WQ0040306_Regional Office Historical File Pre 2018

FILE
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Interim Director
NORTH CAROLINA
Environmental quality
September 28, 2018
Crystal Panico, New Development Program Manager
Union County Public Works
500 N. Main Street, Suite 400
Monroe, NC 28112
Dear Ms. Panico:
Subject: Permit No. WQ0040306
Union County Public Works
Potter Road Farm Sanitary Sewer Extension
Wastewater Collection System Extension Permit
Union County
In accordance with your application received September 24, 2018, we are forwarding herewith Permit No.
WQ0040306 dated September 28, 2018, to the Union County Public Works (Permittee) for the
construction and operation upon certification 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permit shall be effective from the date of issuance until rescinded and shall be subject to the conditions and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 the following conditions contained within this permit:
Condition II.1: This permit shall notbe automatically transferable; a request must be made and approved.
Condition 11.4: 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.
It shall be the responsibility of the Permittee 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.
C)-1
..v
State of North Carolina I Environmental Quality -I Water Resources 1 Water Quality Regional Operations
Mooresville Regional Office i 610 East Center Avenue. Suite 301 I Mooresville. North Carolina 26115
704 663 1699

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 150E 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 bining.
If you need additional information concerning this matter, please contact Ori Trivia at (704) 235 219Ct or
via e-mail at on.tuv a; iz t cdenr. ;ov.
Merely,
DocuS geed by:
A14CC681AF27425_,
Corey Basinger,. Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ
cc: John Ross (P.E.) (E-copy)
Mooresville Regional Office Files (I aserfche)
VVater Resources Central Files (I asertiche)
PERCS (Laserfche)
Page 2 of 8

NORTH CAROLINA
Environmental Quality
STATE OF NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
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
Union County Public Works
Union County
for the construction and operation of approximately 460 linear feet of 8-inch gravity sewer, as part
of Potter Road Farm Sanitary Sewer Extension, and the discharge of 750 gallons per day of
collected wastewater into the Union County Public Works existing sewerage system, pursuant to the
application received September 24, 2018, 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 Environmental Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until rescinded and shall be subject to the specified
conditions and limitations contained therein.
,-Docusigned by:
`----A14CC681 AF27425...
by W. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ
By authority of the Environmental Management Commission
Permit Number: WQ0040306
Permit Issued: September 28, 2018
Page 3of8

SUPPLEMENT TO PERMIT COVER SHEE'
Union County Public Works is hereby authorized to:
Construct, and then operate upon certif;at'on the afcaretnerationed wastewater collection extension. The
sewage and wastewater collected by this system shall be treated in the Twelve Mile Creek Regional
Wastewater Treatment Facility in accordance with 1'enriit Number NC00115359.
Permitting of this project does not constitute an acceptance ref any part of the project that does not
15A NCAC 2T; the Division's Gravity Sewer Minimum Design Criteria adopted. February 1
applicable, 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 ot'the certification provided by a North Caarolina-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,
Construction and operation is contingent upon compliance with the Standard Conditions and any Special
Conditions identified below.
SPECIAL CONDITIONS
I) No flow it excess of the quantity permitted herein, 750 GPD, shall be made tributary to the
subject sewer system until an application for permit modification for an increase in flow has
been submitted to and approved by the Division. [15A NCAC 02T.O3O4 (h)]
II. STANDARD CONDITIONS
This permit is not 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 formai 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 he approved. [ISA NCAC 02'1 0104; G.S 143-215,103)J
This permit shall become voidable unless the wastewater collection facilities are constructed in
accordance with the conditions of this permit; 15.E NCAC 2T; the Division's Gravity Sewer
Minimum Design Criteria adopted February 1.2, 1.996, as applicable; the Division's Minimum. Design
Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June !, 2000, as
applicable and other supporting materials unless specifically mentioned herein, [15A, NCAC
021T.0 110]
This pennit slaa.11 be of ective only with respect to the nature and volume of wastes described in the
application and other supporting data. [15A NCAC 02'T .0l 101
4, The wastewater collection facilities shall he properly maintained and operated at all times. The
Permittee shall maintain compliance 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 pe,rforrnance criteria shall be met: [ 1.5A NCAC 02"T .p 108(b)1:
a. "`he sewer s;°ate
to land or surl`ac
water standards,
hall be effectively maintained and operated at all times to prevent discharge
raters, and to prevent any contravention of groundwater standards or surface
Page 4of8

b. A map of the sewer system shall be developed and shall be actively maintained.
c. An operation and maintenance plan including pump station inspection frequency, preventative
maintenance schedule, spare parts inventory and overflow response has been 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 months and inspections
documented.
f. A general observation of the entire sewer system shall be conducted at least once per year.
g.
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.
h. A Grease Control Program is in place as follows:
1. For public owned collection systems, the Grease Control Program shall include at least
biannual distribution of educational materials for both commercial and residential users and
the legal means to require grease interceptors at existing establishments. The plan shall also
include legal means for inspections of the grease interceptors, enforcement for violators and
the legal means to control grease entering the system from other public and private satellite
sewer systems.
2. For privately owned collection systems, the Grease Control Program shall include at least bi-
annual distribution of grease education materials to users of the collection system by the
permittee or its representative.
3. Grease education materials shall be distributed more often than required in Parts (1) and (2)
of this Subparagraph if necessary to prevent grease -related sanitary sewer overflows.
1. Right-of-ways and easements shall be maintained in the full easement width for personnel and
equipment accessibility.
j. Documentation shall be kept for Subparagraphs (a) through (1) of this Rule for a minimum of
three years with exception of the map, which shall be maintained for the life of the system.
5. The Permittee shall report by telephone to a water resources staff member at the Mooresville Regional
Office, telephone number [phone], as soon as possible, but in no case more than 24 hours
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 SSO and/or spill over 1,000 gallons; or
c. Any SSO and/or spill, regardless of volume, that reaches surface water
Voice mail messages or faxed information is permissible, but this 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].
Page 5 of 8

Persons reporting any of the above oe,eurrences shall file a spill report by completing and submitting
Part 1 of Form CS-SSO (or the most current Division approved form) within five days following first
knowledge of the occurrence. This report must. outline the actions taken or proposed to be taken 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, [GS. 1413-
215.1C(a1)]
6, 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 waiters of the State. [15A NCAC o21,0108(b)]
7. 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. Any wastewater fiow 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.
If the permit is issued to a private entity with an Operational Agreement, then a copy of the
Articles of Incorporation, Declaradons/Covenants/Restrictions, and Bylaws that have been
appropriately riled with the applicable County's Register of Deeds office shall be submitted
with the certification,
A complete certification is one where the form is fully executed and the supporting documents are
provided as applicable, Supporting documentation shall include the following;
a. One copy of the project construction record drawings (plan & profile views of sewer lines &
force mains) of the wastewater collection system extension.. Final record drawings should he
clear on the plans or on digital media (CD or DVD disk) and are defined as the design drawings
that are marked up or annotated with after construction information and show required buffers,
separation distances, material changes, etc.
b. .0ne copy, of the supporting applicable design calculations including pipe and pump sizing,
velocity; purnp cycle times„ and level control settings, pump station buoyancy, wet well storage,
surge protection, detention time in the wet well, and force main, ability to flush low points in
force mains with a pump cycle, and downstream sewer capacity analysis, If a portable power
source or pump is dedicated to multiple stations, an evaluation of all the purnp stationsstorage
capacities and the rotation schedule of the portable power source or pump,. include travel
timeframes, shall he provided.,
c. Changes to the project that do not result in non-compliance with this permit, regulations, or the
MiniMUM Design Criteria should be clearly identified on the record drawings, on the certification
in the space provided, or in written summary form,
Prior to Certification (Final: or .Partial): Permit modifications are required for any changes resulting
in non-compliance with this permit (including pipe length increases of 10°/0 or greater, increased
flow, pump station design capacity design increases of 5% or greater, and increases in the
num berftype of connections), regulations, or the Minimum Design Criteria. Requested modifications
or variances to the Minimum Design Criteria will be reviewed on a case -by -case basis and each on
its own merit. Please note that variances to the Minimum. Design Criteria should be requested and.
approved during the permitting. process prior to construction. After -construction requests are
Page 6 of

discouraged by the Division and may not be approved, thus requiring replacement or repair prior to
certification & activation, [15A NCAC 02T .0116]
8. Gravity sewers installed greater than ten percent below the minimum required slope per the Division's
Gravity Sewer Minimum Design Criteria shall not be acceptable and shall not be certified until
corrected. If there is an unforeseen obstacle in the field where all viable solutions have been
examined, a slope variance can be requested from the Division with firm supporting documentation.
This shall be done through a permit modification with fee. Such variance requests will be evaluated
on a case -by -case basis. Resolution of such request shall be evident prior to completing and
submitting the construction certification. [ 15A NCAC 02T.0105(n)]
9. A copy of the construction record drawings shall be maintained on file by the Permittee for the life
of the wastewater collection facilities. [15A NCAC 02T .0116]
10. 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, construction of additional or replacement wastewater collection facilities,
and/or referral of the North Carolina -licensed Professional Engineer to the licensing board. [15A
NCAC 02T .0104; 15A NCAC 02T .0108(b-c)]
11. 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.
[15A NCAC 02T .0110; 15A NCAC 02T .0108(b)]
12. The issuance of this permit shall not exempt the Permittee from complying withany and all statutes,
rules, regulations, or ordinances that may be imposed by the Division any other Federal, State, or
Local government agencies which have jurisdiction or obtaining other permits which maybe required
by the Division or any other Federal, State, of Local government agencies. [G.S. 143-215.1(b)]
Page 7 of 8

FAST TRACK SEWER ENGINEERING CERTIFICATION
PERMITTEE: UNION COUNTY PUBLIC WORKS
PERMIT #: WQ0040306
PROJECT: POTTER ROAD FARM SANITARY SEWER EXTENSION
ISSUE DATE: SEPTEMBE R 28, .2018
This project shall not he considered complete nor allowed to operate in accordance with standard
Condition 7 of this permit until the Division has received this Certification and all required supporting
documentation. It should be submitted in a manner that documents the Division's receipt, Send the
required documentation to the Regional Supervisor, Water Quality Regional Operations Section at the
address noted in the page Tooter.
Any wastewater floe ma :le tributary to the vvaastvater collection system extension pri,r tt ertrapletion
of this Certification shall be considered a violation of the permit and shall subject the Permrnee to
appropriate enforcement actions, The Permittee is responsible for tracking all partial certifications up
until a final certification is received by the Division. A Final Certification shall be a complete set of
record drawings and design calculations regardless of whether partials have been submitted.
PERMIT"TEFS CERTIFIC ATI.ON
1, the undersigned agent for the Perritte ,hereby state that this pro e.r t has been constructed pursuant to
th,e applicable standards & requirements.. the Professional Engineer below has provided applicable
design/construction information to the Permittee, and the Permittee is prepared to operate & maintain the
wastewater collection system permitted herein or portions thereof,
Printed. N
gn:ature
ENGINEER'S CERTIFICATION
Fate
as a duly registered Professionaal Era ineer in the State of North Cart
having been 'author^ized to observe ([1] periodically, weekly, full time) the construction
project name and location as referenced above for the above Permittee hereby state that., to the hest of
abilities, due care and diligence was used in the observation of construction such that the construction
was observed to be built within substantial compliance of this .permit; l SA NCAC 02T; the Division of
\water Resources' (Division) Gravity Sewer 'vlsnirnuna Design Criteria adopted February. 12, 1996, as
applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting. of Pump Stations and
1 orce Mains adopted June 1, 2000, as applicable; and oilier supporting materials.
North Carolina Professional Engineer's Seal w.'signatl. & date:
0 Final [ Partial (include description)
Certific tion Comments Qua Idlers (a
NC DWR — Water Quality Regional Op ;on Section 610 East Center Avenue, Suite 301, Mooresville, NC 28115
Mooresville Regional Office
Phone: [phone] PAX: (704)-633-6040

O IrAST"'ITt %(:h: SF`\% R S It lI \I
l'i"A O-I 1(i ti: St PI
V`1'Ai IO\
APPLICANT I\I
N,.1 I O \:
Union { oun1 (coal pally, Innla
dlvidurl
(`orporit
p
'\pplica.nt`.og1Qw! t ir)f'i)tataatir>a.
Phone number: F700I :)1'.39 Email Address:. c.rystal,panIe
11. PROJECT' liNE01 \1 TI
I . Project. name:
.`\pplic rtion/1J
If a modification provide the existing, perm
It ne consCrarr°tir�n hilt hart of a master plan.
ateJ
Approximate (oord
Parcel I'D (if applieahlc:l: O713201(11
tor Parcel II) to closest downstre lrrt s :oG<
C."O SI LTANT INFORMATION:
Processional Engineer: ineer.` John H. Ross_.
I irna I:a l� I n, inccring,Inc_,
Mailing address. ?t)1 L \ Van
City: Indian "Trail
T Name:
Latitude: 15.Or I —
Number: I4252
N("00X5,';7()
Partne-c.
.OIOOLhJ
nt\ nc..cc v
nher: V t;)t)(1
:1 ING IDO'1%`IN`+F"REAV'1 SEWER INFOR%1AT. V rent than N°`\4'TFI:
Perrroi( Number (si; \\'000O6421
St`st rrt \l"ide Colic: on System Permit \urnher(s) (if applit tl?lej. 11
Owner Name
nnnt.v
F7ownstreaa
s
(14-1 ti
0

VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes, ❑No ®NIA
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEV) been attached?
El Yes ❑No ®N/A
3. If the Applicant is a Home/Property Owners' Association, has an Operational Agreement (FORM: HOA) been attached?
❑ Yes ElNo ®N/A
4. Origin of wastewater: (check all that apply):
❑ Residential Owned
❑ Residential Leased
❑ School / preschool / day care
❑ Food and drink facilities
▪ Businesses / offices / factories
El Retail (stores, centers, malls)
❑ Retail with food preparation/service
❑ Medical / dental / veterinary facilities
❑ Church
❑ Nursing Home
❑ Car Wash
❑ Hotel and/or Motels
❑ Swimming Pool /Clubhouse
El Swimming PooUFilter Backwash
❑ Other (Explain in Attachment)
5. Nature of wastewater : % Domestic/Commercial 100 % Commercial
% Industrial (See 15A NCAC 02T .0103(20))
�Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .0114(f)? ❑ Yes ® No
> If ves, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(3l)
Daily Design Flow ab
No. of Units
How
Office Facility
25 gal/employee/shift
30
750 GPD
gal/
GPD
gal/
GPD
gal/ ,
GPD
gal/
GPD
gal/
•
GPD
Total
750 GPD
a See 15A NCAC 02T .0114(b), (d), (e)(1land Je)(2) for caveats to wastewater design flow rates"(i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use
areas; and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals
as defined in G.S. 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.0114] shall
be determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 750 GPD (per 15A NCAC 02T .0114)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
El Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
El Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
El Other (Explain):
FORM: FTA 04-16
Page 2 of 5

VII„ GRAVITY SENVEN DESIGN (1-t1TERIA (If Applicable) - 021 .O3J5 & Se ):
1, s ...A11111T1arille gravity sevver to be permitted:
Size (inches) Length (feet)
8 440
Material
PVC
DIP
Section 11 &111 of the MDC fOr Permitting of Gravity Sewers contains information related to design criteria
Section 111 Canis information related to minimum slopes 'for gravity sewerott
Oversizing lines to meet minimum slope requirement. is not allowed and a violatin
VIII. PUMP STATION DESIGN (If Applicable) — 02T t0305 & MDC (Pumn Sta(ions/Foree Mains):
COMPLE'VE FOR EACH PLJNIP sTATIoN iNci,unED 'FIBS PROJECT
Pump station 111:1111 her or name:
2, Approximate Coordinates (Decimal Degrees): Latitude:,
3, Design flu of the pump station: millions gallons per day (firm capacity)
4, Operational point) of the punt pis): ttallons per minute at reel total dynamic head lJ)1I
t
5, Summarize the force main to be permitted for this Pump S
Size (inches)
Length (feet)
(. Power reliability in accordance with 115A N( AC 021' :0305(h)(1t
Sti:,:md by power source or pump with automatic activation and telemetry - 15,A NitTA(T:' 02'r .(.).:305(h)(1.-)03)...
Row.dred for all pump stations with an average daily flow greater than or equal to 15,)00 gallons per day
Must be permanent to facility
Or ir the pump station has tin average daily (low less than 15,000 gallons per day:
ri Portable power source with manual activaticm, quick -connection receptacle tind telemetry - 15A tit:AC 021
.0305(10( 1 tt C.)
Material
or
Portable pumping unit with plugged emergency pump connection and telemetry - 15.A Nt„,'„(1.0 02T ,030,5(h.)( 1)(Cr.
It shall be demonstrated to the Division that the, portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station,
If the portable power source cir pump is dedicated to inuitiple party stations, an evaluation of all the pump stations'
storage capacities and the rotation schedule of .the piiirtable power source or pump, including travel nineframes, shall be
provided in the case of a multiple station power outage,
FORM: ETA 04-16 l'a!!e 1 of 5.

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(i)):
I . Does the project comply with all separations found in 15A NCAC 02T .03 ,) &
✓ 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems:
Setback Parameter*
Storm sewers and other utilities not listed below {vertical)
Water mains (vertical -water over sewer including in benched trenches
Water mains (horizontal)
Reclaimed water lines (vertical - reclaimed over sewer)
Reclaimed water lines (horizontal - reclaimed over sewer)
Separation Required
24 inches
18 inches
10 feet
18 inches
**Any private or public water supply source, including any wells, WS-I waters of Class 1 or
Class II impounded reservoirs used as a source of drinking water
**Waters classified WS (except WS-1 or WS-V), B, SA, ORW, HOW, or SB from normal
high water (or tide elevation) and wetlands (see item IX.2)
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches.
Any building foundation
Any basement
Top slope of embanktnent or cuts of 2 feet or more vertical hei
Drainage systems and interceptor drains
Any swimming pools
Final earth grade (vertical)
15A NCAC
2 feet
l00 fie
50 feet
10 feet
5 feet
10 feet
5 feet
10 feet
36 inches
0305 ` contains alternatives where separations in 02TM305(f) cannot be achieved.
• **Stream classifications can be identified using the Division's NC Surface Water Classifications wehpage
✓ if noncompliance with 02T.03050) or (g), see Section X of this application
No
Does the project comply with separation requirements for wetlands? (50 feet of separation) 0 Yes D No ® N/A
r See the Division's draft separation requirements for situations where separation cannot be meet
• No variance is required if the alternative design criteria specified is utilized in design and construction
• As built documents should reference the location of areas effected
Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? fl Yes fl No
✓ This would include Trout Buffered Streams per 15A_NCAC 2B.0202
4. Does the project require coverage/authorization under a 404 Nationwide or
individual permits or 401 Water Quality Certifications?
• information can be obtained from the 401 & Buffer Permitting Br4nch
©Yes I"`INo
N/A
Does project comply with 15A NCAC 02T.0I05(c)(6) (additional permits./certifications)? ® Yes © No
Per 15A NCAC 021'„0105(c)(6), directly related environmental permit's or certification applications are being prepared, have
been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?°'
Per 15A NCAC 02T,0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer,
© Yes D No l N/A
h line, including type (aerial
If yes, include an attachment with details fo
High priority lines shall be inspected by the
inspections documented per I5A NCAC 02T.040
ater"al, and location),
mittee or its representative at least once every
)(5) or the permitee's individual. System -Wide Coll
-months and
ion permit.
FORM: F'TA 04-16 Page 4 of 5

CERTIFICATIONS:
1. Does the submitted system comply with 15A NC'AC 02F, the Manirr.ur11 Design Criteria for the Pennitting of Pump Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteria ('latest version) as applicable?'
Yes No
If No, complete and submit the Variance/AlternativeDesign Request application (VADC 10-14) and supporting documents
for review. Approval of the request is required prior to submittal of the Fast Track Application and supporting
documents.
Professional Engineer's Certification:
a
(Professional Engineers name from Application
attest that this application for
has been reviewed by me and is accurate. complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. i further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track
Permitting of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain.
portions of this submittal package, inclusion of these materials under my signature and seal signifies that 1 have reviewed this
material and have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and. 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $1.0,000, as well as civil penalties up to $25,000 per violation.
North Carolina Professional Engineer's seal, signature, and date:
Applicant's Certification per 15A NCAC 02T .0106(b):
I, Cf YSTAC._©-_P_dn+lG
Et.,) t7i a o?°A�E,Akr_y_L364.Aon N,�C ._, attes
(Signature Authori(y"s name d title from Application Item 1.3.)
hat thi
pplication for
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. I understand that any discharge of wastewater from this non -
discharge system t© surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a
condition of this permit be violated. I also understand that if all required parts of this application package are not completed
and that if all required supporting information and attachments are not included, this application package will be returned to
me as incomplete.
NOTE — In accordance with General Statutes I43-215.6A and i43-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package 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.
Signat
Date:
FORM IaTA 04-16
Page 5 of 5

State of North Carolina
Department of EriNironmental Quality
Division of Water Resources
Fla TrackingiAccepta .e for v 'r Extension Applications
(FTSE 04-16)
Entity Requesting, Allocationtnion County
Project Name for WhiCh flOW is being requested: S,S.. Ext. to serve Potter Road Farm,
Adore than one FTSE fluty be requirei for a single project if the :Ivnerot the WHITT) is not respimsiblefiff puny)
stations along the route of the proposed wastewater flow
Complete this section only if you are the owner (,)fthe wastewater treatment plant.
a. WWTP Facility Name; Twelve Mile Creek WWTP
b. 1i Permit NC0085359
Ailjimvs are in MGD
c. WWLI) facility's permitted flow 6.0* Does not include
Ni({) diversion to 6 N/lile
d. Estimated obligated flow not yet tributary to the WW-IP 1.6665
e. W \VP facility's actual avg. flow 3.74
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. _Percent of permitted flow used
0,0008
5..4073
90.12
11. Complete this section tOI each pump station you are responsible for along the route of this
proposed wastewater flow.
List pump stations located between the project connection point and the W \VIP:
(A) (H) (( ) (D)—(B+( ) (E)—(A-D)
Design Obligated,
Pump Average Daily Approx, Not Yet Total Current
Station Firm Flow** Current Avg„ Tributary Flow Plus
(Name or Capacity, '' (Firm I pft„ Daily How, Daily Flow, 0 b I igated Available
Number) l',4GD MG D M G D MG[) Flow Capacity***
NIA
,
" The Firm Capacity of any pump station is defincd as the maximum pumped flow that
can be achieved with the largest pump taken out of service.
" Design Average Daily How is the firm capacity of the pump station divided by a peaking
factor (pf) not less than 2.5.
"*. A Planning Assessment .Addend UM shall he attached for each pump station located
between the project connection point and the WWTP W here the Available Capacity is < O.
Downstream Facility Name (Sewer): Twelve Mile Creek WWTP
Downstream Permit Number: WQ0006421
Page 1 of 6
FTSE 04-16

III. Certification Statement:
I Crystal O. Panico certify to the best of my knowledge that the addition of
the volume of wastewater to be permitted in this project has been evaluated along the route to the
receiving wastewater treatment facility and that the flow from this project is not anticipated to
cause any capacity related sanitary sewer overflows or overburden any downstream pump station
en route to the receiving treatment plant under normal circumstances, given the implementation of
the planned improvements identified in the planning assessment where applicable. This analysis
has been performed in accordance with local established policies and procedures using the best
available data. This certification applies to those items listed above in Sections I and II plus all
attached planning assessment addendums for which I am the responsible party. Signature of this
form indicates acceptance of this wastewater flow.
At" .� 9 20isi
Si ing Of cial Signature Dat
Page 2 of 6
FTSE 04-16

A
2013 Van Buren Ave., Suite A
Indian Trail, NC 28079
[phone]
wwww,eagIe©nline.net
A PORTION OF USGS TOPOGRAPHIC MAP
SCALE: 1 "=500
JOB NAME: SEWER EXTENSION FOR POTTER RC FARM
CLIENT: RD. HARREL C.O. LOCATION POTTER ROAD
JOB NUMBER: 6085
INDIAN TRAIL, NC

EXHIBIT "A"
SANITARY SEWER EXTENSION
LOCATED IN
INOIAN TRAIL, UNION COUNTY, NORTH CAROLINA
PARCEL NUMBER: 07132010E
THIS l4A" MAY NOT BE A CERTIFIED SURVEY
AND HAS NOT BEEN REVIEWED BYA LOCAL
GOVERNMENTAL AGENCY FOR COMPLIANCE
WITH ANY APPLICABLE LAND DEVELOPMENT
REGULATIONS AND HAS NOT BEEN REVIEWED
FOR COMPLIANCE WITH RECORDING
'EQUIREMENTS FOR PLATS(G.S. 47-30(n))
„Si�"�'tr�.�u•t= '. qM'. , , , � s as,4,iwivn. , ,

POTTER ROAD FARM, LLC PROJECT
Project Narrative
The proposed project is connection of an existing office building to the public sanitary sewer
system. Proposed sanitary sewer extension is designed to convey 100% domestic sanitary
sewer from proposed development to an existing Union County Public Works 8" sanitary sewer
main running toward Twelve Mile Creek WWTP.
Flow is calculated as follows:
30 Employees at 25 Gallons per Day
30 X 25 = 750
Total Proposed Ro 750 GPD

42
Union County Public Works
500 North Main Street
Suite 400
Monroe. NC 28112
T, 704-296-4210
www.unioncountync.gov
Transmittal
NC Departrraent of Bawl' onrrrental Quality
Division of Water
source
Mooresville tegiona
610 East Center. Avenue
Mooresv(/e, N.r . 28115
Attention
Regarding: Sanitary Sewer fo serve Potter Road Earrrr, k_L.0
We are sending you:
Copies
Date No,
Copy of fetter
Pans
Cover Letter
Date. September 20, 2018
Prints
Shop Drawings
Description
9/20118 Fast Track Application
9120/'18
9/20/18
2 356
are transmitted and checked below:
For approval
Remarks:
Signed:.
Received
Copy of Fast Track Applicati
USGS .Topa Map
Street Level Map
Flow Tracking Form
$480,00 Check (Apptoc
For your
use
As requester
Peter VV. Brown
Date:
Other
Far review and comment