WQ0037415_Regional Office Historical File Pre 2018

NCDENR
North Carolina Departrnent of Environment and Natural Resources
Pat McCrory John E. Skvarla, IE1
Governor Secretary
October 22, 2014
Mr. Larry P. Pressley, P.E., City Manager
City of Statesville
P.O. Box 1111
Statesville, NC 28687
Subject: Permit No. WQ0037415
Northside Drive Sewer Extension 2014
Wastewater Collection System Extension
lredell County, NC
Dear Mr. Pressley:
In accordance with your complete application received October 21, 2014, we are forwarding herewith
Permit No, WQ0037415, dated October 22, 2014, to City of Statesville 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issuance until rescinded, and shall be subject to the conditions and limitations as specified therein.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 and supplement shall be considered a part of this permit and are therefore incorporated therein
by reference.
Please pay particular atte
he following conditions contained within this permit:
Condition 11.4: 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 responsibility of the City of Statesville 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 §1.43-2.15,6C, 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 l imitations 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.
2317 Mail Service Den er Raieigia N tth Coiroithe 27690-2317
Location. 51214 Salishany St. Raleigh. N,nrin am inns 27604
Phone, 919-8 7 'kFAX, 5.11 c07.0452
tnternett
tis E; "& rt Opporknty . rrr ave Employer

i
Mr. Larry P. Pressley
October 22, 2014
Page Two
If you need additional information concerning this matter, please contact Barry Love at [phone] or
via e-mail at [e-mail].
Sincerely,
C
for Thomas A. Reeder
Division of Water Resources
by Michael L. Parker, Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional Office
Electronic copy: Donald L. Munday, P.E.
cc: Mooresville Regional Office, Surface Water Protection Section
Water Resources Central Files
PERCS (e- copy)

MENR
STATE OF NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
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 the
City of Statesville
for the construction and operation of approximately 966 Iinear feet of 8-inch DIP gravity sewer to serve
the Northside Drive Sewer Extension 2014, and the discharge of 600 gallons per day of collected
domestic wastewater into the Fourth Creek WWTF existing sewerage system, pursuant to the complete
application received October 21, 2014, 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.
This permit shaII be effective from the date of issuance until rescinded and shall be subject to the
specified conditions and limitations contained therein.
rmit issued this the 22nd day of October, 2014.
for Thomas A. Reeder
Division of Water Resources
By Authority of The Environmental Management Commission
Permit Number: WQ0037415

S PPLEMEIN
T TO PERMIT COVER SHEET
City of Statesville is hereby authorized to:
Construct, and then operate upon certifcation the aforementioned wastewater collection exrensien. The
sewage and wastewater collected by this system shall be treated in the Fourth Creek Wastewater
TreatmentFacility prior to being discharged into the receiving stream.
Permitting of this project does not constitute an acceptance of any part of theproject that does not meet
15A NCAC 2T; the Division of Water Resources (Division) Gravity Sewer Minimum Design Criteria
adopted February 12, 1996 as applicable; 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 Perrni.ttee's responsibility to
ensure 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
]f, at any° time, the additional wastewater flow volume made tributary to this sewer extension is believed to
exceed the value permitted herein, a modification shall be requested for this permit from the Division of Water
Resources to properly allocate the subject wastewater flow,
2. No flow in excess of the quantity permitted herein, 600 GPD, shall be made tributary to the subject sewer
system until an application for permit modification for an increase in flow has been submitted to and approved
by the Division of Water Resources.
II. STANDARD CONDITIONS
This permit is not transferable. In the event there is a desire for the wastewater collection facilities to change
ownership, or there is a, name change of the Perniittee, 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.
This pertuit shall become voidable unless the wastewater collection facilities are constructed in accordance with
the conditions of this permit; t5A NCAC 2T; the Division of Water Resources (Division) Gravity Sewer
Minimum Design Criteria adopted February 12, 1996 as applicable; the Divisiion's Miniru.m 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.
This pert -nit shall be effective only with respect to the nature and volume of wastes described in the application
and other supporting data,
4. The wastewater collection facilities shall be properly maintained and operated at all tunes, The Perm%ttee 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 permits not required, the
following performance criteria shall. he met as provided in 15A :NCAC 2T .0403:

J
a. The sewer system shall be effectively maintained and operated at all times to prevent 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. An operation 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.
e. High -priority sewer lines shall be inspected at least once per every six -months and inspections are
documented.
f. A general observation of the entire sewer system shall be conducted at least once per year.
g. 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
§ 143-215.1 C.
h. A.Grease Control Program is in place as follows:
1. For public owned collection systems, the Grease Control Program shall include at least biannual
distribution of educational materials for both commercial 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 to control grease
entering the system from other public and private satellite sewer systems.
2. For privately owned collection systems, the Grease Control Program shall include at least bi-annual
distribution of grease education materials to users of the collection system by the permittee or its
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.
J•
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. Noncompliance Notification:
The Permittee shall report by telephone to a Water Resources staff member at the Mooresville Regional Office,
telephone number (704) 663-I699, 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 SSO and/or spill over 1,000 gallons; or
c. Any SSO and/or spill, regardless of volume, that reaches surface water

Voice mail messages or faxed information is permissible, but this ,shall not be considered as the initial verbal
report. Overflows and spills occuning outside normal business hours may also be reported to the Division of
Emergency Management at telephone number [phone] or [phone]. Persons reporting. any of the
above occurrences shall file a spill report by completing and submitting Part 1 of Form CS-SSO (or the most
current Division approved form) within five days following first knowledge of the occurrence. This report must
outline the actions taken or proposed to be taken to ensure that the problem does not recur, Part 11 of Form. CS-
SSO (or the most current Division approved form) can also be completed to show that the SSO was beyond
control..
6. Construction of the gravity sewers, pump stations, and force mains shall he scheduled so as not to interrupt
service by the existing utilities nor result in an overflowor bypass discharge of wastewater to the surface waters
of the State,
7, Per 15A NC.A.0 2T.0.123, 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 certificationis one where the form is.
fallexecuted and the supporting documents are provided as applicable. 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.
If the permit is issued to a private entity with an Operational Agreement, then a copy of the Articles of
Incorporation,. Declarations/Covenants/Restrietions, and Bylaws that have been appropriately filed with
the applicable County's Register of Deeds office shall be submitted with the certification.
A complete certification is one where the form is fully executed and the supporting documents are provided as
applicable. Supporting documentation shall include the following:
a. One copy of the project construction record drawings (plan & profile -views of sewer lines & force mains)
of the wastewater collection system extension. Final record drawings should be clear on the plans or on
digital media (CD or DVD disk) and are dened as the design drawings that are marked up or annotated
with after construction information arid show required buffers, separation distances, material changes, etc.
b. One copy of the supporting pump station design calculations (selected pumps, system curve, operating
point, huoyancy calculations, 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,
c.. Changes to the project that do not result in noncompliance with this pemit, regulations, or the Minimum
Design Criteria should be clearly identified on the record drawings, on the certification in the space
provided, or :inwritten summary form,
Prior to Certification (Final or Partial): Permit modifications are required for any changes :resulting in non-
compliance with this permit (including pipe lengthincreases of 1.0% or greater, increased flow, pump station
design capacity design increases of 5% or greater, and increases in the nu.m.bertype of connections),
regulations, or the Minimum Design Criteria. Requested modifications or variances to the Minimum Design
Criteria will be reviewed on a case -by -case basis 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 or repair prior to certification & activation.
8. A copy of the construction record drawings shall he maintained on file by the Permittee for the life of the
wastewater collection facilities.

9. 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 I, 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, construction of additional or
replacement wastewater collection facilities, and/or referral of the North Carolina -licensed Professional
Engineer to the licensing board.
10. 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.
11. 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 Iimited 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 28 .0200 and 15A NCAC 2H .0500.

FAST TRACK ENGINEERING CERTIFICATION
Permittee: City of Statesville
Project: Northside Drive Sewer Extension 2014 — City of Statesville
Permit No. WQ0037415
Issue Date: 10/22/2014
Complete and submit this form to the permit issuing regional office with the following:
• One copy of the project record drawings (plan & profile views and detail drawings of sewer lines) of the wastewater
collection system extension: Final record drawings should be clear on the plans or on digital media (CD or DVD
disk) in pdf format. Record drawings should indicate the design and the marked up changes during construction.
• 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 resulting in non-compliance with this perrmt reguatons or
minimum design criteria. Modifications should be submitted prior to certification.
This project shall not be considered complete nor allowed to operate until the Division has received this Engineer's
Certification and all required supporting documentation. Therefore, it is highly recommended that this certification
be sent in a manner that provides proof of receipt by the Division.
PERMITTEE'S CERTIFICATION
, 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.
Printed Name, Title Signature
r-
ENGINEER'S CERTIFICATION
Date
El Partial Ej Final
as a duly registered Professional Engineer in the State of North Carolina,
having been authorized to observe (0 periodically, El weekly, El full time) the construction of the subject 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 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, signature, and date:
SEND THIS FORM & SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS
SURFACE WATER PROTECTION SUPERVISOR
MOORESVILLE REGIONAL OFFICE
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
Engineers Certification shall be considered a violation of the permit and shall subject the Permittee to appropriate
L enforcement actions,
MVO Use On!y:
Flo‘v 1"rorn [his pri c1 s ri hutai"V EO:

PIEDMONT DESIGN ASSOCIATES, P.A.
125 East. Plaza Drive, Suite #101
Mooresville, NC 28115
Phone: [phone] Fax: [phone]
Email: [e-mail]
October 7, 2014
RE: Northside Drive Sanitary Sewer Extension
Engineering
Surveying
Planning
To whom it rray concern:
This project consists of approximately 966 linear feet of 8' gravity DIP sanitary sewer line to
serve three or four businesses along Northside Drive in Statesville, North Carolina. The design
flow of this line is 600 GPD. This sewer line is contained in the existing street right-of-way of
Northside Drive,
Please call me if you have any questions, thank you.
Piedmont Design Associates, P.A.
John H. Ha
Design Technician

USE THE TAB KEY TO MOVE FROM FIELD TO FI
Owner!Permittee:
City of Statesville
Full Legal Name (company, municipality, HOA, utility, etc.)
Application Number:
(to be completed by DWR)
© 1 b. Larry P, Pressley,City PE , Manager
Signing Official Name and Title (Please review 15A NCAC 2T .0166 (b) for authorized signing officials)
le. The legal entitywho will own this system is:
0 Individual 0 Federal Municipality 0 State/County 0 Private Partnership 0 Corporation 0 Othe
© I d, PO Box 1111
tl. Mailing Address
0
1f. NC
State
1 h_ 704-878-3584
Telephone Facsimile
2. Project (Facility) Information:
2a. Northside Drive Sewer Extension 2014
Brief Project Name (permit will refer to this name)
3. Contact Person:
3a. Donald L Munday
1 e. Statesville
City
1 g. 28687
Zip Code
[e-mail]
E-mail
2b. Iredell
Name and Affiliation of Someone Who Can Answer Questions Abou
3b, 704-664-7888
Phone Number
Proje
odifiation (of an existing
Owner is Public (skip to Item B(3))
3c.
pecify):
County Where Project is Located
this Application
[e-mail]
E-mail
Modification, Permit No.:
0 Private (go to Item 2(a))
2a, If private, applicant will be;
❑ Retaining Ownership (i.e, store, church, single office, etc.) or
© Leasing units (lots, townhomes, etc. - skip to Item B(3))
0 Selling units (lots, townhomes, etc. - go to Item B(2b))
3. City of Statesville
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Protect
4a, Fourth Creek WWTP 4b. NC-0031836
Name of WWTF WWTF Permit No.
City
5a. Owner of Downstream 12"
m SewerReceiving
;Reing Sewer Size
6, The origin of this wastewater is (check all that apply):
❑ Residential Subdivision
Apartments/Condominiums
• Mobile Home Park
❑ School
❑ Restaurant
Office
Gravity
Force Main
5c..
Permit # of Down
❑ Retail (Stores, shopping centers)
0 Institution
0 Hospital
O Church
❑ Nursing Home
O Other (specify)°
Volume of wastewater to be allocated or permitted for this particular project: 600
*Do not include future flows or previously permitted allocations
if the permitted flow is zero, indicate why:
2b. if sold, facilities owned by a (must choose one)
❑ Public Utility (Instruction D}
Homeowner Assoc./Developer (Instruction E)
ea m Sewer (Instruction F
1 C) % Domestic/Commercial
% Industrial
(Attach Description)
% Other
(Attach Description)
0 Pump Station, Outfall or Interceptor Line where flow will be permitted in subsequent per
Flow has already been allocated in Permit No.
0 Rehabilitation or replacement of existing sewer with no new flow expected
(see 15A NCAC 02T .0303 to determine if a permit is required)
gallons per day
h
not
to this line
FTA 08-13 APPLICATION
Page 4 of"6

THE 'COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
Water Quality Section •
2090 US Highway 70
Swannanoa, North Carolina 28778
[phone]
[phone] Fax
Avery, Buncombe, Burke, Caldwell, Cherokee,
Clay, Graham, Haywood, Henderson, Jackson,_
Macon, Madison, McDowell, Mitchell, Polk,
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
Water Quality Section
225 Green Street Suite 714
Fayetteville, North Carolina 28301-5094
[phone]
[phone] Fax
Anson, Bladen, Cumberland, Harnett, Hoke,
Montgomery, Moore, Robeson, Richmond,
Sampson, Scotland
Mooresville Regional Office
Water Quality Section
610 E. Center Avenue
Mooresville, North Carolina 28115
[phone]
[phone] Fax
Alexander, Cabarrus, Catawba, Cleveland,
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
Stanly, Union
Raleigh Regional Office
Water Quality Section
1628 Mail Service Center
Raleigh, North Carolina 27699-1628
[phone]
[phone] Fax
Chatham, Durham, Edgecombe, Franklin,
Granville, Halifax, Johnston, Lee, Nash,
Northampton, Orange, Person, Vance, Wake,
Warren, Wilson
Washington Regional Office
Water Quality Section
943 Washington Square Mall
Washington, North Carolina 27889
[phone]
[phone] Fax
Beaufort, Bertie, Camden, Chowan, Craven,
Currituck, Dare, Gates, Greene, Hertford, Hyde,
Jones, Lenoir, Martin, Pamlico, Pasquotank,
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wilmington Regional Office
Water Quality Section
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
[phone]
[phone] Fax
Brunswick, Carteret, Columbus, Duplin, New
Hanover, Onslow, Pender
Winston-Salem Regional Office
Water Quality Section
585 Waughtown Street
Winston-Salem, North Carolina 27107
[phone]
[phone] Fax
Alamance, Allegheny, Ashe, Caswell, Davidson,
Davie, Forsyth, Guilford, Rockingham, Randolph,
Stokes, Surry, Watauga, Wilkes, Yadkin
INSTRUCTIONS FOR APPLICATION FTA 08-13 & SUPPORTING DOCUMENTATION Page 3 of 6

z
Z
0 Pump Station Location ID:
Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NGAC,2T .Q114 for;
the value in Item B(7) AND/OR the design flow for line or pump station sizing if a reduced or zero flow is being requested in
Item B(7). Values other than that in 15A NCAC 2T .0114 (b) and (c) must be supported with actual water or wastewater use
data in accordance with 15A NCAC 2T .0114 (f).
3 buildings, 8 employees each at 25 g/d/employee - 600 GPD
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches)
8°' DIP
Length (feet)
965.58
New Gravity or Additional
Force Main
Gravity
11. Summary of Pump Stations wl a Force Mains to be Permitted (attach additional sheets as necessary)
(self chosen - as shown on plans/map for reference)
Longitude: Latitude:
z
0
Design Flow Operational Point Power Reliability Option
(MGD) GPM @TDH 1 - permanent generator MATS; Force Main Size Force Main Length
2 - portable generator w/MTS
2
IL1f!
0
L.
Pump Station Location ID:
Longitude:
Design Flow
(MGD)
(self chosen - as shown on plans for reference)
Latitude:
Operational Paint Power Reliability Option
GPM ;nal 1 - permanent generator w/ATS; Force Main Size Force Main Length
2 - portable generator w/MTS
12. Will the wastewater flow in the proposed sewer lines or pump stations be able to be directed to another
Yes No If Yes, permit number of 21d treatment facility :
(RO - if 'yes" to 6,12 please contact the Central Office PERCS Unit)
I oos the`Sewer system comply with the Minimum Design Criteria for the Permitting of Pump Stations and Force Mains
(latest versipr» the Gravity Sewer Minimum De itln Criteria (latest version) and 15A NCAC Chapter 2T as applicable?
ea en
acility?
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
FTA 08-13 APPLICATION
Page 5 of 6

14. Have the following permits/certifications been submitted for approval for the system or project to be served?
Wetland/Stream Crossings - General Permit or 401Certification?
Sedimentation and Erosion Control Plan?
Trout Buffer Waiver?
Stormwater?
Yes Q No N/A
® Yes El No ®N/A.
El Yes Q No N/A
❑ Yes D No N/A
15. Does this project include any high priority lines (15A NCAC 02T .0402 (2)) involve aerial lines, siphons, or interference
manholes)? These lines will be considered .high priority and must be checked once every six months
Check if Yes: 0 and provide details:
1a.
Owner/Permittee's Certification: (Signature of Signing Official and Project Name)
l j , P, %? t c attest that this application for A/0,,1rt 51P. OP rv,ylhas been
reviewed 6y 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. Note: In accordance with North Carolina General
Statutes 143-215,6A and 143-215.6B, any person who knowingly makes any false statement, representation, or
certification in any appllcat,'in shall be guilty of a Class 2 misdemeanor„ which may include a fine not to exceed $10,000
as well as civil penalties . o $25, 000?,prer violation.
gning Official Sign
ENGINEERING DESIGN DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMI 1 i AL OF THIS
APPLICATION. THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR PROXIMITY
co TO OTHER UTILITIES, DESIGN CALCULATIONS, ETC. REFER TO 15A NCAC 02T .0305
Z
0
2, Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
1, Donald L. Munday ,attest that this application for Northside Drive, Sewer Extension 2014
has been reviewed by me and is accurate, complete and consistent with the infomiation in the engineering plans,
calculations, and all other supporting documentation to the best of my knowledge, I 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 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 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
2a, Donald L. Munda
Professional Engineer Name _..
2b, Piedmont Design Associates, P.A
Engineering Firm
2c. 125 Plaza Drive, Suite 101
Mailing Address
2d. Mooresville
City
2g. 704-8,64-7888
Telephone
2h.
Fac
imile
2e. NC
State
2f. 28115
Zip
2i, [e-mail]
E-mail
NCwPE Seal, Signature Date
FTA 08-13 APPLICATION
Page 6 of"6

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Northside Drive Sanitary Sewer Extension

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Central Files: APS _ SWP _
10/22/2014
Permit Number WQ0037415 Permit Tracking Slip
Program Category Status Project Type
Non -discharge Active New Project
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
Primary Reviewer
barry.love
Coastal SW Rule
Permitted Flow
600
Facility
Version Permit Classification
1.00 Individual
Permit Contact Affiliation
Facility Name
Northside Drive Sewer Extension 2014
Location Address
Owner
Major/Minor Region
Minor Mooresville
County
Iredell
Facility Contact Affiliation
Owner Name
City of Statesville
Dates/Events
Owner Type
Government - Municipal
Owner Affiliation
Larry P. Pressley
PE
City Of Statesville
Statesville
NC 28687111
Orig issue
10/22/2014
App Received
10/21/2014
Draft Initiated
Scheduled
Issuance Public Notice Issue Effective
10/22/2014 10/22/2014
Regulated Activities Requested /Received Events
Office
Wastewater collection
Outfall
Expiration
Additional information received
Additional information requested
Waterbody Name Stroamindex Number Current Class Subbasin

FAST TRACK ENGINEERING CERTIFICATION
woP0 w
Permittee: City of Statesville.., taw ;.� lE �- Permit No. W00037415
Project: Northslde Drive Sewer Extension 2014— ty o�tcmtesvl fe Issue Date: 10122/2014
Complete and submit this form to the permit Issuing regional office with the following:
One copy of the project record drawings (plan & profile views and detail drawings of sewer lines) of the wastewater
collection system extension. Final record drawings should be clear on the plans or on digital media (CD or DVD
disk) in pdf format. Record drawings should indicate the design and the marked up changes during construction..
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
Changesto the project should be clearly identified on the record drawings or in written summary form. Permit
modifications are required for any changes ressijtlnqIn non-compliance with this permit„ regulations or
fnlnimu design criteria. Modifications should be submitted prior to certification.
This project shall not be considered complete nor allowed to operate until the Division has received this Engineer's
Certification and all required supporting documentation, Therefore, It Is highly recommended that this certification
be sent in a mannerthatprovid s proof of receipt by t e Division.
PER
E 6RTtFICATIGN
, the undersigned agent for the Permittee, hereby state that this project has
been constt ucted pursuant to the applicable standards & requirements, the Professional Engineer below has
provided applicable designlconstruction information to the Permittee, and the Permittee is prepared to operate &
maintaln the wastewater collection system permitted heIrr or portions thereof,
5-Mw dlit,. E 4..
Printed Name, Title
Alt
ENGINEER'S CERTIFICATION
© Partial Fri Final
I, PaNAt.D Ailsme,0Ay P.E, as a duly re Istered Professional Engineer in the State of North Carolina,
having been authorized to tolSserve ( periodically, weekly, El full time) the construction of the subject 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 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, signature, and date:
1Nrtlrrrrrr
A
SEND THIS FORM & SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS
SURFACE WATER PROTECTION SUPERVISOR
MOORESVILLE REGIONAL OFFICE
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.
DWQ Use Only.
Flow from this project is tributary to: