HomeMy WebLinkAboutNC0021423_Authorization to Construct_20181002MBD CONSULTING ENGINEERS, P.A.
October 2, 2018
NCDEQ
Division of Water Resources/NPDES
512 North Salisbury Street, 9th Floor
Raleigh, NC 27604
RE: Spruce Pine WWTP Bar Screen Replacement
NPDES No. NCO021423
Application for Authorization to Construct
MBD Project No. 318016/300
To Whom It May Concern:
Enclosed please find the Application for Authorization to Construct for the Spruce Pine WWTP Bar
Screen Replacement project. The project includes the installation of an automatic influent screen to
replace the existing screen at the Spruce Pine WWTP. Construction is estimated to be approximately 10
days.
As a part of this submittal, we have included one hard copy and one digital copy (on CD) of the following
items:
• Cover Letter
• Completed Application
• NPDES Permit
• Engineering Plans
• Engineering Specifications
• Construction Sequence Plan
• Engineering Calculations
We appreciate your review of this project. If you have any questions or if additional information is required,
please contact this office.
Sincerely,
<;Z�)h W. McGougan, P.E.
President
MBD Consulting Engineers, P.A.
1300 Second Ave., Ste. 211 Conway, SC 29526 p. 843-488-0124 f. 843-488-0129
Water Resources
ENVIRONMENTAL QUALITY
14)
State of North Carolina
Department of Environmental Quality
Division of Water Resources
APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-
SECTION 1: INSTRUCTIONS AND INFORMATION
A. The Division of Water Resources will accept this application package for review only if all of the items are provided and the
application is complete. Failure to submit all of the required items will result in the application package being returned as incomplete
per 15A NCAC 02T .0105(b).
B. Plans and specifications must be prepared in accordance with 15 NCAC 02H. 0100 15A NCAC 02T, North Carolina General Statute
133-3, North Carolina General Statute 143-215.1, and Division of Water Resources Minimum Design Criteria for NPDES
Wastewater Treatment Facilities.
C. The plans and specifications submitted must represent a completed final design that is ready to advertise forbid.
D. Any content changes made to this Form ATC-12-14 shall result in the application package being returned.
E. The Applicant shall submit ONE ORIGINAL and ONE DIGITAL COPY (CD) of the application, all supporting documentation and
attachments. All information must be submitted bound or in a 3-ring binder, with a Section tab for each Section, except the
Engineering Plans.
F. Check the boxes below to indicate that the information is provided and the requirements are met.
G. If attachments are necessary for clarity or due to space limitations, such attachments are considered part of the application
package and must be numbered to correspond to the item referenced.
H. For any project that requires review under the State Environmental Policy Act (SEPA), an Authorization to Construct cannot be
issued prior to the completion of a State Clearinghouse advertisement period for a FONSI, EIS, etc. unless the project qualifies for
a Determination of Minor Construction Activity.
1. For more information, visit the Division of Water Resources web site at: http://aortal.ncdenr.orpJweb/wa/swp/ps/nr)des.
J. In addition to this Authorization to Construct, the Applicant should be aware that other permits may be required from other Sections
of the Division of Water Resources (for example: reclaimed water facilities permits; Class A or B biosolids residuals permit).
SECTION 2: APPLICANT INFORMATION AND PROJECT DESCRIPTION
A. APPLICANT
Applicant's name Town of Spruce Pine
Signature authority's name per 15A NCAC 02T .0106(b) Richard Canipe
Signature authority's title Town Manager
Complete mailing address PO Box 189, Spruce Pine, NC 28777
Telephone number 828-765-3000
Email address
B. PROFESSIONAL ENGINEER
Professional Engineer's name
Joseph W. McGougan, P.E.
President / Project Manager
Professional Engineer's title
North Carolina Professional Engineer's License No.
13755
Firm name
MBD Consulting Engineers, P.A.
Firm License number
C-644
Complete mailing address
1300 Second Avenue, Suite 211, Conway, SC 29526
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 1
Water Resources
ENVIRONMENTAL QUALITY
14)
C.
Telephone number
Email address
State of North Carolina
Department of Environmental Quality
Division of Water Resources
APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-
NPDES PERMIT
NPDES Permit number
Current Permitted flow (MGD) — include permit
flow phases if applicable
843-488-0124
jmcgougan@mbd-eng.com
NC 0021423
2.0 MGD
D. PROJECT DESCRIPTION
Provide a brief description of the project: The project includes the removal of the existing automatic bar screen and installation
Of a new step screen in the existing concrete channel.
SECTION 3: APPLICATION ITEMS REQUIRED FOR SUBMITTAL FOR ALL PROJECTS
A. Cover Letter
® The letter must include a request for the Authorization to Construct; the facility NPDES Number; a brief project description
that indicates whetherthe project is a new facility, facility modification, treatment process modification, orfacility expansion;
the construction timeline; and a list of all items and attachments included in the application package.
❑ If any of the requirements of 15_NCAC 02H. 0100 15A NCAC 02T, North Carolina General Statute 133-3. North Carolina
General Statute 143-215.1 and Division of Water Resources Minimum Desipn Criteria for NPDES Wastewater Treatment
Facilities are not met by the proposed design, the letter must include an itemized list of the requirements that are not met.
B. NPDES Permit
® Submit Part I of the Final NPDES permit for this facility that includes Part A (Effluent Limitations and Monitoring Requirements)
for the monthly average flow limit that corresponds to the work that is requested for this project.
C. Special Order by Consent
❑ If the facility is subject to any Special Orders by Consent (SOC), submit the applicable SOC.
® Not Applicable.
D. Finding of No Significant Impact or Record of Decision
❑ Submit a copy of the Finding of No Significant Impactor Record of Decision for this project.
❑ Provide a brief description of any of the mitigating factors or activities included in the approved Environmental Document
that impact any aspect of design of this project, if not specified in the Finding of No Significant Impact or Record of Decision.
® Not Applicable.
E. Engineering Plans
® Per 15A MAC 02T .05041c1(1). submit one set of detailed plans that have been signed, sealed and dated by a North Carolina
:ensed Professional Engineer.
Application for Authorization to Construct Permit (FORM ATC-12-14)
Page 2
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Water Resources
ENVIRONMENTAL QUALITY APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-
14)
® Per 1 NCAC 56.1103(a)(6), the name, address and License number of the Licensee's firm shall be included on each sheet of
the engineering drawings.
® Plans must be labeled as follows: FINAL DRAWING — FOR REVIEW PURPOSES ONLY— NOT RELEASED FOR CONSTRUCTION.
® 15A NCH _.d .0124 requires multiple (dual at a minimum) components such as pumps, chemical feed systems, aeration
equipment and disinfection equipment. Is this requirement met by the design? ❑ Yes or ❑ No. If no, provide an
explanation: _
Plans shall include:
❑ Plans for all applicable disciplines needed for bidding and construction of the proposed project (check as appropriate):
❑ Civil ® Not Applicable
®
Process Mechanical
❑ Not Applicable
❑
Structural
® Not Applicable
®
Electrical
❑ Not Applicable
®
Instrumentation/Controls
❑ Not Applicable
❑
Architectural
® Not Applicable
❑
Building Mechanical
® Not Applicable
❑
Building Plumbing
® Not Applicable
® Plan and profile views and associated details of all modified treatment units including piping, valves, and equipment (pumps,
blowers, mixers, diffusers, etc.)
® Are any modifications proposed that impact the hydraulic profile of the treatment facility? ❑ Yes or ® No. If yes, provide
a hydraulic profile drawing on one sheet that includes all impacted upstream and downstream units. The profile shall include
the top of wall elevations of each impacted treatment unit and the water surface elevations within each impacted treatment
unit for two flow conditions: (1) the NPDES permitted flow with all trains in service and (2) the peak hourly flow with one
treatment train removed from service.
® Are any modifications proposed that impact the process flow diagram or process flow schematic of the treatment facility?
❑ Yes or ®No. If yes, provide the process flow diagram or process flow schematic showing all modified flow paths including
aeration, recycle/return, wasting, and chemical feed, with the location of all monitoring and control instruments noted,
F. ❑ Engineering Specifications
® Per 15A NCAC 02T .0504[cl(2}, submit one set of specifications that have been signed, sealed and dated by a North Carolina
Licensed Professional En ie neer.
® Specifications must be labeled as follows: FINAL SPECIFICATIONS — FOR REVIEW PURPOSES ONLY — NOT RELEASED FOR
CONSTRUCTION.
Specifications shall include:
❑ Specifications for all applicable disciplines needed for bidding and construction of the proposed project (check as
appropriate):
❑ Civil ® Not Applicable
® Process Mechanical ❑ Not Applicable
❑ Structural ® Not Applicable
® Electrical ❑ Not Applicable
Application for Authorization to Construct Permit (FORM ATC-12-14)
Page 3
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Water Resources
ENVIRONMENTAL QUALITY APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-
14)
® Instrumentation/Controls ❑ Not Applicable
❑ Architectural ® Not Applicable
❑ Building Mechanical ® Not Applicable
❑ Building Plumbing ® Not Applicable
® Detailed specifications for all treatment units and processes including piping, valves, equipment (pumps, blowers, mixers,
diffusers, etc.), and instrumentation.
® Means of ensuring quality and integrity of the finished product including leakage testing requirements for structures and
pipelines, and performance testing requirements for equipment.
❑ Bid Form for publically bid projects.
G. Construction Sequence Plan
® Construction Sequence Plan such that construction activities will not result in overflows or bypasses to waters of the State.
The Plan must not imply that the Contractor is responsible for operation of treatment facilities. List the location of the
Construction Sequence Plan as in the Engineering Plans or in the Engineering Specifications or in both: _
H. Engineering Calculations
Per 15A NCAC azr .y5y41(c�( 1, submit one set of engineering calculations that have been signed, sealed and dated by a forth
^arolina Licensed Professional cn ;u, ; the seal, signature and date shall be placed on the cover sheet of the calculations.
For new or expanding facilities and for treatment process modifications that are included in Section 4.C, the calculations shall
include at a minimum:
❑ Demonstration of how peak hour design flow was determined with a justification of the selected peaking factor.
❑ Influent pollutant loading demonstrating how the design influent characteristics in Section 4.13.2 of this form were
determined.
❑ Pollutant loading for each treatment unit demonstrating how the design effluent concentrations in Section 4.13.2 of this form
were determined.
❑ Hydraulic loading for each treatment unit.
❑ Sizing criteria for each treatment unit and associated equipment (blowers, mixers, pumps, etc.)
❑ Total dynamic head (TDH) calculations and system curve analysis for each pump specified that is included in Section 4.C.6.
❑ Buoyancy calculations for all below grade structures.
❑ Supporting documentation that the specified auxiliary power source is capable of powering all essential treatment units.
I. Permits
❑ Provide the following information for each permit and/or certification required for this project:
Permit/Certification
Not
Applicable
Date
Submitted
Permit/ If Not Issued Provide
Date I Certification Status and Expected
Approved Number Issuance Date
Dam Safety
X
Soil Erosion and Sediment Control
X
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 4
Water Resources
ENVIRONMENTAL QUALITY
14)
J. Residuals Management Plan
State of North Carolina
Department of Environmental Quality
Division of Water Resources
APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-
® For all new facilities, expanding facilities, or modifications that result in a change to sludge production and/or sludge
processes, provide a Residuals Management Plan meeting the requirements of 4 NCAC 02T .0504Ii1 and .05M the Plan
must include:
❑ A detailed explanation as to how the generated residuals (including trash, sediment and grit) will be collected, handled,
processed, stored, treated, and disposed.
❑ An evaluation of the treatment facility's residuals storage requirements based upon the maximum anticipated residuals
production rate and ability to remove residuals.
❑ A permit for residuals utilization or a written commitment to the Applicant from a Permittee of a Department approved
residuals disposal/utilization program that has adequate permitted capacity to accept the residuals or has submitted a
residuals/utilization program application.
❑ If oil, grease, grit or screenings removal and collection is a designated unit process, a detailed explanation as to how the
oil/grease will be collected, handled, processed, stored and disposed.
® Not Applicable.
Application for Authorization to Construct Permit (FORM ATC-12-14)
Page 5
r;
Water Resources
ENVIRONMENTAL QUALITY
14)
State of North Carolina
Department of Environmental Quality
Division of Water Resources
APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-
SECTION 4: PROJECT INFORMATION
A. WASTEWATER TREATMENT PLANT FLOW INFORMATION — COMPLETE FOR NEW OR EXPANDING FACILITIES
1. Provide the followine flow information:
Plant Flows
Existing Plant Design MGD
Current NPDES Permit Limit MGD
Current Annual Average
(past 12 months)
Maximum Month
Maximum Day
Peak Hour
For Past 12 Months:
Start Date: month/yr
End Date. month/yr
MGD
MGD
MGD
MGD
For Past 24 Months:
Start Date: month/yr
End Date: month/yr
MGD
MGD
MGD
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 6
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Water Resources
ENVIRONMENTAL QUALITY APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-
14)
B. WASTEWATER TREATMENT FACILITY DESIGN INFORMATION — COMPLETE FOR NEW OR EXPANDING FACILITIES AND
FOR TREATMENT PROCESS MODIFICATIONS
1. Have all of the requirements of 15 NCAC 02H. 0100,15A NCAC 02T, North Carolina General Statute 133-3, North Carolina
General Statute 143-215.1, and Division of Water Resources Minimum Design Criteria for NPDES Wastewater Treatment
Facilities been met by the proposed design and specifications? ❑ Yes or [ No. If no, provide justification as to why the
requirements are not met, consistent with -,5A NCAC 02T .0105[ni:
2. Provide the design influent and effluent characteristics that are used as the basis for the project design, and the NPDES
permit limits for the following parameters:
Parameter
Design Influent
Influent
Concentration
Concentration -
(Must be
Current Annual
supported by
Average (past
Engineering
12 months) if
Calculations
Available
[Section 3.HI3
Project Basis of Design
Design Influent
Load
(Must be
supported by
Design Effluent
Engineering
Calculations Concentration and/or
[Section 3.H]) - Load
NPDES Permit Limits
(monthly average)
i
Ammonia Nitrogen
mg/L Summer
mg/LSummer
(NH3-N) mg/L
mg/L
lb/day
-
mg/L Winter
mg/L Winter
mg/L Summer
i
Biochemical
mg/L Summer
Oxygen Demand mg/L
mg/L
lb/day
(BOD5)
mg/L Winter
per 100 mL
mg/L Winter
per 100 mL
Fecal Coliform
Nitrate + Nitrite
Nitrogen (NO3-N +
mg/L
mg/L
NO2-N)
Total Kjeldahl
mg/L
Nitrogen
mg/L
mg/L
Total Nitrogen
Ib/year
lb/year
mg/L
mg/L
Total Phosphorus
mg/L
mg/L
lb/day
lb/year
lb/year
Total Suspended mg/L - I mg/L Ib/day mg/L mg/L
Solids (TSS) 1
3. Based on the "Project Basis of Design" parameters listed above, will the proposed design allow the treatment facility to
meet the NPDES Permit Limits listed above? ❑ Yes or ❑ No. If no, describe how and why the Permit Limits will not be
met:
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 7
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Water Resources
ENVIRONMENTAL QUALITY APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-
14)
4. Per 15A NCAC 02T.0505(i), by-pass and overflow lines are prohibited. Is this condition met by the design? ® Yes or ❑ No
If no, describe the treatment units bypassed, why this is necessary, and where the bypass discharges:
S. Per 15A NCAC 02T.0505(k), multiple pumps shall be provided wherever pumps are used. Is this condition met by the
design? ❑ Yes or El No. if no, provide an explanation: NIA
6. Per 15A NCAC 02T .0505(l), power reliability shall be provided consisting of automatically activated standby power supply
onsite capable of powering all essential treatment units under design conditions, or dual power supply shall be provided
per 15A NCAC 02H. 0124f21(a). Is this condition met by the design? ® Yes or ❑ No. If no, provide (as an attachment
to this Application) written approval from the Director that the facility:
➢ Hasa private water supply that automatically shuts off during power failures and does not contain elevated water
storage tanks, and
➢ Has sufficient storage capacity that no potential for overflow exists, and
➢ Can tolerate septic wastewater due to prolonged detention.
Per 15A NCAC 02T .0505io1, a minimum of 30 days of residual storage shall be provided. Is this condition met by the
design? p Yes or ❑ No. If no, explain the alternative design criteria proposed for this project in accordance
il2T.105(n): NIA
8. Per 15A NCAC 02T.0505(wr the public shall be prohibited from access to the wastewater treatment facilities. Explain how
the design complies with this requirement: N;/A
9. Is the treatment facility located within the 100-year flood plain? ® Yes or ❑ No. If yes, describe how the facility is
protected from the 100-year flood:
C. WASTEWATER TREATMENT UNIT AND MECHANICAL EQUIPMENT INFORMATION —COMPLETE FOR NEW OR
EXPANDING FACILITIES AND FOR MODIFIED TREATMENT UNITS
1. F
OREUMINARY AND PRIMARY
TREATMENT
(i.e., physical
removal operations and flow equalization):
Calculations
No. of
Plan Sheet
Specification
Treatment Unit
Units
Type
Size per Unit Reference
Reference
Provided?
Step Screen
(Yes or No)
Manual Bar Screen
MGD at peak hourly flow
11510
Mechanical Bar
1
5 MGD at peak hourly flow
G 4-7
Y
Screen
Grit Removal
MGD at peak hourly flow
Flow Equalization
_
gallons
Primary Clarifier
Circular
ft diameter, ft side
water depth
Primary Clarifier
Rectangular
square feet; ft side
water depth
Other
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 8
Water Resources
ENVIRONMENTAL QUALITY
14)
State of North Carolina
Department of Environmental Quality
Division of Water Resources
APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-
2. SECONDARY TREATMENT (BIOLOGICAL REACTORS AND CLARIFIERS) (i.e., biological and chemical processes to remove
orsanics and nutrients)
No. of
Plan Sheet
Specification
Calculations
Treatment Unit
Units
Type
Size per Unit Reference
Reference
Provided?
(Yes or No)
Aerobic Zones/
gallons
Tanks
Anoxic Zones/
gallons
Tanks
Anaerobic
gallons
Zones/Tanks
Sequencing Batch
gallons
Reactor(SBR)
Membrane
—
gallons
Bioreactor (MBR)
Secondary Clarifier
Circular
ft diameter; ft
Rectangular
side water depth
square feet; ft
Secondary Clarifier
side water depth
Other
3. TERTIARY TREATMENT
No. of
Plan Sheet
'Specification
Calculations
Treatment Unit
Units
Type
Size per Unit
Reference
Reference
provided?
(Yes or No)
Tertiary Clarifier
Circular
ft diameter; ft
side water depth
Tertiary Clarifier
Rectangular
square feet; ft
side water depth
square feet
Tertiary Filter
Tertiary Membrane
square feet
_ Filtration
Post -Treatment
—
gallons
Flow Equalization
Post -Aeration
gallons
Other
4. DISINFECTION
No. of Plan Sheet Specification Calculations
Treatment Unit Units Type Size per Unit Reference Reference Provided?
(Yes or No)
gal/day per bank at
Ultraviolet Light (Parallel; in peak hourly flow;
number of banks;
series)
number of lamps/bank
(Gas; gallons of contact
Chlorination tablet; liquid) tank/unit
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 9
Water Resources
ENVIRONMENTAL QUALITY
14)
State of North Carolina
Department of Environmental Quality
Division of Water Resources
APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-
Dechlorination I (Gas; I gallons of contact
tablet; liquid) J tank/unit
5. RESIDUALS TREATMENT
No. of
Plan Sheet
Specification
Calculations
Treatment Unit
Units
Type
Size per Unit
Reference
Reference
Provided?
(Yes or No)
square feet; ft side
Gravity Thickening
Tank
water depth
Mechanical
Thickening/
dry lb/hour
Dewatering
Aerobic Digestion
gallons
Anaerobic
gallons
Digestion
Composting
dry lb/hour
Drying
dry lb/hour
Other
6. PUMP SYSTEMS (include influent, intermediate, effluent, major recycles, waste sludge, thickened waste sludge and plant
drain oumosl
Location No. of
Pumps
Purpose Type
Capacity of
each pump
Plan Sheet
Reference
Specification
Reference
GPM
TDH
7. MIXERS
Location
No. of
Mixers
purpose
Power of
Type each Mixer plan Sheet Specification
Reference Reference
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 10
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Water Resources
ENVIRONMENTAL QUALITY APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-
14)
8. BLOWERS
No,
ersl off Capacity of plan Sheet 'Specification
Islow
Location I Purpose Type each Blower
Reference Reference
9. ODOR CONTROL
D. SETBACKS — COMPLETE FOR NEW WASTEWATER TREATMENT STRUCTURES
1. The minimum distance for each setback parameter to the wastewater treatment/storage units per 15A NCAC 02T .0506(f )
are as follows:
Is Minimum Distance
Minimum Distance
Requirement met by the
Required from Nearest
Setback Parameter Treatment/Storage
Design? If "No", identify
Unit
Setback Waivers in Item D.2
Below
Any habitable residence or place of assembly under separate
100 ft
❑Yes ❑ No
ownership or not to be maintained as part of the project site
Any private or public water supply source 100 ft
❑ Yes ❑ No
Surface waters (streams — intermittent and perennial, perennial
50 ft
❑ Yes
❑ No
waterbodies, and wetlands)
Any well with exception of monitoring wells
100 ft
❑ Yes
❑ No
Any property line
50 ft
0 Yes
❑ No
2. Have any setback waivers been obtained per 15A NCAC 02T .05061d)? ❑ Yes or ❑ No.
If yes, have these waivers been
written, notarized and signed by all parties involved and recorded with the County Register
of Deeds? ❑ Yes or ❑ No. If
no, provide an explanation:
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 11
Water Resources
ENVIRONMENTAL QUALITY
14)
State of North Carolina
Department of Environmental Quality
Division of Water Resources
APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-
SECTION 5: APPLICATION CERTIFICATION BY PROFESSIONAL ENGINEER
Professional Engineer's Certification per 15A NCAC 02T .0105:
I, Joseph W. McGougan, P.E. attest that this application package for an Authorization to Construct
(Typed Name of Professional Engineer)
for the Spruce Pine WWTP Barscreen Replacement _
(Facility and Project Name)
was prepared under my direct supervisory control and to the best of my knowledge is accurate, complete and consistent
with the information supplied in the engineering plans, specifications, calculations, and all other supporting
documentation for this project. I further attest that to the best of my knowledge the proposed design has been
prepared in accordance with all applicable regulations and statutes, 15 NCAC 02H. 0100. 15A NCAC 02T. North Carolina
General Statute 133-3, North Carolina General Statute 143-215.1, and Division of Water Resources Minimum Design
Criteria for NPDES Wastewater Treatment Facilities, and this Authorization to Construct Permit Application, except as
provided for and explained in Section 4.13.1 of this Application. I understand that the Division of Water Resources'
issuance of the Authorization to Construct Permit may be based solely upon this Certification and that the Division may
waive the technical review of the plans, specifications, calculations and other supporting documentation provided in this
application package. I further understand that the application package may be subject to a future audit by the Division.
Although certain portions of this submittal package may have been prepared, signed and sealed by other professionals
licensed in North Carolina, inclusion of these materials under my signature and seal signifies that I have reviewed the
materials and have determined that the materials are consistent with the project design.
I understand that in accordance with General Statutes 143-215.6A and 143-215.613, 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.
North Carolina Professional Engineer's seal with written signature placed over or adjacent to the seal and dated:
755
I„norrly��L g
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 12
State of North Carolina
NC
Department of Environmental Quality
Division of Water Resources
Water Resources
ENVIRONMENTAL QUALITY APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-
14)
SECTION 6: APPLICATION CERTIFICATION BY APPLICANT
Applicant's Certification per 15A NCAC 02T .0106(b):
I, Richard Canipe , attest that this application package for an Authorization to Construct
(Typed Name of Signature Authority and Title)
for the Spruce Pine WWTP Bar Screen Replacement
(Facility and Project Name)
has been reviewed by me and is accurate and complete to the best of my knowledge. 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. I further certify that in
accordance with 15A NCAC 02T.01201 b the Applicant or any affiliate has not been convicted of environmental crimes,
has not abandoned a wastewater facility without proper closure, does not have an outstanding civil penalty where all
appeals have been abandoned or exhausted, are compliant with any active compliance schedule, and does not have any
overdue annual fees.
I understand that the Division of Water Resources' issuance of the Authorization to Construct Permit may be based
solely upon acceptance of the Licensed Professional Engineer's Certification contained in Section S, and that the Division
may waive the technical review of the plans, specifications, calculations and other supporting documentation provided
in this application package. I further understand that the application package may be subject to a future audit.
i understand that in accordance with General Statutes 143-215.6A and 143-215.66 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.
Signature: _ `7�fi�.K..�e Date:
THE COMPLETED APPLICATION AND SUPPORTING INFORMATION SHALL BE SUBMITTED TO:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER RESOURCES/NPDES
By U.S. Postal Service
1617 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1617
By CourierlSpecial Delivery:
512 N. SALISBURY STREET, 9TH FLOOR
RALEIGH, NORTH CAROLINA 27604
TELEPHONE NUMBER: (919) 807-6396
Application for Authorization to Construct Permit (FORM ATC-12-14)
Page 13