WQ0040107_Application (FTSE)_20180808

Central Files: APS SWP
6/22/2018
Permit Number WQ0040107
Permit Tracking Slip
Program Category
Status Project Type
Non -discharge
In review New Project
Permit Type
Version Permit Classification
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
A Individual
Primary Reviewer
Permit Contact Affiliation
dean.hunkele
Coastal SWRule
Permitted Flow
Facility
Facility Name
Major/Minor
Region
Wylie Branch Subdivision
Minor
Wilmington
Location Address
County
Pender
Facility Contact Affiliation
Owner
Owner Name
Owner Type
Pluris Hampstead LLC
Non -Government
Owner Affiliation
Maurice W. Gallarda
PE
2100 McKinney Ave
Dates/Events
Dallas
TX 75201

PARKER & ASSOCIATES, INC.
r r r r r
JACKSONVILLE, NORTH CAROLINA
TO: Mr. Dean Hunkele
NCDEQ - DWR
127 Cardinal Dr. Ext.
Wilmington, NC 28405-3 845
WE ARE SENDING YOU:
LETTER OF TRANSMITTAL
DATE: June 21, 2018
JUN 2 z z 0 d'
4!j
REF: Wylie Branch Subdivision
Pender County, NC
Fast Track Sewer Permit
One (1) original and one (1) copy of the Fast Track Application and Flow Tracking Form; One (1) letter from the NC
Public Utilities Commisian regarding the Application for Certificate of Public Convenience and Necessity;
One (1) check #38500 in the amount of $480.00 for the application fee; One (1) Sewer Narrative, One (1) Color
portion of the Mooretown &Scotts Hill USGS Maps, One (1) copy of the Subdivision Master Development Plan
(with street layout), and One (1) copy of the Overall Offsite Sewer Forceman Plan (Sheet 1 of 16).
DELIVERY VIA:
❑ Regular Mail ❑ Hand
FRI UPS Overnight C.] UPS Ground
THESE ARE TRANSMITTED AS CHECKED BELOW*
�x For Approval 0 As Requested
❑ For Your Use ❑ For Bids Due
❑ other
COMMENTS:
❑ Federal Express
❑ Other
❑ For Review and Comment
' . L A
Jonathan L. McDaniel,_ PE
Vice President
Copies To: Mr. Rand Hoffer - Pluris (w/enclosures)(email only).-
p y
AnthonyS des- A. S des Construction, Inc. (w/enclosures)(email only)
JLM/djh CF (P), LAM
(if enclosures are not as noted, kindly notify us at once)
306 New Bridge Stre t pp.00 Bo 97��,, II sonville, NC 28541-09761(910) 455-2414 Fax [phone]
k 1 VV i mn h 'I{racT�Sewer 'ermi� 8 �f
Secretary.0 1.Y M.Hun a e. y ranc . as
Firm License Number F-0108 I www.parkerjacksonville.com

WYLIE BRANCH
Sewer Narrative
June 2018
Wylie Branch is a 238 lot residential subdivision located near Hampstead in Pender
County. The 231 acre tract is located off of Island Creek Road (SR 1002) approximately 3/4
mile west from its intersection with NC Hwy 210. An unnamed tributary draining to Harrisons
Creek (C; SW) serves as the northeast most property line. The site is completely wooded, and
the existing topography is mostly in the level to moderate range (2 to 5% slopes). The upper
reach of the unnamed tributary to Harrisons Creek crosses the southern portion of the property.
Sewer for Wylie Branch will consist of gravity sewer mains and two (2) sewage pump
stations to be taken over by Pluris Hampstead, LLC upon completion and certification. Pump
station # 1 will serve as a regional type station for the area, and will pump 3 miles away to the
Pluris' WWTF in Hampstead. The forcemain from pump station # 1 will be 10" within the Wylie
Branch Subdivision up to Island Creek Road (SR 1002) where it will be 12" all the way to the
treatment plant. The 12" forcemain will cross within two separate properties, and rights of
easement have already been granted to Pluris. Pump Station #2 is located toward the back of
Wylie Branch Subdivision and serves the portion of the project not able to be served by gravity
sewer from pump station # 1. The 6" forcemain from pump station #2 pumps midway through
the project to the last manhole serving pump station #1. See attached USGS map (Mooretown
and Scotts Hill), and other submittal documents for additional information.
Secretary.0 ULM.Narrative. Stormwater. WylieBranch.7.6.17

} C. :
NORTH CAROLINA
PUBLIC STAFF
UTILITIES COMMISSION
June 19, 2018
Mr. Dan Higgins
Attorney at Law
Burns, Day and Preswell, P.A.
P.O. Box 10867
Raleigh, North Carolina 27605
Re: Pluris Hampstead LLC
Docket No. W-1305, Sub 8
Application for a Certificate of Public Convenience and Necessity -
Wylie Branch Subdivision-Pender County
TO WHOM IT MAY CONCERN:
The North Carolina Utilities Commission has received an Application for Certificate
of Public Convenience and Necessity filed by Pluris Hampstead LLC, to provide
wastewater utility service in Wylie Branch Subdivision in Pender County, North Carolina.
The Public Staff anticipates that approval will be granted upon investigation and review
of the submitted. application.
Please feel free to call if you have any questions or if I can be of further assistance.
Sincerely,
/s/William E. Grantmyre
Staff Attorney
william.grantm [e-mail]
WEG/sld
c: Chief Clerk
Freda Hilburn
David Furr
Executive Director
Communications Economic Research Legal
[phone]
[phone] [phone] [phone]
Accounting
Consumer Services Electric Natural Gas
[phone]
[phone] [phone] [phone]
4326 Mail Service Center - Raleigh, North Carolina 27699-4300 * Fax [phone]
An Equal Opportunity / Affirmative Action Employer
Transportation
[phone]
Water
[phone]

State of North Carolina
Department of Environmental Quality
DIN.R Division of Water Resources
15A NCAC 02T .0300 —FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 &SUPPORTING DOCUMENTATION
n
Application Number: 000 L(CJ ( OTI to be completed b DWR
pp ( p y )
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Pluris Hampstead, LLC (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual E Corporation El General Partnership ❑ Privately -Owned Public Utility
El Federal ❑ State/County ❑ Municipal El Other
3. Signature authority's name: Randy Hoffer per 15A NCAC 02T .0106(b)
Title: Project Manager
4. Applicant's mailing address: PO Box 856
City: Sneads Ferry State: NC Zip: 28460-
5. Applicant's contact information:
Phone number: [phone] Email Address: [e-mail]
II. PROJECT INFORMATION:
1. Project name: Wylie Branch
2. Application/Project status: Z Proposed (New Permit) ❑Existing Permit/Project
If a modification, provide the existing permit number: WQ00 and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Pender
"V"L
4. Approximate Coordinates (Decimal Degrees): Latitude: 34.3777° Longitude:-77.7828° JUN 22 2018
5. Parcel ID (if applicable): 3263-73-0614-0000
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Jonathan L. McDaniel License Number: 37928
Firm: Parker & Associates, Inc.
Mailing address: 306 New Bride Street
City: Jacksonville State: NC Zip: 28540-
Phone number: [phone] Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Hampstead WWTP Permit Number: WQ0037287
. Owner Name: Pluris Hampstead, LLC
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ
System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s):
FORM: FTA 04-16 Page 1 of 5

VI.
GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
E]Yes ❑No ®N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement FORM: DEV) been attached?
❑ Yes [-]No ®N/A
3. If the Applicant is a Home/Property Owners' Association, has an Operational Agreement FORM: HOA) been attached?
El Yes []No ®N/A
4. Origin of wastewater: (check all that apply):
Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wash
Residential Leased ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School / preschool / day care El Medical / dental / veterinary facilities ❑ Swimming Pool /Clubhouse
Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic/Commercial % Commercial
% Industrial (See 15A NCAC 02T .0103(20))
Is there a Pretreatment Program in effect? E I Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .0114(f)? E]Yes 0 No
➢ If yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow a,b
No. of Units
Flow
Single Family Residence
360 gal/unit
238
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
859680 GPD
a See 15A NCAC 02T .0114(b), (d , (e)(1) and (e)(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.01141 shall
be determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 85,680 GPD (per 15A NCAC 02T .0114)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
FORM: FTA 04-16 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8"
10623
PVC
10"
3621
PVC
➢ Section II & III of the NIDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name 1
2. Approximate Coordinates (Decimal Degrees): Latitude: 34.3803' Longitude:-77.7825'
3. Design flow of the pump station: 0.205 millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 375 gallons per minute at 49 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
10
1660
PVC
12
15327
PVC
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1):
Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(B)_
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.03 05(h)(1)(C)
or
Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(1)(C):
➢ 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 or pump is dedicated to multiple pump stations, an evaluation of all the pump stations'
..
capacitiesstorage an a a ro ion schedule o a portable power source or pump, me u ing travelime ames, shall e
provided in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8"
10623
PVC
10"
3621
PVC
➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or na
2. Approximate Coordinates (Decimal Degrees): Latitude: 34.39010 Longitude:-77.78590
3. Design flow of the pump station: 0.137 millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 240 gallons per minute at 38 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
6
1988
PVC
PVC
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1):
Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(B)_
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)(1)(C)
or
4 Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(1)(C):
➢ 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 or pump is dedicated to multiple pump stations, an evaluation of all the pump stations'
storage capacities and tine rotation schedule oir the portable power source or pump, including travel timeirTames, shall e
provided in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T .0305(D & (g)
➢ 15A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems:
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
24 inches
Water mains (vertical -water over sewer including. in benched trenches)
18 inches
Water mains (horizontal)
10 feet
Reclaimed water lines (vertical - reclaimed over sewer)
18 inches
Reclaimed water lines horizontal - reclaimed over sewer)
2 feet
**Any private or public water supply source, including any wells, WS-I waters of Class I or
Class II impounded reservoirs used as a source of drinking water
100 feet
**Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
high water (or tide elevation) and wetlands (see item IX.2)
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade (vertical)
36 inches
➢ 15A NCAC 02T.0305() contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
➢ If noncompliance with 02T.0305(fl or (g), see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) . 0 Yes El No
➢ 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
3. Does the project comply with all setbacks found in the river basin rules per 15A NCAC 02B .0200? Yes [—]No
➢ This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project comply with an individual 404 Permit or any 401 Certifications? Z Yes ❑ No
➢ Wetland -related permits shall be requested, obtained, and adhered to for projects that impact wetlands or surface waters
➢ Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)?
1R,62 0Q.'
Per 15A NCAC 02T.0105(c)(6), directly related environmental permits 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 Z No
➢ If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and
inspections documented per 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting 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/Alternative Design 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_
2. Professional Engineer's Certification:
I, _`T64ATHAn4 1. • M GDAN1 6 L.
(Professional Engineer's name from Application Item III.1.)
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 I 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 $10,000, as well as civil penalties up to $25,000 per violation.
.............................���.�.� �.# r........................
.....,
CA F16
North Carolina Professional Engineers seal, signature, and date. �.�� ... • •. �.�� A.,
37928co—op 0
lab
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......... ........................... ..............................
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, RANDY POP r- ER.,, r RE60JA L MAIVAC2 6 k attest that this application for
(Signature Authority's name &title from Application Item I.3.)
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 to 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 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 $10,000 as well as civil penalties up to $25,000 per violation.
Si
Date:
I 511F
FORM: FTA 04-16 Page 5 of 5

Hunkele, Dean
From: Jonathan McDaniel<[e-mail]>
Sent: Tuesday, August 7, 2018 9:41 PM
To: Hunkele, Dean
Cc: Randy Hoffer - Pluris LLC;[e-mail]
Subject: Re: [External] Re: Pending WQ0040107 Wylie Branch part 2
..... _ ...... .... _........... ..... ........ ....... ..... ... ...... ......... ... ....... _ _ _ . __ ....... ....... . _.......... ................... .
MENEM
OK, got it... the gravity listed was for the entire job. Yes, they both could be considered regional, but PS#1 is the main
regional station that could handle adjoining property not owned by Mr. Sydes (and potentially along Island Creek Road).
PS#1 gravity = 3,018 LF 8" and 1,878 LF 10" at 375 GPM for 72 lots (Wylie sub.) and 570 total
PS#2 gravity = 7,605 LF 8" and 1,743 LF 10" at 240 GPM for 166 lots (Wylie sub.) and 380 total
Please let me know if you need anything else.
Thank you,
Jonathan L. McDaniel, PE
Vice President
PARKER & ASSOCIATES, INC.
Engineers*Surveyors* Planners
306 New Bridge Street
Jacksonville, NC 28540
[phone]
Firm License Number - F0108
On 8/7/2018 5:03 PM, Hunkele, Dean wrote:
I have the separate pump station & FM pages, but the gravity listed is the same on both. I figured that
PS #1 is a regional station given and perhaps even #2 given their size. I like to permit them by pump
station, basin or phasing if lots of gravity --- X ft of gravity, Y-gpm station to serve Z lots, it's easier to
document certification locations.
Thus if you got that to send or can do it to send then I can get it finished tomorrow to await signature &
issuance. -
Environmental Specialist II
Water Quality Regional Operations Section
Division of Water Resources
1

State of North Carolina
Department of Environmental Quality
Division of Water Resources
_ Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Island Creek Develo ers,LLC
Project Name for which flow is being requested: Wylie Branch
More than one FTSE niaj) be required for• a single project if the of-mer of the WWTP is not responsible for all pump
stations along the route of the proposed wasteivater f1'ow
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Pluris Hampstead, LLC
b. WWTP Facility Permit #: WQ0037287
All. flows are in MGD
c. WWTP facility's permitted flow 0.250
d. Estimated obligated flow not yet tributary to the WWTP 0.060
e. WWTP facility's actual avg. flow 0.042
f. Total flow for this specific request 0.8568
g. Total actual and obligated flows to the facility 0.187
h. Percent of permitted flow used 74%
II. 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)
(B)
(C)
(D)=(B+C) (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 / pf),
Daily Flow,
Daily Flow,
Obligated Available
Number)
MGD MGD
MGD
MGD
Flow Capacity***
* 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 < o.
Downstream Facility Name (Sewer): P uris Hampstead, LLC
Downstream Permit Number: WQ0037324
Page 1 of 6

111. Certification Statement:
I Randy Hoffer, Regional Manager 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.
Signing Official Srgnat-um
to
Page 2 of 6
FrF S 04- l 6

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