WQ0044589_Permit (Issuance)_20230719

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, X.
Director
NORTH CAROLINA
Environmental Quality
July 21, 2023
Phillip Bowen, Facilities Management
Roanoke Chowan Community Health Center
120 Health Center Drive
Ahoskie, NC 27910
Subject: Permit No. WQ0044589
Roanoke Chowan Community Health Center
Roanoke- Chowan Community Health Center- Private
Wastewater Collection System Extension Permit
Bertie County
Dear Mr. Bowen:
In accordance with your application received June 21, 2023, and additional information received on July
19, 2023, we are forwarding herewith Permit No. WQ0044589, dated July 21, 2023, to Roanoke Chowan
Community Health Center (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rescinded and shall be subject to the conditions and limitations as specified therein.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 and
supplement shall be considered a part of this permit and are 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 IIA: 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.
Condition 11.7: 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. Permit
modifications are required for any changes resulting in non-compliance with this
permit, regulations, or the Minimum Design Criteria. [15A NCAC 02T.0116]
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.

Roanoke Chowan Community Health Center
Permit No. WQ0044589
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to
request an adjudicatory hearing upon written request within 30 days following receipt of this permit. This
request must be in the form of a written petition, conforming to Chapter 150B of North Carolina General
Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC
27699-6714. Unless such demands are made, this permit shall be final and binding.
If you need additional information concerning this matter, please contact Sarah Toppen at (252) 946-
6481 or via e-mail at [e-mail].
Sincerely,
ROW TOW."
for Richard E. Rogers, Jr.
Director, Division of Water Resources
by Robert Tankard, Assistant Regional Supervisor
Water Quality Regional Operations Section
Washington Regional Office
Division of Water Resources, NCDEQ
cc: Phillip Bowen, Facilities Management ([e-mail])
Nicholas Fitzgerald, PE ([e-mail])
Kevin Smith, Water/Wastewater Superintendent ([e-mail])
Laserfiche
Page 2 of 8

NORTH CAROLINA
Environmental Quality
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
Roanoke Chowan Community Health Center -Private
for the construction and operation of a 90—gallon per minute pump station (RCCHC) with duplex pumps,
on -site audible and visual high water alarms, telemetry, and a portable generator receptacle with
telemetry; as well as approximately 340 linear feet of 2-inch force main with grinder pump; to serve as
part of the Roanoke-Chowan Community Health Center -Private project (Medical Office), and the
discharge of 1,500 gallons per day of collected domestic and commercial wastewater into the Town of
Aulander's existing sewerage system, pursuant to the application received June 21, 2023, and additional
information received on July 19, 2023, and in conformity with the project plans, specifications, 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.
for Richard E. Rogers, Jr.
Director, Division of Water Resources
By Authority of The Environmental Management Commission
Permit Number: WQ0044589
Permit Issued: July 21, 2023
Treatment Facility: Town of Aulander Wastewater Treatment Facility (WQ0000777)
Page 3 of 8

The Permittee is hereby authorized to:
Construct, and then operate upon certification the aforementioned wastewater collection extension.
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.
I. SPECIAL CONDITIONS
This permit shall become voidable unless the agreement between Roanoke Chowan Community
Health Center and the Town of Aulander for the collection and final treatment of wastewater is in full
force and effect. [15A NCAC 02T.0304(b & g)]
2. No flow in excess of the quantity permitted herein, 1,500 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.0304(b)]
3. Each pump station shall be clearly and conspicuously posted using a weatherproof sign with a pump
station identifying name/number, 24-Hour Emergency telephone number, and name of the
owner/operator of the sewer system/pump station and instructions to call the number in the event
of alarm activation or other emergency. Simplex pump stations or vacuum sewer pits serving a single-
family residence may have a placard or sticker on the control panel in lieu of a sign. [15A NCAC 02T
.0305(h)(2)]
Page 4 of 8

II. STANDARD CONDITIONS
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. [15A NCAC 02T.0104; G.S. 143-215.1(d3)]
2. 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.0110]
3. 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 02T.0403. If an individual
permit is not required, the following performance criteria shall be met:
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 everyday (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
Page 5 of 8

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.
Right-of-ways and easements shall be maintained in the full easement width for personnel and
equipment accessibility.
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. Noncompliance Notification:
The Permittee shall report by telephone to a water resources staff member at the Washington
Regional Office, telephone number 252-946-6481, 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].
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.
Page 6 of 8

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:
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. 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 but not limited to pipe length changes 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 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 .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
Page 7 of 8

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 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)]
13. The Permittee shall provide for the pump station and force main the following items:
a. Pump Station Reliability [15A NCAC 02T .0305(h)(1)]:
1. Pump stations, except when exempted by Subparagraph (j)(2) of 15A NCAC 02T.0305,
shall be designed with multiple pumps such that peak flow can be pumped with the
largest pump out of service.
2. A standby power source or pump is required at all pump stations except for those pump
stations subject to Subparagraph (j)(2) of 15A NCAC 02T.0305. Controls shall be provided
to automatically activate the standby source and signal an alarm condition.
3. As an alternative to Part (c) for pump stations with an average daily design flow less than
15,000 gallons per day as calculated using 15A NCAC 02T.0114, a portable power source
or pumping capability may be utilized. It shall be demonstrated to the Division that the
portable source is owned or contracted by the permittee and is compatible with the
station. If the portable power source or pump is dedicated to multiple pump stations, an
evaluation of all the pump stations' storage capacities and the rotation schedule of the
portable power source or pump, including travel timeframes, shall be provided in the case
of a multiple station power outage.
4. As an alternative to Part (ii) for pump or vacuum stations connecting a single building to
an alternative sewer system, wet well storage requirements shall be documented to
provide 24-hours' worth of wastewater storage or, exceed the greatest power outage
over the last three years or the documented response time to replace a failed pump,
whichever is greater. Documentation shall be required pursuant to the permit
application.
b. All pump stations designed for two pumps or more shall have a telemetry system to provide
remote notification of a problem condition to include power failure and high water alarm. [15A
NCAC 02T .0305(h)(1)(E)]
c. High water audio and visual alarm. [15A NCAC 02T .0305(h)(1)(F)]
d. Pump stations shall have a permanent weatherproof sign stating the pump station identifier, 24-
hour emergency number and instructions to call in case of emergency. Simplex pump or vacuum
stations serving a single-family residence shall have a placard or sticker placed inside the control
panel with a 24-hour emergency contact number. [15A NCAC 02T .0305(h)(2)]
e. Screened vents for all wet wells. [15A NCAC 02T .0305(h)(3)]
f. The public shall be restricted access to the site and equipment. [15A NCAC 02T .0305(h)(4)]
g. Air relief valves shall be provided at all high points along force mains where the vertical distance
exceeds ten feet. [15A NCAC 02T .0305(h)(5)]
Page 8 of 8

ENGINEERING CERTIFICATION
Permittee: Roanoke Chowan Community Health Center Issue Date: July 21, 2023
Permit No: WQ0044589 County: Bertie
Project: Roanoke-Chowan Community Health Center- Private
This project shall not be considered complete nor allowed to operate in accordance with Condition 7 of this permit
until the Division has received this Certification and all required supporting documentation, which includes:
• 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.
Permit modifications are required for any changes resulting in non-compliance with this permit. A detailed
description for partial certifications should be attached to this form along with any certification comments.
Certification should be submitted in a manner that documents the Division's receipt. The Permittee is responsible
for tracking all partial certifications up until a final certification is received.
PERMITTEE'S CERTIFICATION
I, the undersigned agent for the Permittee, hereby state that this project has been constructed pursuant to the
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 Name, Title Signature Date
ENGINEERS CERTIFICATION
I, as a duly registered Professional Engineer in the State of North Carolina, having
been authorized to observe (❑ periodically, ❑ weekly, ❑ full time) the construction of the 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 following construction: a 90—gallon per minute pump station
(RCCHC) with duplex pumps, on -site audible and visual high water alarms, telemetry, and a portable
generator receptacle with telemetry; as well as approximately 340 linear feet of 2-inch force main with
grinder pump; to serve as part of the Roanoke-Chowan Community Health Center -Private project
(Medical Office), and the discharge of 1,500 gallons per day of collected domestic and commercial
wastewater into the Town of Aulander's existing sewerage system, and in conformity with the project plans,
specifications, supporting documents, and design criteria subsequently filed and approved. I certify that the
construction of the above referenced project was observed to be built within substantial compliance and intent of
the approved plans and specifications.
North Carolina Professional Engineer's Seal w/signature & date
❑ Final ❑ Partial (include description)
Send the Completed Form & Supporting Documentation to the Following Address:
DWR WATER QUALITY PERMITTING SECTION
WASTEWATER BRANCH — MUNICIPAL PERMITTING UNIT
1617 Mail Service Center
Raleigh, NC 27699