WQ0040534_Application_20181218 (2)

Central Files: APS _ SWP _
12/18/2018
Permit Number WQ0040534
Program Category
Non -discharge
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
Primary Reviewer
ori.tuvia
Coastal SWRuIe
Permitted Flow
1,080
Facility
Facility Name
Crescent Street Sewer Extension
Location Address
Owner
Permit Tracking Slip
Status
Project Type
Active
New Project
Version
Permit Classification
1.00
Individual
Permit Contact Affiliation
Major/Minor Region
Minor Mooresville
County
Cabarrus
Facility Contact Affiliation
Owner Name Owner Type
City of Kannapolis Government - Municipal
Owner Affiliation
Wilmer Melton III
DIR PUBLIC WORKS
PO Box 1199
Dates/Events Kannapolis NC 28081119
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
12/18/2018 12/17/2018 12/18/2018 12/18/2018
Regulated Activities Requested /Received Events
Subdivision Additional information requested
Wastewater collection Additional information received
Outfall
Waterbody Name Streamindex Number Current Class Subbasin

KAN P S
Public Works
December 12, 2018
North Carolina Department of Environmental Quality
Mooresville Regional Office - Water Quality Section
610 East Center Avenue, Suite 301
Mooresville, North Carolina 28115
Re: Crescent Street Sewer Extension
Sewer Extension
City of Kannapolis — Cabarrus County
Dear Sir or Madam:
RECEIVED/NMENR/DWR
DEC 17 2018
WQROS
MOORESVILLE REGIONAL OFFICE
Please find attached for your review and approval the original and one copy of the permit
application, a digital copy (pdfs) on CD of the plans, along with the $480 processing fee for the
above referenced project. Also enclosed is the flow acceptance letter from the Water & Sewer
Authority of Cabarrus County stating they will accept and treat the additional wastewater at the
Rocky River Regional Wastewater Treatment Plant.
The proposed extension will connect to the existing Kannapolis sewer system which extends to
the WSACC Irish Buffalo Creek Interceptor. This wastewater collection system will serve the
proposed Shifa 1 Subdivision on Crescent Street.
The Water and Sewer Authority of Cabarrus County Standard Specifications for Wastewater
Collections Systems were approved by your office and are being maintained by the Division of
Environmental Management. This project will be installed in accordance with these Standard
Specifications.
Please call me at 704-920-4219 if you have any questions.
Sincerely,
14��> - `//
�pl�
MistY L. Tutt, PE
PUBLIC WORKS 401 LAUREATE WAY KANNAPOLIS, N.C. 28081
704-920-4200 WWW.KANNAPOLISNC,GOV

DWR:IWO_01'
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number:
(to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: City of Kannapolis (company, municipality, FICA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal
❑ Other
3. Signature authority's name: Wilmer Melton. III per 15A NCAC 02T .0106(b)
RECEIVEDINCDENRIDWR
Title: Director of Public Works
DEC 17 2018
4. Applicant's mailing address: 401 Laureate Wav
City: Kannapolis State: NC Zip: 28081-0005
WOROS
MOORESVILLE REGIONAL OFFICE
5. Applicant's contact information:
Phone number: [phone] Email Address: wmelton@kannapolisnc gov
1I. PROJECT INFORMATION:
1. Project name: Crescent Street Sewer Extension
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: W000_ and issued date: .
If new construction but part of a master plan, provide the existing permit number: W000
3. County where project is located: Cabarrus
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.464866' Longitude:-80.621115°
5. Parcel ID (if applicable): Within road WW at common comer of 5612-78-1188 and 5612-78-2101
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Jeffery D. Moody License Number: NC 13311
Firm: Alley, Williams. Carmen and King Inc
Mailing address: 120 S. Main Street
City: Kannapolis State: NC
Phone number: 704) 938-1515
Zip: 28081-
Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (W WTF) INFORMATION:
1. Facility Name: Rocky River Regional Wastewater Treatment Plant Permit Number: NCO036269
Owner Name: Water & Sewer Authority of Cabarrus County
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than W WTF):
PermitNumber(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?
❑ 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/Pro eeny Owners' Association. has an Operational Agreement (FORM HOA) been attached?
❑ 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 ❑ 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 0 % Commercial
0 % Industrial (See 15A NCAC 02T .0103(20))
"Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(fl? ❑ Yes ®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 '^
No. of Units
Flow
3-bedroom dwelling units
360 gal/day
3
1,080 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
1,080 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: 1 080 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
❑ Other (Explain):
FORM: FTA 04-16 Page 2 of 5

VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 &MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 237.97 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 name: N/A
2. Approximate Coordinates (Decimal Degrees): Latitude: 0Longitude: - °
3. Design flow of the pump station: millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): gallons per minute at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
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 15,006 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
❑ 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 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.
FORM: FTA 04-I6 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(0):
1. Does the project comply with all separations found in 15A NCAC 02T .0305(f) & (e)
➢ 15A NCAC 02T.0305( contains minimum separations that shall be provided for sewers stems:
® Yes ❑ No
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(e) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webnaee
➢ 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) ® Yes ❑ 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? ® 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 PermittingBranch
ranch
5. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)?
® Yes ❑ No
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 ® 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 Desien Criteria for the Permitting of Pump Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Desien 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:
name from Application Item III.1.)
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.
North Carolina Professional Engineer's seal, signature, and date: ,,wp(!k
3. Applicant's Certification per 15A NCAC 02T .0106(b):
that this application for
(Signature A'uthority'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.
Signature: �� Date:
FORM: FTA 04-16 Page 5 of 5

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Mr. Michael Legg
City Manager
City of Kannapolis
401 Laureate Way
Kannapolis, NC 28081
December 3, 2018
Subject: Flow Acceptance Request — City of Kannapolis
Crescent Street Sewer Extension
Dear Mr. Legg:
WATER & SEWER AUTHORITY
OF CABARRUS COUNTY
232 Davidson Hwy.
Concord, NC 28027
704.786.1783 ♦ 704.795.1564 Fax
www.wsacc.org
This is a notice of capacity for the flow acceptance request received by the Water and Sewer Authority of Cabarrus County
(WSACC) from the City of Kannapolis on November 21, 2018. WSACC has or will have capacity at the Rocky River
Regional Wastewater Treatment Plant and appropriate sewer interceptors to transport and treat the domestic wastewater from
the proposed project entitled Crescent Street Sewer Extension, located along Crescent Street. The referenced project will
serve three homes, with a projected wastewater flow of 1,080 gallons per day (gpd). The wastewater generated by this project
will be conveyed through a proposed gravity system, through the existing gravity system, and then enter WSACC's system at
the existing 48-inch Irish Buffalo Creek Interceptor. WSACC acknowledges it has or will have capacity for wastewater from
the proposed development based on information provided by Alley, Williams, Carmen, and King, Inc. (Civil Engineer for the
project) using North Carolina Department of Environmental Quality (NCDEQ) wastewater flow guidelines.
The WSACC Capital Improvement Program (CIP) has been on pay as you go since Fiscal Year 2005 — 2006, funding Capital
Projects entirely from Capital Reserves, and WSACC expects to continue this policy into the future. Projects on the CIP are
subject to approval by WSACC's Board of Directors, support from local governing bodies, regulatory approval, and funding
availability. The list and schedule of CIP projects are tentative and are revised periodically to reflect changing conditions and
needs.
If construction of this project does not commence within two (2) years of the date of this notice, the notice is rescinded and a
second request and notice will be required before flow capacity is accepted. Please notify WSACC, in writing, when
construction of this project is initiated. This sewer capacity allocation may also be cancelled pursuant to the conditions set
forth in the WSACC Sewer Allocation and Commitment Policy.
Please note that the final commitment to service to provide wastewater treabnent services shall occur upon application for
a building permit for the project and when system development fees are pair! pursuant to N.C.G.S §162A, Article 8.
If you have any questions, please call me at [phone], extension 104.
Sincerely,
J. Thomas al
Utility Systems Engineer
cc: Misty Lippard, PE/Kannapolis
Wilmer Melton/Kannapolis
Jeffery D. Moody, PE/Alley, Williams, Cannon, and King, Inc.
Michael Wilson/WSACC
Tim Kiser, PE/WSACC
Chad VonCannon, PE/WSACC
Mark Lomax/WSACC

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Applications
Divlslon of Water Resources (FTSE-04/16)
(WSACC USE ONLY) Crescent Street Sewer Extension
Section I. Name of wastewater treatment facility (W WTF) receiving wastewater:
® Rocky River Wastewater Treatment Facility — Permit #NC0036269
❑ Muddy Creek Wastewater Treatment Facility — Permit #NC0081621
WWTP facility's permitted flow, MGD 26.500
Estimated obligated flow not yet tributary to the WWTP MGD 2.809
WWTP facility's actual avg. daily flow, MGD 17.040 (64 30% of permit)
Total flow for this specific request MGD 0.001
Total actual and obligated flows to the facility, MGD 19.850
Percent of permitted flow used 74.91 %
Section II. Pump stations along the route from the Jurisdiction's connection point to the WWTP.
Pump Station
Finn Capacity *
(A)
Design Average Daily Flow •"
(B)
Approx. Current
(C)
Obligated, Not Yet
(D)—(B+C)
Total Current Flow
(E)—(A-D)
(Name or Number)
MGD
(FmrJpf)
Average Daily Flow
Tributary Daily Flow
Plus Obligated Flow
Available
Capacity***
MGD
MGD
MGD
MGD
MGD
RRRWWTP MPS
55.440
22.176
11.040
0.698
11.738
10.438
* 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 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 Available Capacity is <0.
Section III. WSACC Certification Statement:
I, J. Thomas Hahn. PE, 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 from the connection to the WSACC interceptor 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 Section I and Section II plus all attached planning
assessment addendums for which I am the responsible party. Signature of this form indicates WSACC's guarantee of
capacity for this wastewater flow. Notwithstanding the guarantee of capacity, WSACC does not make a commitment to
service this wastewater flow until a building permit is requested through the Cabarrus County Building Inspections
Department and WSACC receives payment of the System Development Fee.
's Signing Official Signature

WASTEWATER FLOW ACCEPTANCE FORM
FOR THE
WATER AND SEWER AUTHORITY OF CABARRUS COUNTY
Jurisdiction Requesting Flow Acceptance: Date: 11/19/2018
❑City of Concord ®City of Kannapolis ❑Town of Harrisburg ❑Town of Mt. Pleasant
❑Charlotte Mecklenburg Utilities
Project Title, Description, and Number of Lots/Unit:
Project Title: Crescent Street Sewer Extension
Description: The Crescent Street Sewer Extension engineering plans and specifications as prepared and sealed by Jeffery
D. Moody, NCPE, with Alley, Williams, Carmen and King Inc consist of the installation of approximately 237 97 linear
feet of r PVC SDR 35 Gravity flow sanitary sewer to serve 3 future residential dwelline units.
*Number of Lots: OR *Number of Units: 3 *Must be included in request.
Where will the new line be connected:
❑ Directly into a WSACC Interceptor
® Into the Jurisdiction's existing collection system
❑ Into a private line
Describe the location of the tie-in line to which the new sewer line will connect: The imposed 8-inch sanitary sewer
extension will tie-in to the existine 8-inch sanitary sewer line located on Crescent Street which extends to the 48-inch RCP
WSACC Irish Buffalo Creek Outfall.
Which WSACC Interceptor will the flow ultimately be discharged into: 48-inch RCP WSACC Irish Buffalo Creek
Outfall
What is the WSACC manhole number that the flow will be discharged into? Manhole No. 011173
What is the quantity of flow that will be discharged? 1,080 GPD
Flow type:
® Domestic 100 % ❑ Commercial % ❑ Industrial %
Name of wastewater treatment facility (W WTF) receiving wastewater:
® Rocky River Wastewater Treatment Facility — Permit #NC0036269
Muddy Creek Wastewater Treatment Facility — Permit #NC0081621
Design drawings of new lines will be submitted to WSACC with the request for acceptance. Drawings can be submitted as
a digital file (DWG) or distance and bearing starting with the tap on existing infrastructure.
If the new line is to connect directly into a WSACC interceptor, detailed drawings including specification of the tap, will
be required before flow acceptance will be provided. -
Mark Lomax at 704-786-1783, ext. 231, (must be notified 48 hours in advance of a connection into a WSACC interceptor.
WSACC will inspect connection before, during, and after completion.
/f construction is not started within two (2) year from the (late of approval of the flow acceptance for this project, the
approval is rescinded and a second request and approval ivill he required for the project.
WSACC USE ONLY:
DATE:
Current sewer model shows an Interceptor as being surcharged south of the manhole in question.
Approved ❑ Not Approved
Current Sewer Model shows:

DWRState of North Carolina
Department of Environment and Natural Resources
Division of Water Resources Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE—01/14)
(JURISDICTION USE ONLY)
Jurisdiction Requesting Flow Acceptance for Collection System:
❑City of Concord ®City of Kannapolis ❑Town of Harrisburg ❑Town of Mt. Pleasant
❑Charlotte Mecklenburg Utilities
Project Title, Description, and Number of Lots/Unit
Project Title: Crescent Street Sewer Extension
Description: The Crescent Street Sewer Extension engineering plans and specifications as prepared and sealed by Jeffery D.
Moody. NCPE. with Alley, Williams, Carmen and King_ Inc consist of the installation of approximately 237 97 linear feet of
8" PVC SDR 35 gravity flow sanitary sewer to serve 3 future residential dwelling units
What is the quantity of flow that will be discharged? 1,080 GPD
Flow type:
® Domestic 100 %n ❑ Commercial % ❑ Industrial %
Section I - List the Jurisdiction's pomp stations located between the project connection point and the WSACC
Interceptor connection point.
Pump Station
Finn Capacity *
(A)
Design Average Daily Flow **
(B)
Approx. Current
(C)
Obligated, Not Yet
(D) —(B+C)
Total Current Flow
(E)—(A-D)
(Name or Number)
NIGD
(Firm/pt)
Average Daily Flow
Tributary Daily Flow
Plus Obligated Flow
Available
Ca
NIGD
NIGD
NIGD
NIGD
P y***
acit
NIGD
*The Firm Capacity of any pump station is defined as the maximum pumped now that can be achieved with the largest pump taken out of service.
**Desiga Average Daily Flow is the firm capacity of the pump station divided by a peaking factor not less than 2.5.
***A Planning Assessment Addendum shall be attached for each pump station located between the project connection point and the W WTP where Available Capacity is <0.
Section II. Jurisdiction's Certification Statement:
I, Wilmer Melton, III, Director of Public Works, certify that, to the best of my knowledge, the addition of the volume
of wastewater to be permitted in this project has been evaluated along the route to the receiving WSACC interceptor; and the
flow from this project is not anticipated to cause any capacity related sanitary sewer overflows or overburden on any
downstream pump station in route to the receiving WSACC interceptor 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 Section I plus all attached planning assessment addendums for which, to the best of my knowledge, will not adversely affect
the downst ea wer capacity. Signature of this form indicates acceptance of this wastewater flow.
Jurisdiction's Signing Official Signature Date
Revision Date: 08/09/13