WQ0032308_Regional Office Historical File Pre 2018

ILI fa
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen 11. Sullins, Director
Division of Water Quality
October 18, 2007
Ms. Christie Putnam, Director of Public Works
Union County Public Works
500 North Main Street
Monroe, NC 28112
Subject: Permit No. WQ0032308
Issac Grossman
Wastewater Collection System Permit
Union County, North Carolina
Dear Ms. Putnam,
In accordance with your application received on October 11, 2007, we are forwarding herewith
Permit No. WQ0032308, dated October 18, 2007, to the Union County Public Works 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effective from the date of issuance until rescinded and shall be subject to the conditions and limitations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 2T .0403 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 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 610 East Center Ave., Suite 301 Mooresville, NC 28115 Phone: [phone] Fax: [phone]
Internet: www.ncmwaterquality.org Customer Service: 1-877-623-6748
An Equal Opportunity/Affirmative Action Employer--50°% Recycled/10°% Post Consumer Paper
One
NorthCarolina
Naturally

Ms. Putnam
Page 2
October 18, 2007
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 Public Works for the construction and operation of approximately 70 linear
feet of 8-inch gravity and the discharge of 0 gallons per day of collected domestic wastewater into the
Union County existing sewerage system, pursuant to the application received October 11, 2007, 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 Union County
Public Works WWTP (Crooked Creek NPDES No, NC0069841) 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 inforrnatton concerning this matter, please contact Dee Browder at (704)
663-1699.
Sincerely,
tl
Coleen H. Sullins
cc: Mooresville Regional Office, Collection System Permit Files
Dmitry Shklovsky, DS Engineering
Surface Water Protection Central Files
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 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

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,
Per 15A NCAC 2T .0116, 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
of the wastewater collection facilities.
or
he life
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.
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 ,CAC 2H .0500.
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
[phone]. 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 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 18th day of October, 2007.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
iv
for Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number WQ0032308
3

Fast Track Engineering Certification
Permit No WQ0032308
October 18, 2007
Own erNVVVTP/WQCS
Christie Putnam
Union County Public Works
400 North Church Street
Monroe, NC 28112
PE
Dmitry Shklovsky
DM Engineering
1223 Fax Run Drive
Charlotte, NC 28212
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 reaired for an changes resulting in noncomp1iance with this permt reguIatons 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
L. Partial Final
, as a duly registered Professional Engineer in the State of North Carolina, having been
authorized to observe (Li periodically, El weekly, El full time) the construction of Issac Grossman, a 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 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.
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.

Application Number: do
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! (to be completed by DWQ) �" ��d
_ -- _
,la. Union County Public Works
Full Legal Name (company, municipality, HOA, utility, etc.)
O '1 b. Christie L. Putham, PE, Director of Public Works
(Pleasereview 15A NCAC 2H 0206(b) for authorized signing officials!)
Signing Official Name and Title �..._ __..... _ -
,lc. The legal entity who will own this system is:
❑ Individual ❑ Federal ❑ Municipality ® State/County ❑ Private Partnership ❑ Corporation ❑Other (specify):
O 11d. 500 N. Main Street, Suite 500 :1e. Monroe
LL , Mailing Address City
If. NC lg. 28112
Z State .. Zip Code
0 1h. 704/296-4210 li. 704/296-4232 1j.
Telephone Facsimile _ Email
0 2. Project (Facility) Information _
J 2a, Sanitary Sewer line for Isaac Grossman 2b. Union
13- Brief Project Name (permit will refer to this name) County Where Project is Located
CL
< 3. Contact Person:
3a. Mike Garbark, PE, Assistant of Director of Public Works
Name and Affiliation of Someone Who Can Answer Questions About this Application
'3b. 704/296-4239 — 3c. mikegarbarkeco.union.nc.us
B. PERMIT INFORMATION
4a. Crooked Creek
Name of WWTF WWTF Permit No.
5a. Union County Public Works 15b. 8" ® Gravity '5c. WQ0013944
Owner of Downstream Sewer Receiving Sewer Size j❑ Force Main 1 Permit Number of Downstream Sewer (if known)
6. The origin of this wastewater is (check all that apply):
❑ Public Utility (Instruction III)
❑ Homeowner Assoc./Developer (Instruction IV)
Phone Number E-mail
.1. Project is ® New 0 Modification (of an existing permit) If Modification, Permit No.:
For modifications, attach a separate sheet clearly explaining the reason for the modification (i.e. 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 the original permit.
2 Owner is ® Public (skip to Item B(3)) ❑ Private (go to item 2(a)) i
2a. If private, applicant will be: 2b. If sold, facilities owned by a (must choose one) .
❑ Retaining Ownership (i.e. store, church, single office, etc.) or
❑ Leasing units (lots, townhomes, etc. - skip to Item B(3))
0 Selling units (lots, townhomes, etc. - go to Item B(2b))
Union COunty Public Works
Owner of Wastewater Treatment Facility (W TF) Treating Wastewater From This Project
4b. NC0069841
❑ Residential Subdivision ❑ Car Wash
❑ Apartments/Condominiums ❑ institution
El Mobile Home Park 0 Hospital %Industrial
❑ School 0 Church -
❑ Restaurant ❑ Nursing Home % Other (specify):
® Office 0 Other (specify):
100 % Domestic/Commercial
Volume of wastewater to be allocated for this particular project:
*Do not include previously permitted allocations
gallons per day
8. If the permitted flow is zero, indicate why:
® Interceptor Line - Flow will be permitted in subsequent permits that connect to this line
O Flow has.already been allocated in Permit No.
O Rehabilitation or replacement of existing sewer with no new flow expected
FTA 02/03 - Rev_ 3 04/05

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(1)(1-2) must be supported with actual water or wastewater use data in accordance with 15A
NCAC 2H .0219(I)(3).
. 10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches)
8
Z
ENTER TOTAL LINE LENGTH IN MILES', 0.01
0 11. Summary of Pump Stations to be Permitted (attach additional sheets as necessary) N/A
Location ID Power Reliability Option
— (self chosen - as shown on Design Flow Operational Point ' (1- dual line feed; 2- permanent generator w(ATS; 3-
plans for cross-reference) (MGD) GPM @ TDH portable generator w/telemetry; 4-wet well storage)
0
LL
Z
'12. Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force
Et Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC 2H .0200 as applicable?
W ® Yes ❑ No 1f no, please reference the pertinent minimum design criteria or regulation and indicate why a
CL variance is requested. SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS
PERTINENT TO THE VARIANCE WITH YOUR APPLICATION
Length (feet)
70
Gravity or Force Main
(use the pull down menu)
Gravity
m
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 ® N/A
14. Does this project involve aerial lines or siphons? Check if yes: ❑
;Mese lines will beconsidered..hioh..priorltv.and_must be checked once every six months ..... .......
15. Does this project have gravity sewer lines designed at minimum slopes? ❑
Be aware that the Division will not accept installed lines more than 10% flatter than the minimum slope. Lines installed outside this tolerance should be
corrected prior to submitting the final engineering certification..
FTA 02/03 - Rev. 3 04/05

C. STREAM CLASSIFICATI
F
1. Use the Division's guidance document entitled, "DETERMINING
the stream TREAM CLat SII IC TIOl NSw(FOaRh ORMio TA 02/03 as
(FAST -TRACK SEWER SYSTEMS) to collect ande
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; ARID, __.__ __ _ ._ _ _ _ _ _
® 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 of
(self chosen - as shown on Name Waterbody
map for cross-reference)_._.._-..-...
County
Waterbody Stream Waterbody
River Basin Index Classification
Submit the 8.5" x 11" COLOR topographic map as required in Instruction -VI
regardless of whether a classification is provided!
D. CERTIFICATIONS
2a. Dmitry Shklovsky
Professional Engineer Name
2b. DS Engineering
Engineering Firm
2c. 1223 Fox Run Drive
Mailing Address
2d. Charlotte 2e. NC 2f. 28212
City State Zip
2g. 704/497-0081 2h..775/269-9739 2i. [e-mail]
Telephone Facsimile E-mail
1. Applicant's Certification:
• I, Christie L. Putham, PE, Director of Public Works, attest that this application for Sanitary Sewer line for Isaac
Grossman has been reviewed by me and is accurate and complete to the best of my knowledge. l 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
Car. . General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement,
. rese tation,'or c ificatio'n any - :. ication shall be guilty of a Class 2 misdemeanor which may include a fine not to
xce % '.10, 000 as - /rvil p altles up to $25, 000 per violation.
1
ng Official Signature
2. Professional Engineer's Cfication:
Date
I attest that this application for Sanitary Sewer line for Isaac Grossman 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 seal signifies that 1 have reviewed this material and have judged it to be consistent with 's
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.
``,I%IIt1Gllt11/77f7
O. 'FOSS/p :i t.
* • SEAL
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'ra'tfUJ. 29•0 7
Seal, Signature & Date
FTA 02/03 - Rev. 3 04/05

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Permit Number WQ0032308
Central Files: APS SWP
10/18/07
Permit Tracking Slip
Program Category
Non -discharge
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer
Extensions
Primary Reviewer
dee.browder
Permitted Flow
0
Facility
Fast Track
Facility Name
Sanitary Sewer line for Isaac Grossman
Location Address
Owner
Status
Active
Version
1.00
Project Type
New Project
Permit Classification
Individual
Permit Contact Affiliation
Major/Minor
Minor
Region
Mooresville
County
Union
Facility Contact Affiliation
Owner Name
Union County Public Works
Dates/Events
Orig Issue
10/18/07
App Received
10/11/07
Regulated Activities
Office
Wastewater collection
Outfall NULL
Draft Initiated
Scheduled
Issuance
Owner Type
Government - County
Owner Affiliation
Christine Putnam, Director Interim
500 N Main St Ste 500
Monroe NC 281124730
Public Notice Issue Effective
10/18/07 10/18/07
Renuested/Received Events
Additional information requested
Additional information received
Expiration
Waterbody Name Stream Index Number Current Class Subbasln

UNION COUNTY PUBLIC WORKS
500 N. Main Street, Suite 500
Monroe, NC 28112
704/296-4210
Fax [phone]
To: NC Department of Environment and Natural Resources
Mooresville Regional Office
610 East Center Avenue
Suite 301
Mooresville, N.C. 28115
Attention:
Regarding: Sanitary Se
We are sending you:
er to serve Isaac Grossman (Public)
Copy of letter
Z Other
Copies I ©ate No, I Description
1
1
9/28/07
10/3/07
LI Plans
TRANSMITTAL
Date: 10/9/07
Prints 0 Shop Drawings
Original Non -Discharge Permit Application
Copy of Non -Discharge Permit Application
Check for $48O.gg (Application Fe
These are transmitted as checked bolo
For approval Li For your use Lj As requested
Remarks:
Signed:
For review and comments
Received by: Date:
on.

WATER
QGr
ri
Ot
January 22, 2008
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen Sullins, Director
Division of Water Quality
Christie Putnam, Public Works Director
Union County
500 North Main Street
Suite 500
Monroe, North Carolina 28112
SUBJECT: Sanitary Sewer
Permit No. WQ0032308
Wastewater Collection System Extension
Final Engineering Certification
Dear Permittee:
The Division received a final engineering certification for the subject project on December 12, 2007.
A full review of the certification materials may or may not be conducted. !t is assumed that receipt
of this certification indicates compliance with all regulations, design criteria and the permit. Please
be reminded that the Permittee is responsible for keeping a copy of the final record drawings for
the life of the project. If you have not received a copy, please contact your consultant
immediately to obtain a copy.
You are receiving this letter because the Division has you listed as the responsible party. If this
permitted system is no longer owned by you, please complete Form PNOCF-S as this permit is not
automatically transferable. Form PNOCF-S can be downloaded from
http://h2o.enr.state.nc.us/ndpu/ndpuapps.html#Sewer.
If you have any questions concerning this document or the completion of Form PNOCF-S (if
necessary), please contact Ms. Dee Browder at the letterhead address or via E-mail at
[e-mail].
Sincerely,
ti Robert Krebs
Surface Water Protection Regional Supervisor
Enclosure
Cc: Dmitry Shklovsky, DS Engineering
Issac Grossman
Surface Water Protection Section Central Files (certification page only}
One NrthCarolina
Naturally
Pretreatment, Emergency Response and Collection Systems Unit Internet http;//h2o.enr.nc.state,us/ndpu
1617 Mail Service Center, Raleigh, NC 27699-1617 An Equal Opportunity Action Employer
Telephone [phone] Fax [phone]% recycled/10% post -consumer paper

r
rack Engineering Certific ttion
No. WQ0032308 Corrected
r 30, 2007
Issac Grossman
4213 Pima Cotton Drive
Charlotte, NC 28226
WWTP/WQCS
Christie Putnam
Union County Public Works
400 North Church Street
Monroe, NC 28112
PE
Dmitry Shklovsky
DS Engineering
1223 Fox Run Drive
Charlotte, NC 28212
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.
Tthis project shall not be considered complete nor all y' d to operate tart€i tEngineer's
required supporting documentation have been received by the 'Division. Therefore* it is f
that this certification be sent in a manner that provides proof of receipt by the Divis
ENGINEER'S CERTIFICATION
E Partial
Final
; Ftifir tion and all
ghly reconnmeed
n.
1, Dim 1f -1 5-4 co5 Y as a duly registered Professional Engineer in the State of North Carolina, having been
authorized to observe (!'+i periodically, D weekly, 0 full time) the construction of Sanitary Sewer, a 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 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.
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
€10 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.

UNION COUNTY PUBLIC WORKS
500 N. Main Street, Suite 500
Monroe, NC 28112
704/296-4210
Fax [phone]
To: NC Department of Environment & Natural Resources
Mooresville Regional Office
610 East Center Avenue, Suite 301
Mooresville, NC 28115
Attention: Dee Browder
Regarding: Engineer's Certification for Isaac Grossman
We are sending you: n Copy of letter
Other
Date
No. J Description
TRANSMITTAL
Date: 12/11/07
L Plans Prints Ej Shop Drawings
Record Drawings
Engineer's Certification for Sewer (Permit `Q0032308
Corrected)
These are transmuted as checked below:
For approval
Remarks:
Signed:
Received by:
IE For your use I S As requested L
NC D NR MR0
DWQ Surface Water Pro
For review and comments
Date:
Cl