WQ0023761_Regional Office Historical File Pre 2018

v4A1 Michael F. Easley, Govemor
Rp
G William G. Ross Jr., Secretary
7 North Carolina Department of Environment and Natural Resources
= - Alan W. Klimek, P.E., Director
Division of Water Quality
Coleen H. Sullins, Deputy Director
Division of Water Quality
Mr. Jon Dyer, Director of Public Works
Union County
400 North Church Street
Monroe, North Carolina 28112
April 6, 2004
Subject: Permit No. WQ0023761
Union County
Hadley Meadows
Wastewater Collection System Extension
Union County, North Carolina
Dear Mr. Dyer:
In accordance with your application received on April 1, 2004, we are forwarding herewith
Permit No. WQ0023761, dated April 6, 2004, to Union County 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until rescinded, and shall be subject to the conditions and limitations as specified therein.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 2H .0227 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 2H .0200; 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 Internet http1/h2o.enr.state.nc.ust
919 N. Main Street, Mooresville, NC 28115 Telephone [phone] Fax [phone]
DENR Customer Service Center Telephone [phone]

Mr. Jon Dyer
Page 2
April 6, 2004
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 Union County for the construction and operation of approximately 6,910 linear feet of 8-inch
gravity sewer to serve 66 three -bedroom residences as part of the Hadley Meadows project, and the
discharge of 23,760 gallons per day of collected domestic wastewater into Union County's Twelve Mile
Creek WWTP (NPDES No. NC0085359) existing sewerage system, pursuant to the application
received April 1, 2004, and in conformity with 15A NCAC 2H .0200; 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.
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 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.
If you need additional information concerning this matter, please contact Sonja Williams at (704)
663-1699.
Sincerely,
for Alan W. Klimek, P.E.
cc: Union County Health Department
Mooresville Regional Office, Water Quality Section (WWTF Permit No. NC0085359)
Marc A. Houle, Yarbrough -Williams & Houle, Inc.
Water Quality Central Files
NDPU Files

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 2H .0200; 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 2H .0227. if an individual
permit is not required, the following performance criteria shall be met as provided in 15A NCAC 2H
.0227:
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 lime.
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 §143-215.1 C.

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. Upon completion of construction and prior to operation of these permitted facilities, a certification, a
copy of the construction record drawings, as well as supporting design calculations for any pump
stations permitted as part of this project shall be received from a North Carolina -licensed
Professional Engineer certifying that the facilities have been installed in accordance with this
permit; 15A NCAC 2H .0200; 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 Main adopted June 1, 2000 as applicable; and other supporting materials. If this
project is to be completed in phases and partially certified, you shall retain the responsibility to
track further construction approved under the same permit, and shall provide a final certificate of
completion once the entire project has been completed. A copy of the construction record
drawings, indicating the facilities constructed in the phase being certified, shall be submitted with
each partial certification. Mail the Engineer's Certification, one copy of the "Construction Record
Drawings," and one copy of the supporting design calculations to the Non -Discharge Permitting
Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617.
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 2H .0200; 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.
2

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.
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 (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 Il of Fomi 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 6th day of April, 2004.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
for Alan W. Klimek, R E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number W00023761
3

Fast Track Engineering Certification
Permit No. WQ0023761
April 6, 2004
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 resulting 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 the Hadley Meadows,
Union 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 2H .0200; 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
919 N. MAIN STREET
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.

CK APPLICATION for GRAVITY SE AVERS, PUMP STATIONS, AND FORCE MAINS
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD!
Owner:
a. Union County Public Wort s l Separtm nt
Full Legal Name (company, municipal"rty, HOA, utility,
Application Number:
(to be completed by DWO) \"10-032.-
1b. Jon. C. D er, Director
SigningOfficial Name and Title Please review 15A NCAC 2H 0266(b) for authorized signing cffic
'lc The legal entity who will own this system is:
individual d Federal alVluniciparity �.
County 0 Private Partnership L Corpar Lion L Othe
.400 North Church Street e Monroe
Street Address City
NC
State
h. 704-296-4210
Telephone
Project (Facrlr'ty) inirrrratron
2a. Hadley Meadows
Brief Project Name (permit
Contact Person:
_._.... _
Name and A
b. 704-296-4214
704-296-4232
Facsimile
ector of Public Works
cation of Someone Who Can Answer Questions About this Application
[e-mail]
Phone Number
E-mail
PAGE 3
Project i New 0 Modification (of an existing permit) 1f Modification, Permit No.: .
For modifications, attach a separate sheet clearly explaining the reason for the modification (Le. adding another
l phase, changing lone 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 8(3)
2a. If private, applicant will be:
Retaining Ownership (i.e. store, church, single office, etc.) o
Leasing units (lots, townhomes, etc. skip to Item 8(3))
0 Selling units (lots, townhomes, etc, - go to Item B(2b))
0 Private (go to item 2(a))
Union County Public Works
II 2b. If sold, facilities owned by a (must.choose one)
r` 0 Public Utility (Instruction III)
0 Homeowner Assoc./Developer (lnstruction iV
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
4a. Twelve Mile Creek 4b. NC 0085359
Name of WWTF
Union Co. Public Works
ar of Downstream Sewer Receiving Sewer
origin of wastewater is (c
The this _..
_ YT`heck all that apply)
Residential Subdivision
0 Apartments/Condominiums
0 Mobile Horne Park
0 School
0 Restaurant
0 Office
F Permit No.
0018912
Permit Number of Downsmrr Sewer (if known
0 Car Wash
0 Institution
0 Hospital
El Church.-_----
0 Nursing Home
0 Other (specify)°
Volume of wastewater to be permitted in this project: 23760 gallons per day
If the permitted flow is zero, indicate why:
0 Interceptor Line - Flow will be permitted is subsequent permits that
0 Flow has already' been allocated in Permit No.
0 Rehabilitation or replacement of existing sewer with no new flow expected
100 % Domestic/Comi iercial
% Industrial
% Other (specify):
nnect to this line

CK APPLICATION for GRAVITY SEWERS, PUMP STATI NS, AND FORCE MAINS PAGE 4
9, Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2H
.0219(I) 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 approved prior to submittal of this application, Submit a separate request to
the Division of Water Quality, Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617 in
accordance with 15A NCAC 2H .0219(I)(3).
(3 Bedrooms) (120 GPD) (66 Lots)=23,760 GPD
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches) Length (feet)
8
Gravity or Force Main
(use the pull down menu)
6910 Gravity
Z ENTER TOTAL LINE LENGTH IN MILES 1 . 1
0
1— 11. Summary of Pump Stations to be Permitted (attach additional sheets as necessary)
<
E Location ID Power Reliability Option
ce (self chosen - as shown on Design Flow Operational Point (1- dual line feed; 2- permanent generator w/ATS; 3-
0 plans for cross-reference) (MGD) GPM @ TDH portable generator witelemetry; 4-wet well storage)
LL
12.
Lfl
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?
Li Yes El No If no, please reference the pertinent minimum design criteria or regulation and indicate why a
variance is requested:
Section V. Sewers in Relations to Streams and Other Water Bodies
Di Alignment
.cross the stream as nearly perpendicular to the stream flow as possible_„"
The Project required acquisition of off site right of way from several property owners along an existing stream. The route agreed to with
the off site owners involved two creek crossings, Due to meanders along the existing stream, the two crossings, while approximately 75°
to the immediate upstream channel, are crossing at an angle of approximately 60° to the general flow of the stream.
13, Have the following permits/certifications been submitted for approval?
Wetland/Stream Crossings - General Permit or 401 Certification? Yes LI No El N/A
Sedimentation and Erosion Control Plan? El Yes El No N/A
Stormwater? El Yes [1] No NJ N/A
A 02/03. - Rev. 1 06/03

ZACK APPLICik EION fur GRAVITY SEWERS, PEN YNS, AM ; 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:
0
C. STREAM
z
0
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,
Li 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
Hadley Meadows Culvert Branch Union Catawba 11-133-1-1 C
Submit the 8.5" x 11" COLOR topographic map as required in Instruction VI
regardless of whether a classification is provided!
1. Applicants Certification:
I, Jon C. Dyer, attest that this application for Hadley Meadows has been reviewed by 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 retumed as incomplete. Note: In accordance with North Carolina General Statutes 143-215.6A and 143-215.6B,
any person who knowingly makes arjy false statement, representation, or certification in any application shall be guilty of
a Class 2 misdemeanor which may dude a fine not to exceed $10,000 as well as civil penalties up to $25,000 per
violation.
igning Offrcit Snature
2. Professional neer's Certification:
I attest that this application for Marc A. Houle, P.F. has been reviewed by me and is accurate, complete and consistent
with the information in the engineering plans, calcul-ations, 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 certain portions of this submittal package may
have been developed by other professionals, 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 143-215.6B, any person who knowingly makes any false statement, representation, or
certification in any application shall he 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.
/7 1
2a; Marc A. Houle, P.E.
Professional Engineer Name
2b; Yarbrough- & Houle, Inc;
Engineering Firm
2c. P. 0, Box 7007
Address
: t
.! 4:
` 47
.2d, Charlotte 2e. NC 2f, 28273
City State Zip
2g; 704-556-1990 2h. 704-556-0505 2i, Marchylwh.corn____
Telephone Facsimile E-mail
.
Seal, Signature & Da e
ETA 02/03 ev.
00/03

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131171

04/06/04
• Permit Number WQ0023761
Permit Tracking Slip
Program Category
Non -discharge
Status Project Type
In review New Project
Permit Type Fast Track Version Permit Classification
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Individual
Extensions
Primary Reviewer Permit Contact Affiliation
sonja.williams
Permitted Flow
23760
Facility
>`ility Name
Hadley Meadows
Location Address
Owner
Major/Minor Region
Minor Mooresville
County
Union
Facility Contact Affiliation
Owner Name
Union County
Dates/Events
Owner Type
Government - County
Owner Affiliation
Scheduled
Orig Issue App Received Draft Initiated Issuance
04/01/04
Public Notice Issue
4/b /o#
Effective Expiration
Regulated Activities Requested/Received Events
Subdivision
Wastewater collection
Outfall NULL
Additional information requested
Additional information received
Waterbody Name Stream Index Number
Current Class Subbasin

UNION COUNTY PUBLIC WORKS
400 N. Church Street
Monroe, NC 28112-4804
704/296-4210
Fax [phone]
To: NC Department of Environment and Natural Resources
Mooresville Regional Office
919 North Main Street
Mooresville, N.C. 28115
Attention:
Regarding: Sanitary Sewer to serve Hadley Meadows Subdivision
We are sending you: ❑ Copy of letter ❑ Plans El Prints ❑ Shop Drawings
TRANSMITTAL
Other
Date: 3/30/04
Copies
Date
No.
Description
1
3/25/04
Original Non Discharge Permit Application
1
3/25/04
Copy of Non Discharge Permit Application
3/11/04
22175
N1
Check for $400.00 (Application Fee) u� AT R Lr RESOURCES
AND NATURAL RESOURCES
MOORESVIL11. ; 'UNA - oFFlcE
APR 0 1 2004
These are transmitted as checked below:
WATER QUALITY SECTION
® For approval ❑ For your use ❑ As requested ❑ For review and comments
Remarks:
Signed:
Received by: Date:

UNION COUNTYPUBUC WORKS
400 N. Church Street
Monroe, NC 28112-4804
704/296-4210
Fax [phone]
To: Mooresville Regional Office
Water Quality
610 East Center Ave. Suite 301
Mooresville NC 28115
Attention:
TRANSMITTAL
Date: 11/4/04
Regarding: Record Drawings and Engineers Certification for Hadley Park (Formerly Hadley
Meadows) Final Certification
We are sending you:
Date
10/5/04
Copy of letter Plans E Prints ❑ Shop Drawings
Other
Description
Record Drawings
Engineer's Certification for Sewer (W'Q0O23761)
These are transmitted as checked below:
For approval For your use n As requested (— For review and comments
Remarks:
Signed:..
Received by: Date:

200 L:4BPM
Fast Track Engineertnq Certification
Permit)
April6, 004
Complete and submit this form to the permit issuing regional offic
it h the following:
One copy of the project record drawings (plan & profile views of sewer lines) of the rvasteweter 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 pro
ifica
um ae n cn
houid be clearly identified on the record dr
d for env uhanQes result€n in non -co
Permit
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 CERTIFIGATIow
Partial
Final
, as a duly registered Frofessonal Engineer in " Sttate of Now Oarodsrta, having
been auth,:ri ed t observe periodic.ally, E weekly, full time) the construction of the Hadley Meadows,
e Permittee hereoy state that, to the best of my abilities, due care and diligence was
used to the observation of the construction such that the construction was observed to be built within substantial
mpti
is permit' 15A NCAC 2H .0200; the Division of Water Quality's (Division) Gravity Sewer Minimum
Design Criteria adopted February 12, 1995 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.
nce of
North Carotin a Professional Engineer's
real, signature, and date;
SEND THIS FORM & SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TO THE, FOLLOWING ADDRESS
MOORESVILLE REGIONAL OFFICE
919 N. MAIN STREET
MOORESVILLE NC 28116
The Petrrxittee is responsible for tracking all partial certifficatic ns up until a final certification is received. Any
wastewater d0 Y made tributary to the wastewater collection system extension prior to campie
Engineer's Certiflcati©n shall be considered a violation of the permit and shall subject the Permtttee to appropriate
enforcement actions.