be reincorporattd into the application package and the
entire application package may then be submitted to Water Quality Pe mils and Enginntering Unit_
A cover Setter, which briefly describes the project, should Ix irxluded with c.arh appiicaon package. If necessary for ela iry,
feel free to include attachments to the application form. Such attachments will be corside,„d as part of the applicauon and
should be numbered to correspond to the section to which they ref
All rnaze.-ials and fees submit in support of this rcgrest fer a Ft ,--.; bme t rr^''�. of the Division of Environmena:
M.a..n.agement.' Lh:,iforc, if to permit i not issue's for a;,y rC<��. L'; ' :�'V�'_ ,, _". s', brnitC:d materials ._>
cpaoc.
0F.'i .

_lame and
Completzmut at agioecringmini: OHM Remediation Services, Corp. •
5335 Triangle Parkway, Suite 450,
Tclepooe Numbs: ( 7 7 0
Norcross Sd,.. GA 2 ' 30092
729-3900
Professional Engineer's Certification:
L • Keith G. Angell a.^ that this application for Former Cape .Fear Wood Preservir,
has baa reviewed by me and is acct ate and complete to the best of my Imawledge. I fusshc an that to the best of my knowledge
the proposed design has been prepared in accordance with the applicable regulations. Although certain portions of this subminrl
package may have been developed by other professionals, inclusion of these materials under my rig ansre and seal signifies that I have
reviewed this material and have judged it to be consistertt with the popescioo. d�ga.
North CarolinaProfcssional Engineer's Seal, Signature, sad
d Da= 40-A,, Cp RO` ,'1,,,
AL '
r.
SEs,
ss
.F •. si',G 1 Nan,,,.ems
' 4; ........
ii'siasig Iwo
Applicant's Certification:
L Victor Ganjehsani , a.IP-st that
has been ttrviewed.by me and is' accurate and complete to th
application are not completed and that if all required su
will be returned tb me - incom
Sit
• Sit
this appucsrioaforFormer Cape Fear Wood Preserving
•f my EMduledge, 1 understand that if all required parts of this
and unseh n s are not included, this appIicatiea peer ge
0tti.55t0 Dam 4-
i > 8
THE COMPLETED APPLICATION PACKAGE;f97V ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD i3E.ikE _ FOLLOWING ADDRESS:
NORTH CAROLINA DIVISION OF ENVIRONMENTAL MANAGEMENT
WATER QUALITY SECTION
PERMITS AND ENGINEERING U TT
POST OFFICE BOX 29535
RALEIGH, NORTH CAROLINA 27626-0535
TELEPH ONE NUMBER: [phone]
FOR?1: GSPSA 11/9ry

16.
DIVISION OF ENVIRONMENTAL MANAGEMENT REGIONAL OFFICES (11/93)
Asheville Regional WQ Supervises
' 59 Woad5n Place
Asheville. NC 28801
(704) 251 Q5208
-Fax [phone]
Avery Ma=
B uncocn Ma&sce
Bch McDowell
Caldwell Mitchell
Clcaolcae Polk
Clay Rutherford
Graham Swain
Haywood TrIvaaia
Henderson ?zany
Jack=
Fayetteville Regional WQ Supervisor
Wachovia Building, Suite 714
Fayetteville, NC 28301
[phone]
Fax [phone]
Anson
Emden
Cumberland
Holm
Montgomery
Moore
Robeson
Richmond
Sampson
Scotland
Washington Regional WQ Supavimr
Poet Office Box 1507
Washington, NC 27889
[phone]
Fax [phone]
Beattftxt
Bettie
Carnom
C IX7Wut
OWm
anima
I,.
• Cues
Groere
Batted
Piet
Winston-Salem Regional WQ Supervisor
8025 North Point Boulevard, Suite 100
Winston-Salen, NC 27105
[phone]
Fax [phone]
Rockingham
Randolph
Stokes
Story
Wamuga
Wilms
Yamdn
Alarn -Lc
Alleghany
Ae4
Caswell
Davidscon
Davie
Forsyth
Guilfod
11/9 3
•
Jones
Martin
Pamlico
Pasqecrank
Pitt
Tn
Washington
WVc
Mooresville Regional WQ Supavisor
919 North Main Street
Mooresville, NC 28115
[phone]
Fax [phone]
Az
Cabarrus
Catawba
Gaston
Lincoln
Ivies l r+ rg
Rtrv>zt
Stanly
Union
Cleveland
4ge S or
Raleigh R.egiocial WQ Supervisor
Post Of c Box 27687
Raleigh, NC 27611
(919) 57I-4700
Fax [phone]
Chatham Nash
Doh.= Northampton
Edgecoebe Orange
Franklin PC=
Granville Vance
. Halifax Waltz
• Johnston Wzasu
Ise Wilson
Wt1mington Region. WQ Su ervisor
127 Cardinal Drive Extension
Wilmington, NC 28405.3845
[phone]
Pax ;910) 350-2044
•
13rreswide New Hanover
Cart../y Oas1cw
Colurnl= Fender
Dzplin' ''

State of North Carolina
Department of Environment, Health, and Natural Resat:: cu'
Division of Environmental Mann.c tent
512 Nonh Salisbury Street • Raleioh. North Carolina: (C( I�;
James G. Marun. Governor
Will:arn W. Cobey, Jr.. Sccrctirr
Memorandum
To: Delegated Municipalicies 11
From: Steve W. Tedder. Chief (`�
Water Quality Secdon
May 1, 1991
Subject: Delegated Municipalities C`:cc::iist for Revised Non-Disch:tr�,e Perm: .Appit 3t::,;%:,
The Division of Environmental Management's Water Quality Section has revised thy=
Gravity Sewer Non -Discharge Permit Application Form. The form now incorporates the bast:
in'[ormation that the Division feels is necessary in order for the delegated municipalities to perform
review on a gravity sewer project for the Division; therefore. the Division will no longer require th :t
the "Delegated Municipalities Gravity Sewer Design Checklist" be completed and submitted. We do.
however, require that the delegated municipality perform the same type of review as always required
and complete the bottom portion of this page and attach it as the last page of all gravity sewer
applications that are being submitted as a delegated municipalities project. If you have any questions
on this matter, please contact Mr. Randy Jones at 919/733-5083.
DELEGATED MUNICIPALITY GRAVITY SEWER CERTTrtCATT(
(THIS FORM MAY BE PHOTOCOPIED FOR USE AS AN ORIGINAL)
Applican: PURL Tr WCPFN CQ`4'`TScTM: n THE CITY ri- FAYrTTFlit t i N.oRTu, CAF rT .t'1A—
Pro'cct Name: Former^ � Fear Wood Preservirrj St — SC'Curd
J
Delegated tC'Iunicipality Reviesver's Certification:
I, VITTCP C;AN TFRSANT , attest that the subject plans and
specifications have been reviewed under my supervision and that those plans and specifications ar':
consistent with the information that hats been specified on the Non-Disch.r_e Application and
Division of Environmental Mi aSement's minimum design requirements for Eravity sewer projects
Delegated t•'tunicipality P.cvicwer's NC Prc essional Encir•,•:er's Pcgistratio;, No l/.365
Seal and St n2.curo
•
d :_i