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WQ0023904_Regional Office Historical File Pre 2018
Michael F. Easley, Governor William G. Ross Jr., Secretary North Carolina Department of Environment and Natural Resources Alan W. Klimek, P.E. Director Division of Water Quality November 24, 2004 Mr. Jon Dyer, Public Works Director Union County 400 North Church Street Monroe, North Carolina 28112 Subject: Permit No. WQ0023904 Modification Union County Kings Grant Wastewater Collection System Extension Union County, North Carolina Dear Mr. Dyer: In accordance with your application received on November 16, 2004, we are forwarding herewith Permit No. WQ0023904, dated November 24, 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 This permit shall be effective from the date of issuance until rescinded, shall void Permit No. WQ0023904 issued May 13, 2004, and shall be subject to the conditions and limitations as specified therein.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. The modification includes the reduction of 8-inch gravity sewer from approximately 2,196 linear feet to approximately 1,794 linear feet, the reduction of three -bedroom homes from 20 to 19, and the reduction of wastewater flow from 7,200 gallons per day to 6,840 gallons per day. 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 610 East Center Ave., Suite 30I Mooresville, NC 28115 Phone: (704) 663-1699 Fax: (704) 663-6040 Internet: h2o.enr.state.nc.us Customer Service: I-877-623-6748 An Equal Opportunity/Affirmative Action Employer— 50% Recycledl10% Post Consumer Paper No a Carolina 71laturallj Mr. Jon Dyer Page 2 November 24, 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 1,794 linear feet of 8-inch gravity sewer (reduction of original permit of 2,196 linear feet of 8-inch gravity sewer) to serve 19 three - bedroom residences (reduction of original permit of 20 homes) as part of the Kings Grant project, and the discharge of 6,840 gallons per day (reduction of original permit of 7,200 gpd) of collected domestic wastewater into Union County's existing sewerage system, pursuant to the application received November 16, 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. The sewage and wastewater collected by this system shall be treated in the Union County Twelve Mile Creek WWTP (NPDES No. NC0085359) prior to being discharged into the receiving stream. If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to request an adjudicatory hearing upon written request within 30 days following receipt of this permit. This request must be in the form of a written petition, conforming to Chapter 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 Basinger at (704) 663-1699. for Alan W. Klimek, P.E. cc: Union County Health Department Mooresville Regional Office, Water Quality Section (WWTF Permit No. NC0085359) Steven Wilson, DPR Associates, Inc. Water Quality Central Files Marie Doklovic, PERCS NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES RALEIGH WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT This permit shall be effective from the date of issuance until rescinded and shall be subject to the following specified conditions and limitations: 1. This permit shall become voidable unless the wastewater collection facilities are constructed in accordance with the conditions of this permit; 15A NCAC 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 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. I 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 2H .0220, upon completion of construction and prior to operation of these permitted facilities, the completed Engineering Certification form attached to this permit shall be submitted with the required supporting documents to the address provided on the form. A complete certification is one where the form is fully executed and the supporting documents are provided as applicable. 7. A copy of the construction record drawings shall be maintained on file by the Permittee for the life of the wastewater collection facilities. 8. Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 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. 11. Noncompliance Notification: The Permittee shall verbally report to a Division of Water Quality employee at the Mooresville Regional Office, telephone number (704) 663-1699, as soon as possible, but in no case more than 24 hours or on the next working day, following the occurrence or first knowledge of the occurrence of either of the following: a. Any process unit failure, due to known or unknown reasons, that renders the facility incapable of adequate wastewater transport, such as mechanical or electrical failures of pumps, line blockage or breakage, etc.; or b. Any failure of a pumping station or sewer line resulting in a by-pass directly to receiving waters without treatment of 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 (800) 858-0368 or (919) 733-3300. Persons reporting any of the above occurrences shall file a spill report by completing Part I of Form CS-SSO (or the most current Division approved form), within five days following first knowledge of the occurrence. This report shall outline the actions taken or proposed to ensure that the problem does not recur. Part 11 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 24th day of November, 2004. NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION for Alan W. Klimek, 1S. E., Director Division of Water Quality By Authority of the Environmental Management Commission Permit Number WQ0023904 3 Fast Track Engineering Certification Permit No. WQ0023904 Modification November 24, 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 Kings Grant, 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 610 EAST CENTER AVENUE, SUITE 301 MOORESVILLE NC 28115 ATTN: DEE BROWDER 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. 11 /24/04 ermit Number WQ0023904 Permit Tracking Slip Program Category Non -discharge Permit Type Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions Primary Reviewer sonja.basinger Permitted Flow 0 Facility Facility Name Kings Grant Location Address Owner Fast Track Status Project Type In review Major modification Version Permit Classification Individual Permit Contact Affiliation Major/Minor Minor Region Mooresville County Union Facility Contact Affiliation Owner Name Union County Dates/Events Owner Type Government - County Owner Affiliation John Dyer 400 N Church St Monroe NC 28111 Scheduled Orig Issue App Received Draft Initiated Issuance 05/13/04 11/16/04 Regulated Activities Subdivision Wastewater collection Outfall NULL Public Notice lssu Effective 1 i 24/64. Requested/Received Events Additional information requested Additional information received Expiration Waterbody Name Stream Index Number Current Class Subbasin DPR ASSOCIATES, INC... 420 HAWTHORNE LANE - CHARLOTTE, NC 28204 ' PH. (704) 332-1204 PAY TO THE ORDER NCDENR OF THE SUM OF FOUR HUNDRED DOLLARS 00/100 ONLY W Lbcz39b4 DATE ' ; : 10/05/2004 • 7874 AMOUNT $400.00 . • 00000 1:053 L0 L Ir 2 L1:5 2 L6459387'J'. Security Featu FKAPPLICATION for GRA'4%ITY SE USE THE TAB KEY TO MOVE FROM FIELD TO FIELD Owner; UNION COUNTY DEPARTMENT OF PUBLIC WORKS Full Legal Name mpany, municipality, HOA, u ERS, PUMP STATIONS, AND FORCE MAINS Application Number: (to be completed by DWQ) od' PAGE 3 b, JON C. DYER, PE - DIRECTOR Signing Official Name and Title (Please review 15A NCAC 2H .0206(b) for authorizedsigning officials[) c. The legal entity who will own this system is: 0 Individu lMj Federal Q Municipality 1 Statel eunty 0 Private Partnership©Corpor tir n j ther(sfseci Ida 400 N. CHURCH STREET Street Address le. MONROE City µ1f. NC 1g. 28112 State Zip Code 1 h. 704-296-42.10 =1 i, 704-296-4232 1 j. Telephone Facsimile E-mail ....__...._�" Irtfc rrndfrc n. _ m Prci'enf ,acilif .____.�.__..�._._� a.. KINGS GRANT Brief Project Name (permit will refer to this name) + ntactPerson: Via. Ci. RLES P. ?aCAIN, P.E., DEPUTY DIRECTOR CP P'UEI,TC WORKS Name and Affiliation of So b. (704) 296-4214 Phone Number Project is New Modification ho Can Answer Questions About this Application caii@co.union.nc.us of an existing permit) E-mail If Modification, Permit No.µ WQ0023904 For modifications, attach"a separate sheet clearly explaining the reason for the modification (Le. adding another phase, changing line size/length, etc.). Only Include the modified information in this permit application - do not duplicate project Information in B(7) and B(10-11) that has already been Included in ithnooriginal permit. 2. Owner is Public (skip to Item B(3)) 0 Private (go to item 2(a)) private, applicant will be: 2t. if , facilities owned by a (must choose one) 0 Retaining Ownership (Le. store, church, single office, etc:) or 0 Leasing units (lots, townhomes, etc, - skip to Item 8(3)) 0 Selling units (lots, townhomes, etc. - go to item B(2b)) UNION COUNTY DEPARTMENT OF PUBLIC WORK of Wastewater Treatment Facility (WWTF) Treatin ''4a, TWELVECREEK _ MILE C _. __.. Name of WWTF a UNION COUNTY 0 Public Utility (Instruction III) © Homeowner Assoc.fDeveloper (Instruction IV) From This Project l4b. NC 0085359 WWTF Permit No. sic. VWQ 0023711 Owner of Downstream Sewer Receiving Sewer Size j Permit Number of Downs The origin of this wastewater Is (check a Residential Subdivision 0 Apartments/Condominiums 0 Mobile Home Park School 0 Restaurant ❑ Office apply); O Car Wash 0 Institution © Hospital 0 Church © Nursing Home 0 Other (specify): Volume of wastewater to be permitted in this project: 0 gallons per day rea ewe known) °I� Domestic/Commercial Industrial %ti Other (specify): If the permitted flow is zero, indicate why: 0 Interceptor Line - Flow will be permitted is subsequent permits that connect to this line (11 Flow has already been allocated in Permit No. WQ0023904 (reduction of l.rats 0 Rehabilitation or replacement of existing sewer with no new Flaw AYnPrbPri FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 4 • Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2H .0219(1) for Item B(7) or the design flow for line or pump station sizing if zero flow in the space below. Values other than that in 15A NCAC 2H .0219(I)(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), (I. BEDROOMS) (1.20 GPO (19 •LOTS) 6,840 GPD (MODIFIED 'PERMIT) (3 BEDROOMS)(120 GPD) (20- LOTS) = 7,200 GPD (ORIGINAL PERMIT) • 10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary) • g ems_. ,11. Summary of Pump Stations to be Permitted (attach additional sheets as necessary) Size (inches) Length (feet) Gravity or Force Main (use the pull down menu) 8" 0 Gravity 1794 LF (Modified Permit) 2196 LF (Original Permit) ENTER TOTAL LINE LENGTH IN MILES! 0.34 MILES • Location ID (self chosen - as shown on • Cans for cross-reference) Design Flow (MGD)._. Operational Point GPM @ TDH Power Reliability Option • (1- dual line feed; 2- permanent generator w(ATS; 3- portable generator wltelemetrv, 4-wet well storage) . Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Forc- Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC 2H .0200 as applicable? ® Yes ❑ No If no, please reference the pertinent minimum design criteria or regulation and indicate why a variance is requested: SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS PERTINENT TO THE VARIANCE WITH YOUR APPLICATION 13. Have the following permits/certifications been submitted for approval? Wetland/Stream Crossings - General Permit or 401 Certification? ® Yes ❑ No ❑ NIA Sedimentation and Erosion Control Plan? ® Yes ❑ No ❑ N/A Stormwater? ® Yes ❑ No ❑ NIA CK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 5 C. STREAM' CLASSIFICATION 1. Use the Division's guidance document entitled, "DETERMINING STREAM CLASSIFICATIONS FOR FORM (FAST -TRACK SEWER SYSTEMS)" to collect and record the stream classification data below (attach additional necessary). This document is available from our web site or by contacting the appropriate Division of Water regional office (see instructions for addresses) OR indicate the following: FTA 02./03 sheets as Quality any down slope ® A Stream Classification is not needed because all parts of the project are at least 100 feet away from waterbody; AND, ■ 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 ! 1 (self chosen - as shown on 1 Name of ! Waterbody Stream Waterbody map for cross-reference) Waterbody County j River Basin i Index Classification ., _.. _ _ SITE !PRICE MILL CREEK' UNION CATAWBA ! t 11-136-2-2 C i 33! i i Submit the 8.5" x 11" COLOR topographic map as required in Instruction VI regardless of whether a classification is provided! D. CERTIFICATIONS 1. Applicant's Certification: . 1, JON C. DYER, attest that this application for KINGS GRANT 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 lass 2 misdemeanor lotion. which may include a fine t to exceed $10, 000 as well as civil penalties up to $25, 000 per %%''' ping Official Signalur Date . Professional Engineers ertification: ! attest that this application for KINGS GRANT has been reviewed by me and is accurate, complete and consistent with the information in the engineering plans, calculations, and al! 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 ! 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 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. STEVEN S. WILSON, PE a0,6211aseaap,, Professional Engineer Name e.,` 1 ?t CARO(�D°eorQ 2b. DPR ASSOCIATES, INC. ems .e"�c �' di,G�'� ape s �'4. � �"�j. Engineering Firm 2c. 420 HAWTHORNE LANE 15497 4 Address d. CHARLOTTE e. NC 2f. 28204 "Q®d>, R. 001 ilit:rogee ,,,. ' es � City State Zip .8'''P. kC,' S Id \4S'`�e 2g. 704-332-1204 2h. 704-332-1210 21. SSWILSON@DPRASSOCIATES.NET 3a•41"•rtea�nIto%' b 7i Telephone 1 Facsimile : E-mail Seal, Slgnaturl �� D to TT A nntnn n _ 1 n/Inn Reason for modification of Kings Grant sewer permit: 1. Sewer location has been modified due to difficulty in acquiring easements. Overall length of sewer has changed from . 2,196 LF to 1,794 LF. 2. One lot has been eliminated and total number of lots has been lowered from 20 to 19. Topa E. Da 0° Magnetic Declination: 4,6°W UNION COUNTY PUBLIC WORKS 400 N. Church Street Monroe, NC 28112-4864 704/296-4210 © / Fax 7I /296-4232 TRANSMITTAL To: Mooresville Regional Office Water Quality 610 East Center Ave. Suite 301 Mooresville NC 28115 Attention: Dee Browder Date: 2/20/06 Regarding: Record Drawings and Engineer's Certification for Sewer to serve Kings Grant Subdivision (Final Certification) We are sending you: Copy of letter Plans L Prints ' Shop Drawings l Other Description Record Drawings Engineers Certification for Sewer ( w!`Q00239 4 AND . OC These are transmitted as checked below: 0 For approval For your use [] As requested Remarks: Signed For review and comments Ti Received by: Date: r k Engineering Certification 00023904 2, 2005 d 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 X Final I, Steven S. Wilson, as a duly registered Professional Engineer in the State of North Carolina, having been authorized to observe (X periodically, ❑ weekly, ❑ full time) the construction of the Kings Grant project, Union County for the Permittee hereby state that, based on a final inspection 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: 0 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 action. Y:12003 Projects1030731Documents1WQ0023904KingsGrantCertification.doc