WQ0034980_Regional Office Historical File Pre 2018

4
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coieen FL Sullins Dee Freeman
Governor Director Secretary
5epter ber 8, 20 t 0
Mt. Zion United Church of Christ
Mr Tom Brooke, Trustee
1415 South Main Street.
China Grove, NC 28023
Subject: Permit. No. WQ0034980
Mt. Zion United Church of Christ
Wastewater Collection System
Rowan County, North Carolina
Dear Mr, Brooke,
In accordance with your application received on September 2, 2010, we are forwarding herewith
Permit No, WQ0034980 dated September 8, 2010, 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rescinded, and shall be subject to the conditions and limitations as specified therein.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 Fetter
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 27 .0403 or any
individual system -wide collection system permit issued to the Perrrmittee.
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.
Mooresville Regional Office
Location: 610 East Center Ave., Suite 301 Mooresville, NC 28115
Phone: [phone] t. Fax; [phone] t Customer service: 1-877-523-6748
Internet: hall/porraLncdent.or2lweb/wy%honielro
An Equal Opportunity t Affirmative Action Employer — 5014 Recycleed in Pest Consumer paper

Mr. Brooke.
Page 2
September 8, 2010
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 Mt. Zion Church of Christ for the construction and operation of 266 linear feet of 6-inch
gravity sewer, and the discharge of 1575 gallons per day of collected domestic wastewater into
Salisbury -Rowan ` WTP (Grants Creek Train) existing sewerage system pursuant to the application
received September 2, 2010, 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 Creek
Wastewater Treatment Facility P (NPDES No.NC0023884) prior to being discharged into the
receiving stream.
Assessing subsequent impacts to the downstream collection system and treatment
facility is the complete responsibility of the City of Salisbury. The City of Salisbury must utilize
whatever tracking tools necessary for planning additions of sewer flow in order to maintain
compliance with the WWTP permitted limits and the WQCS00019 permit requirements.
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 15.0E 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 Mr. Samar Bou-
Ghazale at [phone].
Sin
or
erely,
Mooresville Regional Office, Collection System Permit Files
Surface Water Protection Central Files
PERCS
or

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.
1

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 constructicn 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 comp ying 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 [phone] 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 all 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 [phone] or
[phone]. Persons reporting any of the above occurrences shall file a spill report by
completing Part 1 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 8th day of September 2010.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Y
for Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number WQ0034980
3

Fast Track Enqineerinq Certification
September 8, 2010
OwnerfWQCS
Permit No, WQ0034980
Mt. Zion United Church of Christ
1415 South Main St
China Grove, NC 28145
PE
Darryl Wagoner, P.E.
Salisbury. Engineering & Planning
516-A North Main St.
Salisbury, NC 28144.
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 dearly identified on the record drawings or in written summary form, Permit
modifications are required for any changes resulting in non-comliancewiththisperrnit, 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.
ENGINEERS CERTIFICATION
Partial EI Final El
1, , as a duly registered Professional Engineer in the State of North Carolina, having been
authorized to observe ( LI periodically„ LI weekly, El full time) the construction of Sanitary Sewer Extension to
serve Mt, Zion United Church of Christ, a Rowan 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 material's,
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
4

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0
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A. APPLICATION
NFORMATION
LL1
a
m
USE' FIE.: TA.:KEY EY TC)•MOVE FROMFIELD TO rIEL.DI Application Number:
(to be completed by MCI)9. OwnerlPermittee:
1a. Mt. Zion United Church of Christ
Full Legal Name (company, municipality, HOA, utility, etc.)
lb. Tom Brooke
\AN Op3i-eis)0
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials])
1 c. The legal entity who will own this system is:
0 Individual ❑ Federal 0 Municipality 0 State/County 0 Private Partnership ❑ Corporation ®Other (church):
1 d. 1415 South Main Street
Mailing Address
1 f. N.C.
State
1 e. China Grove
City
1g. 28023
1 h. 704-857-1169 11. 1 j.
Telephone Facsimile
2. Project (Facility) Information:
2a. Mt. Zion United Church of Christ
Brief Project Name (permit will refer to this name)
3. Contact Person:
3a. Darryl Wagoner, Salisbury Engineering & Planning
Zip Code
E-mail
2b. Rowan
County Where Project is Located
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b. 704-633-8550
3c. [e-mail]
Phone Number E-mail
. Project is ® New ❑ Modification (of an existing permit) If Modification, Permit No.:
2. Owner is 0 Public (skip to Item B(3)) ® 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))
❑ Selling units (lots, townhomes, etc. - go to Item B(2b))
3. City of Salisbury
2b. If sold, facilities owned by a (must choose one)
❑ Public Utility (instruction C)
0 Homeowner Assoc./Developer (Instruction D)
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
4a. Salisbury -Rowan WWTP (Grants Creek Train) 4b. NC 0023884
Name of WWTF WWTF Permit No.
5a. City of Salisbury 5b. 8" ® Gravity 5c.
Owner of Downstream Sewer 'Receiving Sewer Size ❑ Force Main i Permit # of Downstream Sewer (Instruction E)
6. The origin of this wastewater is (check all that apply):
❑ Residential Subdivision
❑ Apartments/Condominiums
❑ Mobile Home Park
❑ School
0 Restaurant
❑ Office
❑ Retail (Stores, shopping centers)
❑ Institution
❑ Hospital
® Church
0 Nursing Home
❑ Other (specify):
100 % Domestic/Commercial
% Industrial (attach
description.)
; (RO: contact your Regional Office
Pretreatment staff)
% Other (specify):
7. Volume of wastewater to be allocated or permitted for this particular project: 1575_ gallons per day
*Do not include future flows or previously permitted allocations
B. If the permitted flow is zero, indicate why:
❑ Pump Station, Outfall or Interceptor Line where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit No.
❑ Rehabilitation or replacement of existing sewer with no new flow expected (see 15A NCAC 02T .0303 to determine if a
permit is required)

•
•
-
• s.
•
•silt:. .. _!c,' r ,L

9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2T 0114 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).
400 seats x 3 GPD/seat = 1200 GPD
day care: 25 persons at 15 GPD/person = 375 GPD
Total
1575 GPD
10, Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches)
4"
Length (feet)
266 LF
New Gravity or Additional
Force Main
Gravity
11. Summary of Pump Stations wl associated Force to be Permitted (attach additional sheets as necessary)
Pump Station Location ID (self chosen - as shown on plans/map for reference)
Design Flow Power Reliability Option
Operartional Point . (MGD) 1permanent generator WATS; Force Main Size Force Main Length
GPM QTD—, -
2- portable generator w/MTS
Pump Station Location ID (self chosen - as shown on plans/map for reference)
Design Flow
(MGD)
Operational Point
GPM el TDH
Power Reliability Option
1 - permanent generator w/ATS; 2 - portable generator w/MTS
Force Main Size
Force Main Length
12. Will the wastewater flow in e proposed sewer lines or pump stations be able to be directed to another treatnrient facility?
El Yes No If Yes, permit number of 2nd treatment facility
(RO — if "yes" to 612 please contact the Central Office PERCS Unit)
13. 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 Chapter 2T as
applicable?
Yes 0 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

V a
•
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. 1" 1 %.1 .. ( ! ,
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Have the following permits/certifications been submitted for approval for the system or project to be served?
Wetland/Stream Crossings - General Permit or 401Certification? El Yes 0 No i N/A
Sedimentation and Erosion Control Plan? Yes 0 No 0 N/A
Storrnwater?
Yes E1 No
N/A
15. Does this project include any high priority lines, (see 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
1. Owner/Permittee's Certification: (Signature of Signing Official and Project Name)
1, Tom Brooke , attest that this application for Mt Zion United Churchof ChnsL 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 143-215.6B, 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
la
penalties up to $25,000 per violation.
lonature
ENGINEERING DESIGN DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL OF THIS
APPLICATION, THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR PROXIMITY
cn TO OTHER UTILITIES, DESIGN CALCULATIONS, ETC. REFER TO 15A NCAC 02T ,0305
0
6
2. Professional Engineer's Certification (Signature of Design Engineer and Project Name)
I, Darryl Wagoner , attest that this application for _Rowan Count Satellite Jail 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. 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 fudged it to be consistent with the proposed design.
Note: In accordance with NC General Statutes 143-215,6A and 143-215.6B, 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. Darryl W_agoner
Professional Engineer Name
2b. Saltsbu En ineerin Plannin
Engineering Firm
2c. 516-A North Main Street
Mailing Address
2d. Salisbury
2e. N C 2f 28144
City State Zip
2g. 704-633-8550 2h, 704-633-8550 2i, [e-mail]
Facsimile E-mail
Telephone
077i.-V,S,Sr`(.•
SEAL 1\1'
9572

IJO ).L- Ili SJ. J r rmai-
0* wA.r ici
") °t
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
Flow Traeking/Acceptance for Sewer Extension Permit Applications
(FTSE —10/07)
Project Applicant Name: Mt. Zion United Church of Christ
Project Name for which flow is being requested: Mt. Zion United Church of Christ -
More than COW FTSE-10/07 may be required fora singlepryect if the owvnerof the WYYTP is not responsible for all
p:rmp.stat:ons along the route of the proposed wastewater flow.
AKIEPP
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name:
b. WWTP Facility Permit #:
Ali flrnvs are in MOD
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
c. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
II. Complete this section for each pump station you are responsible for along the route of this
proposed wastewater flow.
List pump stations located between the project connection point and the WWTP
Pump Station Name Approx, Capacity, MGD Approx. Current Avg.
(Firm/Design) Daily Flow,lvlGD
The proposed wastewater will gravity flow via an 8 in. sewer maitt to the Salisbury Rowan
Utilities Sewer Interceptor. There arc no purnpstations between the project connection point
and the interceptor.
III. Ce ific do tate nt:
, certify that, to the best of my knowledge, the addition of the
volume ofwastewater to be permitted in this project has been evaluated along the route to the receiving
wastewater treatment facility and that the flow from this project is not anticipated to cause any capacity
related sanitary sewer overflows or overburden any downstream pump station en route to the receiving
treatment plant under normal circumstances. This analysis has been performed in accordance with local
established policies and procedures using the beat available data. This certification applies to those items
listed above in Sections I and II for which I am the responsible party. Signature of this form indicates
acceptance of this wastewater flow,

State of Nortth Carolina
and Natural Resources
ision of Water Quality
Traclung/Acceptance for Sewer Extension Permit Applications
(FTSE _ 10/07)
Project Applicant Name:
Project Name for which flow is
tlt one FTSE-10/07 may be required for a single project tithe owner of the WWTP is not responsible for all
he proposed wastewater flow.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name:
b. WWTP Facility Permit : _NCO023114
TP
c. WWTP facility's permitted. flow
d. Estimated obligated flow not yet tributary to the WW''TP
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
Alt flows are in MGD
mod..
0
Previously Antic
,b;
75.03°/4`
II. Complete this motion for each pump station you are responsible for along the route of this
proposed waste%
List pump stations located between the project co point and the WWTP
TP
Pump Station Name
II
1
v
wa
related
treatment
established
listed above is
ace
nce of this wastewater flow,
Official Signature
Approx. Capacity, MGD Approx. Current Avg.
(FirtnJDesign) Daily Flow, MGD
my knowledge, the addition of the
n evaluated along the route to the riving
project is not anticipated to cause any cat ity
den any cwttstream pump station en route to the receiving
This analysis has been performed in accordance with local
best available data. This certification applies to those items
ich l am the responsible party. Signature of this farm indicates
e

08-31-' 10 15:56 FROM- 7'-y6t? 1-160-L/IUN4 r-ate
Town of Landis
Established in 1901
Dennis Brown, Mayor
Craig Sloop, Mayor Pm Texn
James. Purr, Alderman
Tony I�i![on, Alderman
Roger Safrir, Alderman
312 South Main Street
P, O. Box 8163
Lams, North Carolina 28088
Phone: [phone]
Fax: [phone]
August 31, 2010
Mt Zion United Methodist Church
1415 S, Main Street
ChinaGrove, NC 28023
Mr. Darryl Wagoner,
In reference to ►our email sent to my office dated August 30, 2010, let this letter.
please serve as confirmation that the Town of Lands currently provides water
service to Mt Zion United Church of Christ find has the capacity and will provide
fire flow protection. The Town of Landis Wastewater Collection. System has the
capacity to transfer the projected wastewater flow to the Salisbury Rowan utilities
sewer interceptor.
Water System ID # 01-$0-038
Collection System Permit # WQCSO0343
If you should need any further information, please do not hesitate to contact rue.
Sincer.ely,_____ _. _.....
Waymon Steve Rowland
Public Works Director

CannecxGIS
1:500 feet
http://rowan.connectgis.00nn'Map/I
asps.?Map=http://rowan.c.onnectgis.co n ar... 8/23/2010

North Carolina Secretary of State
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Secretary SECRETARY OF STATE
PO Box 29622 Raleigh, NC 27626-0622 [phone]
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NC MT. ZION UNITED CHURCH OF
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INCORPORATED
Non -Profit Corporation information
SOSID: 0099159
Status: Current -Active
Effective Date: 11/30/1978
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North CArolina Secretary of State Page 2 of 2
Citizenship: DOMESTIC
State of Inc.: NC
Duration: PERPETUAL
Registered Agent
Agent Name:
Office Address:
Mailing Address:
Principal Office
CARRIGAN, DONALD
1501 S MAIN ST MT ZION
UNITED CHURCH OF CHRIST
CHINA GROVE NC 00000
1501 S MAIN ST MT ZION
UNITED CHURCH OF CHRIST
CHINA GROVE NC 00000
Office Address: NO ADDRESS
Mailing Address: NO ADDRESS
Officers
http://www.secretary.state.nc.us/corporations/Corp.aspx?PitemId=4775283 9/3/2010

SALISBURY ENGINEERING Ek PLANNING
516-A NORTH MAIN STREET
September 1., 2010
Dee Brouder
DEN R
Division of Water Quality
Mooresville Regional Office
610 East Center Avenue, Suite 301
Mooresville, NC 28115
RE: Sanitary Sewer Service to serve
Mt. Zion United Church of Christ
Rowan County
Dear Ms* Brooder;
ALISBURY, NC 28144
DAARYL L WAGONER,PE
704-633-8950
RECEIVED
DIVISION OF WATER QUALITY
SEP - 2 '1
SWF' 3FCTION
MOORESVLE RLOIONAL OFFICE
Please find enclosed two applications for approval, a flow acceptance letter, a flow
tracking permit application, a color site map, and a check for $480.00 for the above
referenced project.
This package. is submitted for approval. Please advise immediately if additional
information is required.
Sincerely,
Enclosures

Central Files: APS SWP
09/08/10
Permit Number WQ0034980
Permit Tracking Slip
Program Category
Non -discharge
Permit Type Fast Track
Gravity Sewer Extension, Pump Stations, & Pressure Sewer
Extensions
Primary Reviewer
samar. bou-ghazale
Coastal SW Rule
Permitted Flow
1575
Facility
Facility Name
Mt. Zion Church of Christ
Location Address
Owner
Status
Active
Project Type
New Project
Version Permit Classification
1.00 Individual
Permit Contact Affiliation
Major/Minor
Minor
Region
Mooresville
County
Rowan
Facility Contact Affiliation
Owner Name
Mt Zion United Church of Christ
Dates/Events
Orig Issue
09/08/10
App Received
09/02/10
Regulated Activities
Draft Initiated
Scheduled
Issuance
Owner Type
Non -Government
Owner Affiliation
Tom Brooke
1415 S Main St
China Grove
NC 28023
Public Notice Issue Effective
09/08/10 09/08/10
Reauested!Received Events
Expiration
Church
Wastewater collection
Outfall NULL
Additional information requested
Additional information received
Waterbody Name Stream Index Number Current Class Subbasin
1

ENGINEER'S CERTIFICATION
I, Darryl Wagoner, as a duly registered Professional Engineer in the State of
North Carolina, hereby certify that construction of these permitted facilities has
been completed in substantial accordance with approved plans and
specifications.
PROJECT: Mt. Zion Church of Christ
OWNER: Mt. Zion Church of Christ
ENGINEER: Salisbury Engineering & Planning
COUNTY: Rowan
SIGNATURE:.
REGISTRATION NUMBE
DATE: July 12, 20 2