WQ0024075_Regional Office Historical File Pre 2018

a- - t -
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
Coleen H. Sullins, Deputy Director
Division of Water Quality
June 30, 2004
Mr. Russell Colbath, Director of Water Resources
City of Monroe
Post Office Box 69
Monroe, North Carolina 28111
Subject: Permit No. WQ0024075
City of Monroe
Jimmy Stegall Project
Wastewater Collection System Extension
Union County, North Carolina
Dear Mr. Colbath:
In accordance with your application received on June 1, 2004, and additional information
received on June 29, 2004, we are forwarding herewith Permit No. WQ0024075, dated June 30, 2004,
to the City of Monroe 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 This permit shall be effective from the date of issuance until rescinded, and shall be subject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.
drA
NCDENR
Mooresville Regional Office
919 N. Main Street, Mooresville, NC 28115
Internet http://h2o.enr.state.nc.us/
Telephone [phone] Fax [phone]
DENR Customer Service Center
Telephone [phone]

Mr. Russell Colbath
Page 2
June 30, 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 the City of Monroe for the construction and operation of approximately 308 linear feet of 8-
inch gravity sewer to serve as a relocation of existing sewer line to serve a service station as part of the
Jimmy Stegall project, and the discharge of 750 gallons per day of collected domestic wastewater into
the City of Monroe's existing sewerage system, pursuant to the application received June 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.
The sewage and wastewater collected by this system shall be treated in the City of Monroe's
WWTP (NPDES No. NC0024333) 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 Williams at (704)
663-1699.
Sincerely,
0, P
for Alan W. Klimek, P.E.
cc: Union County Health Department
Mooresville Regional Office, Water Quality Section (WWTF Permit No. NC0024333)
Chris Hope, PE
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 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. 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 Department of Environment
and Natural Resources, Water Quality, 919 N. Main Street, Mooresville, NC 28115.
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 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 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 30th day of June, 2004.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Dr /�Ir /
for Alan W. Klimek, ., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number W00024075
3

Fast Track Engineering Certification
Permit No. WQ0024075
June 30, 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 El Final
1, , as a duly registered Professional Engineer in the State of North Carolina, having
been authorized to observe (❑ periodically, El weekly, ❑ full time) the construction of the Jimmy Stegall, 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
WATER QUALITY
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.

06/30/04
Permit Number WQ0024075
Program Category
Non -discharge
Permit Tracking Slip
Status Project Type
In review New Project
Permit Type Fast Trick Version Permit Classification
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Individual
Extensions
Primary Reviewer Permit Contact Affiliation
sonja.williams
Permitted Flow
750
Facility
Facility Name
Jimmy Stegall
Location Address
Owner
MajorlMinor Region
Minor Mooresville
County
Union
Facility Contact Affiliation
Owner Name
City of Monroe
Dates/Events
Owner Type
Government - Municipal
Owner Affiliation
Russell Colbath, Director Resources
Water of
PO Box 69
Monroe
NC 28111
Scheduled
Orig Issue App Received Draft Initiated Issuance
06/01/04
Public Notice Issue
(1130 fo4-
Effective Expiration
Regulated Activities Requested/Received Events
Commercial or industrial. other Additional information requested 06/18/04
Wastewater collection Additional information received 06/29/04
Outfall NULL
Waterbody Name Stream Index Number Current Class Subbasin

CITY OF MONROE
P.O. BOX (,9 - MONROE, NC 28111-0069
FAX [phone]
May 26, 2004
D. Rex Gleason, PE
NC DENR-DWQ
Non -Discharge Permitting Unit
919 N Main St
Mooresville, North Carolina 28115
SG CEP T, OF „ENVIRONNIti4T
AN0NAT SOURCES
REF" - nNAL OFFICE
JUN 0 1 2004
ATr
. 1.4 44. f
Re: Gravity Sewer Relocation at intersection of Rocky River Road and
Old Charlotte Hwy (04-58)
Dear Mr, Gleason:
Please find enclosed one original and one copy of a gravity sewer extension fast track
application along with an 8.5" x 11" 7.5-minute USGS Topographic Map for the above
mentioned project. Also enclosed is a check for the $400 00 application fee. The City's
Standard Specifications for Sanitary Sewer will be used.
Please call me at [phone] if you have any additional questions or concerns.
Respectfully„
7t
Crystal D. Outlaw, E.I.
Water Resources Engineer
c: Mr. Russ Colbath, PE,
Mr. Duane Wing°, P.E.
Ms, Jennifer Hornberger, El
Mr, Jim Loyd, RE
Mr, Randy Griffin
Mr. Phil St. Martin
File: Rocky River Road and Old Charlotte Hwy (Stegall Property) (04-58(42))
d Ck1CUM A . . t fax CortstruediontAPASAm

11:52AM FROit-
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Full Legal Name (company,
z lb, Russell G. C©Ibath, Di
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North Carolina
-State
111. 704-262-460
LO TO MELD!
Name and Tatte (Phase review i5A NCAC 2H .02{T6(b) f
Telephone
2. Profpot [Facility)
:2a. Jimmy Stall
Brief Project Name (permit will
ntact Person:
uane S. Wind©, P.E. Cikvo
Name and A
3b. 704
Phone Num _
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ni9ipplity 0
704-2ts3-6492
Facsimile
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h a separate
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in B(7) and
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2a. If private, applicant will be:
is name)
Num
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county 0 Private Partnership ©Corporation 0 alit©✓ (specify);.
i i g. 28111.0069
Zip Code
rcolttathrrtdrtenc
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2b. nion
County Wi
Project Is Lotted
Anstr autions About this Aplfcabon
doming©@monro n
t No.,
y exptalning the re esvtt for the rttod'dication (i.e. adding another
ty include the modified Information in this permit application - do not
(10.11) that has already been included in the original permit
0 Private (go to Item 2(a))
T 2b. If sold. facilities owned by a (✓host chocsa
Retaining Ownership (i.e. store, church, single office, etc.) or 0 Public Utility (Instruction III)
Z 0 Leasing units (lots, townhomes, etc, - skip to Item 8(3)) 0 Homeowner Assoc./Developer (Instruction IV)
Q 1 0' Selling units (lots, townhomes, etc. - go to item B(2b))
z
4ty of Monroe
Owner of Wastswa
nroe WWTP
Name of WWTF
xof Monroe
ner of Downstream Sewer
The origin of this wastewater is (.-
Residential Subdivision
Apartments/Condominiums
Mobile Home Park
0 school
(l Restaurant
0 Office
Sb. 8-Intl
Receiving Sewer Size
11 that apply):
Car Wash
0 Institution
0 Hospital
0 Church
0 Nursing Home
Other (specify):
Permit N
7. Volume of wastewater (4be_pepittel in this project. ZQ gallons per day
5. It the permmitted flow is zero, Indicate why;
0 Interceptor Line - Flow will be permitted is subsequent perrrtits that conr�t to this lint
0 Flow has already been allocated In Permit No.
Rehabilitation or replacement of existing sewer

4 11:52AA1 FROM- 7-474 P.003/003 F-100
1-TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 4
9. Provide the wastewater flow calculations used in determining the permitted flaw 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 NCAO 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(1)(3).
Service Station - One urinal = 250 GPD
Two water closets 250 GPD each » 500 GPD
Total volume of wastewater to be permitted in this project = 750 GPD
' 10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches) Length (feet) Gravity or Force Main
u (se the pull down menu)
8"
308
ENTER TOTAL UNE LENGTH IN MILES! .06
Gravity
.Q ;11. Summary of Pump Stations to be Permitted (attach additional sheets as necessary)
I _ Location ID I Power Reliability Option
cc (self chosen - as shown on Design Flow ; Operational Point (1- dual line feed; 2- permanent generator w/ATS; 3-
0 plans for cross-reference)_1 (MGD) _ GF'M Q TDH . port01e.9enerat2r w/toletttetry;. 4-wet well storage), .
wl
_.
s12. Does the sewer system comply with the Minimum Design Criteria for the Fait -Track -Permitting of Pump Stations and Force
i Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC 2H .0200 as applicable?
n Yes ❑ No if no, please reference the pertinent minimum design criteria or regulation and Indicate why a
variance is requested:
SUBMIT IWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS PERTINENT TO THE VARIANC
{
113. Have the following permits/certifications been submitted for approval?
Wetland/Stream Crossings - General Permit or 401 Certification? 0 Yes 0 No ® N/A
Sedimentation and Erosion Control Plan? 0 Yes ❑ No N/A
5lormwater? ❑ Yes 0 No EZ1 N/A
r—•• MInn — w n41n•

z
0
APPLI :ATI©N for GRAVI Y SE'4VERS, PUMP STATIONS, AND FORCE MAINS
PALE 5
Use the Division's guidance document entitled, "DETERMINING STREAM CLASSIFICATIONS FOR FORM FTA 02103
(FAST -TRACK SEWER SYSTEMS)" to collect and record the stream classification data below (attach additional sheets a
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;
A Stream Classification is not needed because all parts of the project are at least 100 feet away from any down slope
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
(self chosen - as shown on Name of Waterbody Stream Waterbody
map for cross-reference) Waterbody County River Basin Index Classification
i r6 Jiea.:tel'! s 6, ki3Ort 'Va./k- l i?
Submit the 8.5" x 11" COLOR topographic map as required in Instruction VI
regardless of whether a classification is provided!
Applican
1, Russell G. Colbath attest that this application for Jimmy Stegall 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 returned as incomplete. Note: In accordance with North Carolina General Statutes 143-2156A and 143-215.68,
any person who knowingly makes any false statement, representation, or certification in any application shall be guilty o
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,
igning Official Signature
Professional Engineer's Certification;
Date
1 attest that this application for Jimmy Stegall has been reviewed by me and is accurate, complete and consistent with the
information in the engineering plans, calculations, and all other supporting documentation to the best of my knowledge. 1
further attest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable
regulations, Gravity Sewer Minimum Design Criteria for Gravity Sewers adopted February 12, 1996, and the Minimum
Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 and the watershed
classification in accordance with Division guidance. Although certain portions of this submittal package may have been
developed by other professionals, inclusion of these materials under my signature and se& signifies that 1 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 143-215.613, 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. Chris L. Hope, PE
Professional Engineer Name
2b, Chris L. Hope, PE
Engineering Firm
2c. 2617 Rolling Hills Drive
Address
2d, Monroe
City
2e, NC 2f, 28110
State
2g, 704-882-1500 2h. 704-882-3263 2i, ch©e arolina.rr.com
Telephone Facsimile
E-mai
Zip

Name: BAKERS
Date: 5/20/104
Scale: 1 inch equals 1000 feet
Location: 035° 02' 01:8" N 080° 36' 00.8" W

JUN-29-2004 11:52A)A FRQM-
T-4T4 P.001/003 F-100
2517 Rang Hills Olive f Monroe. N.C. 281101(704) 882-1500
[phone] Fax
Fax
To: S04119 WA 163446
F
Chris Hope
Engineering Services
ris
Fax: •701 (Q(, 3 - 601{0 Pages: 3
Phone:
ift: ,1`"4n9 S &irL ,
Data: 6/2.41/ p
CC:
0 Urgent ❑ For Review 0 Please Comment 0 Please Reply 0 Please Recycle
• Comments:

pFAST -TRACK APPLICATION for GRA
r
SE"i ERS3 PUMP STATIONS, AND FORCE M fNS PAGE 3
1b,
0
1c.
1d.
0
1f.
z
lh.
2.
2a,
3.
' 3a.
3b.
USE THE TA
Owner:
City of Monroe_
Full Legal Name (company, mun- icipality, HOA, utility, etc.)
OVE FROM FIELD TO FIELD!
Russell G. Colbath, Director
Signing Official Name and Ti
Application Number:
(to be completed by DWQ)
Dater Resources
Please review 15A NCAC 2H .0206(b) for authorized signing officials!)
The legal entity who will own this system is.
O Individual 0 Federal i' Municipality 0 State/County 0 Priva
P.O_ Box 69
Street Address
North Carolina
State
704-282-4601
Telephone
1 i. 7€34-283-6492
Facsimile
Project (Facility) Information:
Rocky River Road and Old Charlotte Hwy Relocation (04-58)
Brief Project Name (permit will refer to this name)
Contact Person:
Partnership 0 Corpo
Monroe
City
lg 28111-0069
Zip Code
Duane S. Wingo, P.E. City of Monroe
Name and Affiliation of Someone Who Can Answer Questions ki1JVUI LITM rt rirrrc:aovn
704-282-4604
Phone Number
Project is New 0 Modification
For modifications, attach a separate sheet clearly explaining the reason for the modification (Le. adding another
phase, changing line sizefength, etc.). Only include the modified information in this permit application - do not
duplicate project information in 8(7) and B(1O-11) that has already been included in the original permit.
2. Owner is Public (slip to Item B(3)) 0 Private (go to Item 2(a))
2a. If private, applicant will be. 2b. If sold, fa
ed
3c. dwinptpmonroenc.org
E-mail
es owned by a (`must choose one
O Retaining Ownership (i.e. store, church, single office, etc.) or { Public Utility (Instruction III)
O Leasing units (lots, townhomes, etc. - skip to item B(3)) [ Homeowner Assoc,. /Developer (Instruction IV)
O Selling units (lots, townhomes, etc. - go to Item B(2b))
City of Monroe
Owner of Wastewater Tree
4a. Monroe WWTP
Name of WWTF
5a. of Monroe
Facility (VWVTF) Treating
Owner of Downstream Sewer
The origin of this wastewater is
0 Residential Subdivision
0 Apartments/Condominiums
0 Mobile Home Park
0 School
0 Restaurant
0 Office
5b. 8-inch
Receiving Sewer Size
ck all that apply) -
El Car Wash
0 Institution
0 Hospital
Cj Church
0 Nursing Home
Other (specify):.
7. Volume of wastewater to be permitted in this project: 7 50
8, If the permitted flow is zero, indicate why:
0 Interceptor Line - Flow will be permitted is subsequent pen
0 Flow has already been allocated in Permit No.
CI Rehabilitation or replacement of existing sewer with no ner
ewater From This Project
4b. NCOO 24333
WVVTF 'Permit No.
unknown
Permit Number of Downst
Iocation only
if known
100 % Domestic/Commercial
% Industrial
% Other (specify).
hat connect to this line
expected

VT1RACK
APR, CATION for GRAVITY SEWERS, PUMP STATIONS, AN II FORCE .MAINS
PACE 4
9. 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(l)(3).
Cif is
1 r
_% '7.3 0 . r);ekr��
10, Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches)
Length (feet)
308
ENTER TOTAL LINE LENGTH IN MILES ,06
0
1. Summary of Pump Stations to be Permitted. (attach additional sheets as necessary)
Gravity or Force Main
(use the pull down menu)
Gravity
Location ID Power Reliability Option
(self chosen - as shown on Design Flow Operational Point (1- dual line feed; 2- permanent generator wfATS; 3-
plans for cross-reference) (MGD) GPM @ TDH portable generator w/telemetry; 4-wet well storage)
12 Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force;
Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC 2H ,0200 as applicable?
Yes ❑ 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 V'VITMI YOUR APPLICATION:
3, Have the following permits/certifications been submitted for approval?
Wetland/Stream Crossings - General Permit or 401 Certification? ❑ Yes ❑ No N/A
Sedimentation and Erosion Control Plan? ❑ Yes ❑ No N/A
Stormwater?' ❑ Yes ❑ No N/A
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