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WQ0031280_Regional Office Historical File Pre 2018
Michael F. Easley, Governor William G. Ross Jr., Secretary North Carolina Department of Environment and Natural Resources Alan W. Klimek, P.E. Director Division of Water Quality January 31, 2007 Mr. James Justice, Town Manager 413 North Main Street Mooresville, NC 28115 Subject: Permit No. WQ0031280 • Lowe's Corporate Headquarters, Phase III Town of Mooresville Wastewater Collection System Extension Iredell County, North Carolina Dear Mr. Justice, In accordance with your application received on January 5, 2007, we are forwarding herewith Permit No. WQ0031280, dated January 31, 2007, to the Town of Mooresville for the construction and operation 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 This permit shall be effective from the date of issuance until rescinded and shall be subject to the conditions and limitations as specified therein.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 Permit Condition 3 which 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. Permitting of this project does not constitute an acceptance of any part of the project that does not meet 1) 15A NCAC 2T; 2) the Division of Water Quality's (Division) Gravity Sewer Minimum Design Criteria adopted February 12, 1996, as applicable; 3) 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 -licensed 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. 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. No `Carolina 7Vaturaly Mooresville Regional Office 610 East Center Ave., Suite 301 Mooresville, NC 28115 Phone: (704) 663-1699 Fax: (704) 663-6040 Internet: www.ncmwaterquality.org Customer Service: 1-877-623-6748 An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper Prill:vir. Page 2 January 31, 2007 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 the Town of Mooresville for the construction and operation of approximately 697 linear feet of 8-inch gravity sewer and the discharge of 75,000 gallons per day of domestic wastewater into the Town of Mooresville existing sewerage system, pursuant to the application received January 5, 2007 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 Environment and Natural Resources and considered a part of this permit. The sewage and wastewater collected by this system shall be treated in the Town of Mooresville Rocky River WWTP (NPDES Permit No. NC0046728) prior to being discharged into the receiving stream. 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 150E 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 matter, please contact Dee Browder at (704) 663-1699. Sincerely, for Alan W. Klimek, P.E. cc: Mooresville Regional Office, Collection System Permit Files Theron Pickens, LandDesign Inc. Surface Water Protection Central Files Tom Asenzo, PERCS NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES RALEIGH WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT This permit shall be effective from the date of issuance until rescinded and shall be subject to the following specified conditions and limitations: 1. This permit shall become voidable unless the wastewater collection facilities are constructed in accordance with the conditions of this permit; 15A NCAC 2T; the Division of Water Quality's (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 unless specifically mentioned herein. 2. This permit shall be effective only with respect to the nature and volume of wastes described in the application and other supporting data. 3. 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 of these facilities as required by 15A NCAC 2T .0403. If an individual permit is not required, the following performance criteria shall be met as provided in 15A NCAC 2T .0403: a. The sewer system shall be effectively maintained and operated at all times to prevent discharge to land or surface waters, and any contravention of the groundwater standards in 15A NCAC 2L .0200 or the surface water standards in 15A NCAC 2B .0200. b. A map of the sewer system shall be developed and shall be actively maintained. c. An operation and maintenance plan shall be 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. e. High -priority sewer lines shall be inspected at least once per every six-month period of time. f. A general observation of the entire sewer system shall be conducted at least once per year. g. inspection and maintenance records shall be maintained for a period of at least three years. h. Overflows and bypasses shall be reported to the appropriate Division regional office in accordance with 15A NCAC 2B .0506(a), and public notice shall be provided as required by North Carolina General Statute §143-215.1C. 4. This permit shall not be transferable. In the event there is a desire for the wastewater collection facilities to change ownership, or there is a name change of the Permittee, 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 or may not be approved. 5. 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. 6. Per 15A NCAC 2T .0116, 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 to the address provided on the form. A complete certification is one where the form is fully executed and the supporting documents are provided as applicable. 7. A copy of the construction record drawings shall be maintained on file by the Permittee for the life of the wastewater collection facilities. 8. 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 1, 2000 as applicable; and other supporting materials may subject the Permittee to an enforcement action by the Division, in accordance with North Carolina General Statutes §143- 215.6A through §143-215.6C. 9. 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. 10. 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 other government agencies (local, state and federal) which have jurisdiction, including but not limited to applicable river buffer rules in 15A NCAC 2B .0200, erosion and sedimentation control requirements in 15A NCAC Ch. 4 and under the Division's General Permit NCG010000, and any requirements pertaining to wetlands under 15A NCAC 2B .0200 and 15A NCAC 2H .0500. 11. Noncompliance Notification: The Permittee shall verbally report to a Division of Water Quality employee at the Mooresville Regional Office, telephone number (704) 663-1699, as soon as possible, but in no case more than 24 hours or on the next working day, 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 failure of a pumping station or sewer line resulting in a by-pass directly to receiving waters without treatment of ail or any portion of the influent to such station or facility. 2 Voice mail messages or faxed information is permissible, but 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 (800) 858-0368 or (919) 733-3300. Persons reporting any of the above occurrences shall file a spill report by completing Part I of Form CS-SSO (or the most current Division approved form), within five days following first knowledge of the occurrence. This report shall outline the actions taken or proposed to ensure that the problem does not recur. Part II of Form CS-SSO (or the most current Division approved form) can also be completed to show that the SSO was beyond control. Permit issued this the 31 st day of January 2007. NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION for Alan W. KlimekP ., Director Division of Water Quality By Authority of the Environmental Management Commission Permit Number WQ0031280 3 Fast Track Engineering Certification Permit No. WQ0031280 January 31, 2007 James Justice Town of Mooresville 413 North Main Street Mooresville, NC 28115. Complete and submit this form to the permit issuing regional office with the following: • One copy of the project record drawings (plan & profile views of sewer lines) of the wastewater collection system extension • Supporting design calculations (selected pumps, system curve, operating point, available storage if portable generator(s) or storage greater than longest past three year outage reliability option selected) for any pump stations permitted as part of this project • Changes to the project should be clearly identified on the record drawings or in written summary form. Permit modifications are required for any changes resultinq_in non-compliance with this permit, regulations or minimum design criteria. This project shall not be considered complete nor allowed to operate until this Engineer's Certification and all required supporting documentation have been received by the Division. Therefore, it is highly recommended that this certification be sent in a manner that provides proof of receipt by the Division. ENGINEER'S CERTIFICATION ❑ Partial ❑ Final , as a duly registered Professional Engineer in the State of North Carolina, having been authorized to observe (❑ periodically, ❑ weekly, ['full time) the construction of Lowe's Corporate Headquarters, Phase 111, an lredell County project for the 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 2T; the Division of Water Quality's (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, signature, and date: SEND THIS FORM & SUPPORTING DOCUMENTATION WITH REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS MOORESVILLE REGIONAL OFFICE SURFACE WATER PROTECTION 610 EAST CENTER AVENUE, SUITE 301 MOORESVILLE NC 28115 The Permittee is responsible for tracking all partial certifications up until a final certification is received. 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. ca 0 0 2 LL CATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 3 USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! 1 Owner: la. Town of Mooresville Full Legal Name (company, municipality, HOA, utility, alc) lb. James Justice, Town Manager Signing Official Name and Title (Please review 15A NCAC 2H .0206(b) for authorized signing officials!) Application Number: (to be completed by DWQ lc, The legal entity who will own this system is: 0 individual 0 Federal El Municipality 0 State/County 0 Private Partnership 0 Corporation 0 Other (specify): Id. 4'13 North Main Street Mailing Address 1f, North Carolina State I h, 704 663 3800 1i, 704 662 6298 e. Mooresville City lg. 28115 Zip Code j, jiusticeOciLmooresville nc.us Telephone Facsimile 2, Project (Facility) Information: 2a, Lowe's Corporate Headquarters, Phase U 2b. Iredelt Brief Project Name (permit will refer to this name) 3. Contact Person: 3a. D. Theron Pickens, P,E, Name and Affiliation of Someone Who Can Answer Questions About this Application 3b. 704 376 7777 3c, tpickens landdesign,corn - — Phone Number E-mail 1 Project is New D Modification (of an existing permit) If Modification, Permit No.: For modifications, attach a separate sheet clearly explaining the reason for the modification (i.e. adding another phase, changing line size/length, etc.). Only include the modified information in this permit application - do not duplicate project information in B(7) and B(10-11) that has already been included in the original permit. 2 " Owner is Public (skip to Item B(3)) 0 Private (go to Item 2(a)) 2a. If private, applicant will be: County Where Project is Located 2b, If sold, facilities owned by a (must choose one) 0 Retaining Ownership (i.e, store, church, single office, et or D Public Utility (Instruction III) 2 0 Leasing units (lots, townhomes, etc, - skip to Item B(3)) 0 Homeowner Assoc./Developer (Instruction IV) 0 0 Selling units (lots, townhomes, etc. - go to Item B(2b)) 3. Town of Mooresville Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project re 4a. Town of Mooresville Rocky River WWTP 4b, NC0046728 0 Name of WWTF- WWTF Permit No, tsj i LL 5a. Town of Mooresville 5b, 12" Gravity 5c. Owner of Downstream Sewer Receiving Sewer Size 0 Force Main Permit Number of Downstream Sewer (if known) 6. The origin of this wastewater is (check all that apply): 0 Residential Subdivision 0 Car Wash 0 Apartments/Condominiums 0 Institution 0 Mobile Home Park 0 Hospital 0 School 0 Church 0 Restaurant 0 Nursing Home n office 0 Other (specify), 7. Volume of wastewater to be allocated for this particular project: ,7,999 gallons per day *Do not include previously permitted allocations 199 % Domestic/Commercial % Industrial 'X, Other(speci(y): 8. If the permitted flow is zero, indicate why: 0 Interceptor Line Flow will be permitted in subsequent permits that connect to this line Li Plow has already been allocated in Permit No, 0 Rehabilitation or replacement of existing sewer with no new flow expected /TA 100.1 - Rev,. 04105 APPLI TION fur rt;R.AVITY SEWERS, Pt f IP STATI .)NS, .ALAI) FORCE l' IAINS PA i 4 Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2H .0219(1) for Item B(7) or the design flow for line or pump station sizing if zero flow in the space below, Values other than that in 15A NCAC 2H .0219(1)(1-2) must be supported with actual water or wastewater use data in accordance with 15A NCAC 2H .02I9(I)(3), Total volume of wastewater generated = 3,000 X 25ga1/employee/day 75,00 gal/day 10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary) Size (inches) 8" 8 ENTER TOTAL LINE LENGTH IN MILES 0 z 0 ce N/A NA Length (feet) 222 219 Summary of Pump Stations to be Permitted (attach additional sheets as necessary) 0 Il Z Gravity or Force Main (use the pull down menu) Gravity Gravity Gravity Location ID Power Reliability Option (self chosen - as shown on Design Flow Operational Point (1- dual line feed; 2- permanent generator wlATS; 3- plans for cross-reference) (MGD) GPM @ TDH portable generator w/telemetry; 4-wet well storage) N/A N/A 12, Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC 2H 0200 as applicable? Yes Cj No If no, please reference the pertinent minimum design criteria or regulation and indicate why a variance is requested. SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS PERTINENT TO THE VARIANCE WITH YOUR APPLICATION 13, Have the following permits/certifit ahons been submitted for approval? Wetland/Stream Crossings - General Permit or 401 Certification'? © Yes No E N/A EYes No LJNIA Stormwater? E Yes 0 No D N/A 14. Does this project involve aerial lines or siphons? Check if yes These lines will be considered hlah orioiiiv ,rid mint be checked once every six monitr.S 15. Does this project have gravity sewer lines designed at minimum slopes? El r3e amine that the Division will, not accept unsltalied lines more than 10 flatter thrah the mrnimurn slope Li s installed outside this tcleca e Should be Corrected prior to submitting them final engineeirin;g celificelrrori. Sedimentation and Erosion Control Plan? APPL_1CAT'ION for RS, PUMP STATIONS, A 11 FORCl) i9+'[A1NS PACE 1, Use the Division's guidance document entitled, "DETERMINING STREAM CLASSIFICATIONS FOR FORM FTA 02/03 (FAST -TRACK SEWER SYSTEMS)" to collect and record the stream classification data below (attach additional sheets as necessary). This document is available from our web site or by contacting the appropriate Division of Water Quality regional office (see instructions for addresses) OR indicate the following: El A Stream Classification is not needed because all parts of the project are at least 100 feet away from any down slope waterbody; AND, D A Stream Classification is not needed because the design does not depend on wet well storage as a power reliability option for any pump station near a Class C down slope waterbody. Location ID on Map (self chosen - as shown on Name of Waterbody Stream Waterbody map for cross-reference) Waterbody County River Basin Index Classification Proposed Sanitary Sewer Work Creek Iredell Catawba 11-105 WS-IV, B;CA l a, Submit the 8.5" x 11" COLOR topographic snap as required in Instruction VI regardless of whether a classification is provided! Applicant"s Certificatio 1, James Justice, attest that this application for Lowe's Corporate Headquarters, Phase Ill has been reviewed by me and is accurate and complete to the best of my knowledge. I 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, Note: In accordance with North Carolina General Statutes 143-215.6A and 143-215,68, any person who knowingly makes any false statement, representation, or certification in any application 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, Signing Official Signature 2. Professional Engineer's r ification: / 6I6— Date I attest that this application for D. Theron Pickens, PE has been reviewed by me and is accurate, complete .and consistent with the information in the engineering plans, 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 adopted February 12, 1996, and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 and the watershed classification in accordance with Division guidance, Although certain portions of this submittal package may have been developed by other professionals, inclusion of these matennals under my signature and seal signifies that l have reviewed this material and have judged it to be consistent with the proposed design. Note: In accordance with NC General Statutes 143-215,6A and 143.215.68, any person who knowingly makes any false statement, representation, or certification in any application 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. 2a, D, Theron Pickens, P.E Professional Engineer Name b. LandDesqn.�.v...mM. Engineering Firm 2c, 22'3 N Graham Street Mailing Address 2d, Charlotte 2e. NC 2f, 28202 City State Zip 2g. 704 376 7777 2h. 704 332 3246 2i, tpickensdlartctdesigncorn Telephone Facsimile E-mail 11 A 02/03 - Rev. 3 (14/U5 L©we's Corporate Headquarters Phase III Mooresville, NC Iredell Co. USGS Mooresville, NC 24K Quad Fast Track Application Exhibit Sanitary Sewer aiid 223 N. Graham St, Charlotte, NC 26202 7©4, 376,7777 T 1:12,OOO 0/.1110, Klay 000ber :25. 20 5 11:2,5.19 AM G.1.1:WA111Z YStMapsHTlbar4Fost TrF541^*FM,mMtl s rHUM- .T-585 P001/001 F-031 TOWN OF PLANSING & GIG DEPARTMENT November 22, 2006 Mr. Theron Pickens, PE LandDesign 223 North Graham St. Charlotte, NC 28202 Re:'Lowe's Corporate HO Phase I11 Flow Acceptance Letter Derek Slocum. El Civil Engineer Town of Mooresville P. O. Box 876 Mooresville, NC 28115 (704) 799-8017 Fax 662-8298 Mr. Pickens: • The Mooresville Town Board had previously approved the above -referenced project and agreed to provide potable water service to and accept the sewer flow from the proposed commercial project. -The Town of Mooresville's Water System Management Plan submitted approximately duly 30, 2000, was approved and assigned WSMP No. 00-01958. Mooresville's Water Filter Plant PWS ID# is 01-49.015. Both water and sewer systems are owned and maintained by the TcrYvn of Mooresville. Wastewaterwiil be treated by the Town of Mooresville's Rocky River WWTP, NPDES Permit Nv.-NC0046728.--This prof s eipetted input intO ttie WNW is 75,000 gpd. It is your responsibility, as the engineer of record, to certify to the State that construction has been n completed in accordance with the approved plans and specs. The Town will conduct periodic inspections during.construc tiion and will hold a final inspection prior to accepting ttie waterlines and sanitary sewer system into the Town's system. Two reproducible (mylar) copies of the "As-BuiIC drawings, on CD (compact disc) format, along with your engineer's certification are required to be submitted to this office prior to acceptance by the Town Of Mooresville. We look forvrard to working with you on this project. Call me at (704)799-8017 if you have questions. Civil Engineer CC: Cliff Webb, WIli TP Operations Supervisor Permit Number WQ0031280 Central Files: APS SWP 01/31/07 Permit Tracking Slip Program Category Non -discharge Permit Type Fast Track Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions Primary Reviewer dee.browder Permitted Flow 75000 Facility Status Active Project Type New Project Version Permit Classification 1.00 Individual Permit Contact Affiliation Facility Name Lowe's Corporate Headquarters, Phase III Location Address Owner Major/Minor Minor Region Mooresville County Iredell Facility Contact Affiliation Owner Name Town of Mooresville Dates/Events Owner Type Government - Municipal Owner Affiliation James Justice PO Box 878 Mooresville NC 281150878 Orig Issue App Received 01/31/07 01/05/07 Regulated Activities Commercial or industrial, other Wastewater collection Outfall NULL Draft initiated Scheduled Issuance Public Notice Issue 01/31/07 Effective Expiration 01/31/07 Requested/Received Events Additional information requested Additional information received Waterbody Name Stream Index Number Current Class Subbasin Fast Track Engineering Certification Permit No. WQ0031280: • :January 31, 2007 James Justice . Town of Mooresville 413 North Main Street .. Mooresvi I le; . NC.281.15. Complete and submit this form to the permit issuing regional office with the following:- • One copy of the project record drawings '(plan & profile views of sewer lines) of the',wastewater collection system extension . • Supporting design calculations' (selected pumps, system curve, operating point,. available storage -if portable "generator(s) or storage greater than longest past three year outage reliability option selected) for any pump - stations permitted as•partof this project ' . • Changes to the project should be clearly identified on the record drawings or.in written suntiMary form. Permit modifications are'required for any changes re_ s_ulting in non-compliance with this.perrriit, r gulations or minimum design criteria. This project shall not be considered complete nor allowed to operate until this Engineer's Certification and al{ - required supporting documentation have been received by the Division.- Therefore, it.is highly recommended that,this'certification be sent in a manner that provides prnof-of receipt by the Division. ENGINEER'S CERTIFICATION - ❑ Partial - 0 Final I, 7 Z ' — (r 61( , es a duly registered Professional Engineer in the State of North Carolina, having been authoried•to.observe periodically, 0 weekly; 0 full time) the construction of Lowe's Corporate Headquarters, Phase III, an Iredell County project for the Permittee, hereby state that; to the best of my abilities, due care and diligence was used inthe observation of the -construction such that the construction was observed•to be built within • substantial compliance of this permit; 15A NCAC 2T;, the Division of Water Quality's (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; signature, and dater • . _ as,; -`SEAL. r = • 028995 I �4��'g0i PtG-``\� to1ifl" SEND THIS FORM & SUPPORTING ,DOCUMENTATION WITH REQUIRED:ATTACHMENTS TO THE FOLLOWING•ADDRESS: MOORESVILLE REGIONAL OFFICE • SURFACE WATER PROTECTION . 610 EAST CENTER AVENUE, SUITE 301 MOORESVILLE NC •28115 • The Permittee is responsible for tracking all-partialcertifications up until -a final certification is received. 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 Perniittee to appropriate enforcement actions.- -