WQ0038371_Regional Office Historical File Pre 2018

Water Resources
ENVIRONMENTAL QUALITY
Ms. Crystal Panico, New Development
Union County Public Works
500 N. Main Street, Suite 400
Monroe, NC 28112
Dear Ms. Panico:
A`T MCCRORY
Governor
DONALD R. VAN DER VAART
Secretary
S. JAY ZIMMERMAN
Director
April 1, 2016
Program Manager
Subject: Permit No. WQ0038371
Union County Public Works
Dhulab Medical Offices
Wastewater Collection System Extension Permit
Union County
In accordance with your application received March 23, 2016, we are forwarding herewith Permit No.
WQ0038371 dated April 1, 2016, to 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effective from the date of issuance until rescinded and shall be subject to the conditions and limitations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 11.1: This permit shall not be 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.
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 1508 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.
State of North Carolina I Environmental Quality I Water Resources I Water Quality Regional Operations
Mooresville Regional Office' 610 East Center Avenue, Suite 301 I Mooresville, North Carolina 28115
704 663 1699

if you need additional information concerning this matter, please contact Barry Love at [phone]
or via e-mail at [e-mail].
bvNLCorey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional C]fhoe
Division ofWater Resources, N[DE[l
cc: Todd Michael Born, P.E.(e-cum)
Regional Office Files
Water Resources Central Files
Page 2 of 8

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
Union County Public Works
Union County
for the construction and operation of approximately 381.04 linear feet of 8-inch gravity sewer, to serve 2
medical office buildings as part of the Dhulab Medical Offices project, and the discharge of 2000 gallons
per day of collected domestic wastewater into the Union County Public Works existing sewerage system,
pursuant to the application received March 23, 2016, 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
co •iti•ns`nd imitations contained therein.
byW. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional Office
Division of Water Resources, NCDEQ
Permit Number: WQ0038371
Permit Issued: April 1, 2016
Page 3of8

SUPPLEMENT TO PERMIT COVER SHEET
Union County Public Works is hereby authorized to:
Construct, and then operate upon certification the aforementioned wastewater collection extension. The
sewage and wastewater collected by this system shall be treated in the Union County Twelve Mite Creek
Wastewater Treatment Plant in accordance with Permit Number NC0085359.
Permitting of this project does not constitute an acceptance of any part of the project that does not meet
15A NCAC 2T; the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996, as
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 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.
Construction and operation is contingent upon compliance with the Standard Conditions and any Special
Conditions identified below.
SPECIAL CONDITIONS
No flow in excess of the quantity permitted herein, 2000 gallons per day, 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.0304(b)]
II. STANDARD CONDITIONS
1. 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 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. [15A NCAC 02T.0104; G.S 143-2151(d3)]
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'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 materials unless specifically mentioned herein. [15A NCAC 02T.0110j
This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data. [15A NCAC 02T .0110]
4, 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: [15A NCAC 02T .0108(b)]:
Page 4 of 8

ppP
a. The sewer system shall be effectively maintained and operated at all times to prevent discharge
to land or surface waters, and to prevent any contravention of groundwater standards or surface
water standards.
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 are
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 (i) 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,
following the occurrence or first knowledge of the occurrence of either of the following:
Page 5 of 8

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].
Persons reporting any of the above occurrences shall file a spill report by completing and submitting
Part I 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 11 of Form CS-SSO (or the most current Division approved
form) can also be completed to show that the SSO was beyond control. [G.S. 143-215.1C(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 waters of the State. [15A NCAC 02T.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 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,
If the permit is issued to a private entity with an Operational Agreement, then a copy of the Articles
of incorporation, Declarations/Covenants/Restrictions, and Bylaws that have been appropriately
filed 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 be 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. One copy of the supporting applicable design calculations including pipe and pump sizing,
velocity, pump 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 pump stations' storage
capacities and the rotation schedule of the portable power source or pump, include travel
timeframes, shall be provided.
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.
Page 6 of 8

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% or greater, increased flow,
pump station design capacity design increases of 5% or greater, and increases in the number/type 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 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 027.0105(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)1
12. 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 the Division any other Federal, State, or
Local government agencies which have jurisdiction or obtaining other permits which may be
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 SE
PER&NRT6E:
9ER&M|T#:
PROJECT:
ISSUE DATE:
ERENGINEERING CERTIFICATION
Union County Public Works
VVQ0038372
Dhu|abMedical Offices
April 1,Z016
This projectshaUnotbeconoWeredc0mpletenora|lowedtuVperatelnaccmrdancevvithConditioo7of
this permit until the Division has received this Certification and all required supporting documentation. It
should besubmitted inamanner that documents the Division's receipt. Send the required documentation
the Regional Supervisor, Water Quality Regional Operations Section at the address at the bottom,
Any wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Certification shall be considered o violation of the permit and shall subject the Perrnittee to
appropriate enforcement actions, The Perrni\tee is responsible for tracking all partial certifications up
until a final certification is received. A Final Certification shall be a complete set ofrecord drawings and
design calculations regardless nfwhether partials have been submitted.
PERM[rrEE'S[ERT»F|CAr|ON
Lthe undersigned agpntfnrthePennktee,herebvsta0uthotthisprojecthasboenromstnuctedpursuant
to the applicable standards& requirements, the Professional Engineer be|nm/ has provided applicable
design/construction information tothe Permi|ten, and the Pemnitteeisprepared tnoperate &maintain
the wastewater collection system permitted herein o/portions thereof.
Printed Name, Title
Signature Date
ENGINEER'S CERTIFICATION
L _ __ , as a duly registered Professional E r in the State of North Carolina,
having been authorized to observe (__ periodically, | \ weekly, � full time) the construction of the
project name and location as referenced above for the above 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 15/\ NCa[0IT; the
Division of Water Resources' (Division) Gravity Sewer K8iuinoom Design Criteria adopted February 12,
1996,asapplicable; the Division's Minimum Design Criteria for the Fast -Track Permitting nfPump Stations
and Force Mains adopted June 1, 2000, as applicable; and other supporting materials.
North Carolina Professional Engineer's Seal w/signature & date:
nFina|
Partial (include description
Certification Comments/Qualifiers ifnecmssamA-
otat"ormurthcar^luim|cn~rQ"m*matguuty|Wmtermes"wces Iwater Qu6no^oioualumeTatio"
wW"sVillem°*o=uOffice |mnFast Center ^.ei=.Suite s`,|Mooresville, North Carolina ze'0

e
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD Application Number:
(to be completed by DWR)
tQwnerlPQrnnittee:-�._�
1a. Union County Public Works
Full Legal Name (company, municipality, HOA, utility, etc.)
stal Panico, PE, New Develo went Pro ram Manager
Signing Official Name and Title (Please review 15A NCAC 2T . 106 (b
- lc. The legal entity who will own this system is:
Individual 0 Federal 0 Municipality
Q ld. 500 N. Main. Street, Suite 400
LL Mailing Address
Z
North Carolina
uthorized signing officials
State/County 0 Private Partnership 0
State
1 h, [phone] 'ti. [phone]
Telephone Facsimile
2. Proiect (Facility) Information:
2a. Dhulab Medical Offices _
0.. Brief Project Name (permit witl refer to Phis name)
3. Contact Person:
3a. Crystal Panico, PE
Name and Affiliation of
3b
[phone]
Phone Number
le. Monroe
City
28112.
Zip Code
c stai.panico
E-mail
2b. Union
orporation 0 0
unioncountvnc.rlov
County Where Project i
ho Can Answer Questions About this Application
3c. crystal.panico@unio
Project is New 0 Modification
an e
ing permi
E-mail
Modification, Permit No.:
ountyrt .s ov
Owner iPublic (skip to Item 8(3)
0 Private (go to Item 2(e))
If private, applicant will be.
Retaining Ownership (i.e. store, church, single office, etc.) o
0 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
2b. If sold, facilities owned by a (must choos
one)
0 Public Utility (Instruction D)
0 Homeowner Assoc,/Developer (Instruction E)
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
4a Tweivemile Wastewater Treatment Plant �_ ... 4b. NC0085359359 u�
Name of WWTF
5a, Union County Public Works 5b. 8
Owner of Downstream Sewer Receiving
6. The origin of this wastewater is (check all
0 Residential Subdivision
0 Apartments/Condominiums
• Mobile Home Park
0 School
O Restaurant
Office I
Gravity
Sewer Size 10 Force Main
that apply)-
0 Retail (Stores, shopping centers)
0 Institution
0 Hospital
0 Church
0 Nursing Home
0 Other (specify):
WWTF Permit No.
5c. WQ0020132
Permit # of Downstream
Instruction F)
100% Domestic/Commercial
% Industrial
(Attach Description)
° Other
(Attach_ Desch
Volume of wastewater to be allocated or permitted for this particular project 2,000 gallons per day
*Do not include future flows or previously permitted allocations
If the permitted flow is zero, indicate why:
0 Pump Station, Outfall or Interceptor Line where flow will be permitted in subsequent permits that connect to this line
0' Flow has already been allocated in Permit No,
0 Rehabilitation or replacement of existing sewer with no new flow expected
(see 15A NCAC 02T .0303 to determine if a permit is required)
FTA f)-14 APPLICATION Page 4of 6

9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2T .0114 for
the value in Item B(7) AND/OR the design flow for tine or pump station sizing if a reduced or zero flow is being requested in
Item B(7). Values other than that in 15A NCAC 2T .0114 (b) and (c) must be supported with actual water or wastewater use
data in accordance with 15A NCAC 2T .0114 (f).
(2) Buildings with (4) practitioners & (1) shift per building x 250 GPD per practitioner per shift = 2,000 GPD.
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches)
Length (feet)
New Gravity or Additional
Force Main
8
381.04
New Gravity
!
W
M
Z
,, '11. Summary of Pump Stations wl associated Force Mains to be Permitted (attach additional sheets as necessary)
Z
0 Pump Station Location ID: (self chosen - as shown on plans/map for reference)
0
Longitude: Latitude:
Z
0
Q
2
Design Flow
(MGD)
Operational Point
GPM grim2
Power Reliability Option
1 - permanent generator w/ATS;
- portable generator w/MTS
.
Force Main Size
Force Main Length
re
0
I.L.
?
PumpStation Location ID: (self chosen - as shown on plans/map for reference)
Longitude: Latitude: '
le
IJ.I
O.
•
m
Design Flow
(MGD)
GPM @TDH Operational Point
Power Reliability Option
1 - permanent generator w1ATS;
2 - portable generator w/MTS
Force Main Size
Force Main Length
12. Will the wastewater flow in the proposed sewer lines or pump stations be able to be directed to another treatment facility?
• Yes ® No If Yes, permit number of 2nd treatment facility :
(RO — if "yes" to B,12 please contact the Central Office PERCS Unit)
13. Does the sewer system comply with the Minimum Design Criteria for the Permitting of Pump Stations and Force Mains
(latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC Chapter 2T as applicable?
If No, complete and submit the VariancelAlternative
►rl Yes
Design
■ No
Request (VADC 10-14) application and supporting
documents for review. Approval of the request is required prior to submittal of the Fast Track Application and
supporting documents. .
FTA 10-14 APPLICATION
PaaeS of 6

14: Have the following permits/certifications been submitted for approval for the system or project to be served?
Wetland/Stream Crossings - General Permit or 401 Certification? ❑ Yes ❑ No ® NIA
Sedimentation and Erosion Control Plan? ® Yes ❑ No 0 NIA
Trout Buffer Waiver? ❑ Yes ❑ No ® N/A
Stormwater? ® Yes 0 No 0 N/A
15. Does this project include any high priority lines (15A NCAC 02T .0402 (2)) involve aerial lines, siphons, or interference
manholes)? These Tines will be considered high priority and must be checked once every six months
Check if Yes: ❑ and provide details:
C. CERTIFICATIONS
1. Owner/Permittee's Certification: (Signature of Signing Official and Project Name)
1, Crystal Panico, attest that this application for Dhulab Medical Offices has been
reviewed by me and is accurate and
application are not completed and that
application package is subject to being
143-215.6A and 143-215.68, any
complete to the best of my knowledge. I understand that if all required parts of this
if all required supporting documentation and attachments are not included, this
returned as incomplete. Note: In accordance with North Carolina General Statutes
person who knowingly makes any false statement, representation, or certification
Class 2 misdemeanor, which may include a fine not to exceed $10,000 as well
violation.
in any application shall be guilty of a
as civil penalties up to $25,000 per
1a. 763/Iio//(p
Sig n Offi 1 Signature Date
ENGINEERING DESIGN DOCUMENTS MUST BE COMPLETED PRIOR
APPLICATION. THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE
TO OTHER UTILITIES, DESIGN CALCULATIONS, ETC. REFER
TO SUBMITTAL OF THIS
OF SEWERS, THEIR PROXIMITY
TO 15A NCAC 02T .0305
2. Professional Engineers Certification: (Signature of Design Engineer and Project
1, Todd Born ,attest that this application for Dhulab Medical Offices has been
Name)
reviewed by me and is accurate,
and all other supporting
knowledge the proposed design has
Design Criteria for Gravity Sewers
Permitting of Pump Stations and Force
Division guidance. Although other
inclusion of these materials under my
it to be consistent with the proposed
any person who knowingly makes
complete and consistent with the information
documentation to the best of my knowledge.
been prepared in accordance with the applicable
adopted February 12, 1996, and the Minimum
Mains adopted June 1, 2000 and the watershed
professionals may have developed certain portions
signature and seal signifies that 1 have reviewed
design. Note: In accordance with NC General
any false statement, representation, or certification
include a tine not to exceed $10,000 as well as
in the engineering plans, calculations,
I further attest that to the best of my
regulations, Gravity Sewer Minimum
Design Criteria for.the Fast -Track
classification in accordance with
of this submittal package,
this material and have judged
Statutes 143-215.6A and 143-215.68
in any application shall be guilty of a Class 2 misdemeanor which may
civil penalties up to $25,000 per violation.
2a. Todd Michael Born
oµ1sUffB
�.• �40,
�N4
42P 40
SEAL E
= i 35009
. • �T!-
NO
�% s�j„~HGi... it 1 �16
',,''+��irm � + `' p�`
NC PE Seal, Signature & Date
Professional Engineer Name
2b. Site & Structure, p.c.
Engineering Firm`
2c. 4719 Mortonhall Road
Mailing Address
2d. Charlotte
e. NC f. 28215
City
State Zip
2g. [phone] h. NIA ,2i. [e-mail]
Telephone J Facsimile E-mail
FTA 10-14 APPLICATION
Page of6

Dhulab Site
March 11, 2016
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March 11, 201E
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State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 08-13)
Project Applicant Name: Union County
Project Name for which flow is being requested: Dhu.lab Medical Offices
More than one FTSE ,no; be required for
stations along the route of the proposed was kwat t° 1ot�?
if"the owner of°the fiFT,P i.s not responsible for all pump
I. Complete this section only if you are the owner of the wastewater treatment plant..
a. WWTP Facility Name: Twelve Mile WWTP
b. WWTP Facility Pertnit : k: NC0085359
c. WWTP facility's permitted .flow
4li flows are in MGD
6.0
d. Estimated obligated flow not yet tributary to the WWTP 1.7172
e. WWTP facility's actual avg. flow
4,08
:f. Total flow for this specific request 0.0020
g. Total actual and obligated flows to the, facility 5.7992
h. Percent of permitted flow used 96.65
Complete this section for 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 WWTP:
(A)
Design
Pump Average Daily
Station Firm Flow**
(Name or Capacity,* (Firm ? pf).
Number) MGD MGD
02.887
(B)
Approx.
Current Avg.
Daily Flow,
MGD
0.763
(C) (D)=(B+C) (E)=(A-I))
Obligated,
Not Yet Total Current
Tributary Flaw Plus
Daily Flow., Obligated Available
MGD Flow Capacity***
0.1841
0.9471
0.2079
* The Firm Capacity of any pump station is defined as the maximum pumped flow that
can be achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm, capacity of the pump station divided by a peaking
factor (pf) not less than 2.5.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the .Available Capacity is < {1.
Page 1,
FTSE 08-13

rIII. Certif cation 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.
arhe &.,. (Pd.44,;(A9
Signii(g Oftici 1 Signature
,3if(0//6.
Date
Page 2 of 3
FTSE 08-13

FTSE PLANNING ASSESSMENT ADDENDUM (PAA)
Submit a planning assessment addendum for each pump station listed in Section II where Available
Capacity is < 0.
Pump Station (Name or Number):
Given that:
a. The proportion and amount of Obligated, Not Yet Tributary Daily Flow (C) accounts for
% and MGD of the Available Capacity (E) in Pump Station
and that
b. The rate of activation of this obligated, not yet tributary capacity is currently approximately
MGD per year; and that
c. A funded Capital Project that will provide the required planned capacity, namely
is in design or under construction with
planned completion in ; and/or
d. The following applies:
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification
to allow this flow to be permitted, without a significant likelihood of over -allocating capacity in
the system infrastructure.
I understand that this does not relieve the collection system owner from complying with G.S.
143-215.67(a) which prohibits the introduction of any waste in excess of the capacity of the
waste disposal system.
Signing Official Signature Date
Page 3 of,3
FTSE 08-13

SITE &
STRUCTURE P.C.
Engineering • Design • Project Management
March "11, 2016 LTR-S15002-002
Crystal Panico, PE
Union County Public Works New Development Program Manager
500 N. Main Street, Suite 400
Monroe, NC 28112
Ms, Panico:
Subject: Cover Letter for Sanitary Sewer Main Extension
Project Name: Dhulab Medical Offices
Indian Trail -Fairview Road
Indian Trail, NC 28079
The purpose of this letter is to provide a brief project narrative for the sanitary sewer
main extension for the project listed in the subject heading above. The project consists
of an approximate 380-foot gravity sanitary sewer main extension to serve (2) new
medical office buildings. The gravity sanitary sewer main extension will be constructed
with 8-inch diameter SDR 35 pipe and will include installing (4) new precast concrete
manholes. The development will create 2,€ 00 Gallons Per Day of new wastewater flow.
We request the approval of the proposed plans by Union County Public Works and
NCDENR Division of Water Resources and a notice to construct be issued. Thank you
for your consideration and if you have any questions please don't hesitate to call.
Best regards,
Todd M. Born, P.E.
4719 Mortonhali Road • Charlotte, NC
Phone: [phone] • Fax: [phone]
Email [e-mail]

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
Mooresville, N.C. 28115
Attention:
Regarding: Sanitary Sewer to serve Dhulab Medical Offices
We are sending you: 0 Copy of letter El Plans
Other
Date No. Description
over Letter
Fast Track Application
TRANSMITTAL
Date: 3/16/16
Prints 0 Shop Drawings
Copy of Fast Track Application
Flow Tracking Form
$480,00 Check (Application Fee
These are transmitted as checked below:
For approval 0 For your use 0 As requested 0 For review and comments
Remarks:
Signed:
Received by: Date:

Central Files: APS _ SWP
4/1/2016
Permit Number WQ0038371 Permit Tracking Slip
Program Category Status Project Type
Non -discharge Active New Project
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
Primary Reviewer
barry.love
Coastal SWRuIe
Permitted Flow
2,000
Facility
Version Permit Classification
1.00 Individual
Permit Contact Affiliation
Facility Name
Dhulab Medical Offices
Location Address
Owner
MajorlMinor Region
Minor Mooresville
County
Union
Facility Contact Affiliation
Owner Name
Union County
DateslEvents
Owner Type
Government - County
Owner Affiliation
Cindy Coto
500 N Main St
Monroe
NC 28112
Orig Issue
4/1/2016
App Received Draft Initiated
3/23/2016
Scheduled
Issuance Public Notice Issue Effective Expiration
4/1/2016 4/1/2016
Regulated Activities Requested !Received Events
Office
Wastewater collection
Outfall
Additional information requested
Additional information received
Waterbody Name
Streamindex Number Current Class Subbasin

Water Resources
Environmental Quality
February 16, 2017
Ms. Crystal Panico, New Development Program Manager
Union County Public Works
500 N. Main Street, Suite 400
Monroe, NC 28112
SUBJECT: Final Engineering Certification Acknowledgement
Project: Dhulab Medical Offices
Permit No. WQ0038371
Permittee: Union County Public Works
County: Union
Dear Ms. Panico:
�
r
f
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. JAY ZIMMERMAN
Director
The Division of Water Resource's Mooresville Regional Office received the final engineering
certification with record drawings for the subject sewer extension project on February 15, 2017.
Enclosed is a certification page for your records. A full review of the certification materials may
or may not be conducted. It is assumed that receipt of this certification indicates compliance with
all regulations, design criteria and the permit. However, if a full technical review is conducted,
you will be notified of any items of non-compliance.
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 such copy from your consultant, please contact
them immediately to obtain a copy.
Lastly, 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 or your company, please complete Form PNOCF
since the permit is not automatically transferable. Form PNOCF can be downloaded from
http://portal.ncdenr.orglweb/wg/swp/ps/es/pnoc from the Collection, Systems Applications page.
Should you have any questions, please do not hesitate to contact me at [phone].
Sincerely,
Barry Love
Environmental Specialist
cc: Mr. Todd M. Born, P.E., (Site & Structure, p.c., 4719 Mortonhall Road, Charlotte, NC 28215)
Central Files
— Nothing Compares—.
State of North Carolina I Environmental Quality 1 Water Resources 1 Water Quality Regional Operations
Mooresville Regional Office 1610 East Center Avenue. Suite 3011 Mooresville, North Carolina 28115
704-663-1699

FAST TRACI( SEWER ENGINE N(4 CERTIFICATION
PERMITTU : union County Public Works
f'CRM1711: WQ0038371
R UIt C`t; Dhulab tv edIcal Offices
ISSUE DATE,: April 1, 2016
This proj
err
the Re
sltiered complete nor allowed to operate ita accrrlar ce with Condition 7 of
Division has received this Certification and all required supporting documentation. It
in a manner that documents the Division s receipt. Send the required documentation
Water Quality Regtonal Operations Section ,at the address at the bottom.
Any wastewater flow made tributary to tare to astewater' coliectiorl system extension prior to compl
of this Certification shall be considered a via latirTrt rrf tine perlaait and slaail sttltjec;t the ferrnittee to
appropriate enforcement actions, The Permittee 1s hesponsii)ie for tracking all lraatiei ertlficatitns rtp
until a final certification is received, A Final Certification shall be a complete set o�
design alculalions regardless of whether partials have been submitted,
TTIFICAT€ON
I, the rind ersigt)erl agent for the Permittee, hereby state that this paoject has been constructed pursuant
to the applicable standards & requirements, the Professional Engineer below has provided applicable
design/construction infortrration to the Permittee, and the Permittee is prepared to operate & maintain
t permitted freit`t or portirans thereof,
N IN €9S CERTIFICM O
Nott'h Carolina,
having bd to observe �periaydically, ! weekly, frtil titaae) tf e construction of the
project name anri faction as referenced above for the above Perm i tree 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 he built within substantial compliance of this permit; 15A NCAC 02T; the
Division of Water Resources' (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 Mnlns adopted June 1, 2000, as applicable; and other supporting materials,
North Cat
(44.•,M, as a rioi register d Professitart
e
L=rnginee's Seal w/signature & date:
de description)
Comments/Quafiflersattach if necessary).
SarrenS'NoishC.'aroiieaV6Yar an;eurnlQiniray{r,VaierRnouates1WierQuality Iltgi©nalopelmions
".arr.Pssi4�� Rc lasol1 Ofl:cel,bl{iEly Cenler rlvknue, Soilc 101 11,1coreiville. h:orkh Carolina ,Z61 15
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