WQ0019635_Application_20200302

State of north Carolina
DWR
Department of Environmental duality
Division of Water Resources
SINGLE: -FAMILY RFSIDENCE WASTEWATER IRRIGATION SYSTEM RENEWAL
Division of Water Resources FORM: SFRWWIS-R 09-18
This form is for renewal without modification for single -fancily residence wastewater irrigation system permits.
Fin more mfurnantion, visit the Water Quality Pernrlttrnrry S'ectiun',c :1'rin-l�rsCls(ttgt Branch
PERMIT INFORMATION:
I Permit No.: WQ0019635
'_. Permittee: Michael and Jamie Odle (),e., deeded property owners)
_. Signature authority's name: Michael and JanlieOdle (i.e., deeded property owner or legal representative) t I5A
A I tlb},h>]
RECEIVED/NCDE9./DWR
4. Physical address of residence with treatmenirrigation system: 5835 Wilkins Dr —
City: Durham State: NC Zip: 27705 County: ®range MAC 0 202a
5 Permittee's mailing address (if different from above);
City: State: _ Zip: Non -Discharge
6. Perncittee's contact information.
permitting Unit
Primary Contact, Phone number: t N81 I Primary ctmail address:
Secondary Contact:.__ Phone number: dj)yY��/k79 Secondary email address
7. Has the treatment/irrigation system been installed? ® Yes or ❑ No
Applicant's Certification per 15A NCAC 02T ,0106tb:
i"i;cA�-Gut-,t i : e 091'C -, attest that this rrnes.°al application h.,, been reviewed by me, and is
accurate and complete to the best of my knowledge. I understand "hat any unauthorized discharge o?'saastewater from this non -discharge
system to surface waters or the land may result in an enforcement action that may include civil henaltivs injunctive relief, and,'or criminal
prosecution. 1 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 are not completed, this applica.ion may be returned to the as incomplete. [ further
certify that the Applicant or any parent, subsidiary, or other affiliate of the Applicant has not been convicted of an environmental crime,
has not abandoned a wastewater facility without proper closure, does not have an outstanding civil 17cnalty where all appeals have been
exhausted or abandoned, ar • ei,,a ctive compliance schedule, and does not have any overdue annual fees.
Signature: T Date: __. _ O- S �v20
THE COMPLETED APPLICATION SttALL BE SUBMITTED TO:
By U.S. Postal Service: 1]► Courier: 131, Email:
Non -Discharge Branch Non -Discharge Branch —Archdale 942VV
1617 Mail Service Center 512 N. Salisbury St.
Raleigh, NC 27699-1617 Raleigh, NC 27604
TELEPHONE NUMBER: [phone]
FORM: SFRWWIS-R 09-19 Page 1 of 1

2 MAR 20L0 State of North Carolina
DWR Dcl)artntent of* Environmental QualitN
Non -P1gc,hargz:, Division of Water Resources
blvlslonofWnterRenoLrces�8l°ID'.JJJ Wt�j` jt �111.Y H:SIUENCF:11'AS`rF:W�iT[:ItIRRI(;AT'IQtiSY'S"fE t
OPERATION ,AND MAINTENANCE AGREEMENT
FORM: 1k HAMS -O&M 09-18
Permit NO, NVQ0019635
Prrnrittec.liciia�l,ant_1_altic,Ckilc(i.c.,all deeded properlyowners)
County: Oranee
`]'lie Pennittee agrees to operate and maintain the single-family residence wastewater treatment and irrigation system as
fol loll s:
1, inspect the septic tank annually, and pump out solids as needed.
'. Inspect and clean the septic tank effluent filter annually. (rfapplic:c,ble)
lncpect the tablet chlorinator weekly. Add wastewater grade chlorine tablets (e.g., calcium hypochlorite) as needed.
tiwinmiiing pool grade chlorine tablets are not acceptable_ Qlapplicable)
J, Inspect the ultraviolet disinfection unit weekly. Clean or replace the lamps and quartz sleeves as needed. (if
crpplic'able)
5. Inspect all storage tanks, pumps, and alarms monthly. Remnvc the floating scam layer in all pump/storage tanks
when putnpint, the septic tank solids out.
6. Inspect the spray irrigation system monthly to verify: proper operation of the spray heads; that there are no leaks;
that vegetative growth does not obstruct the spray heads; that the irrigated wastewater is not ponding in or running
off the designated irrigation area; and that there are no objectionable odors. t. J'applic able)
7. Inspect the drip irrigation system monthly to verify: proper operation of the drip lines. that there are no leaks: that
vegetative growth does not obstruct the drip emitters; that the irrigated A, astewaier is no; pending in or running off
the designated irrigation area; and that there are no obiectionable odors. (►f'(TP11Cahle )
8. Maintain a set of Division -approved engineering plans and specifications,
9. Pay the required annual fee.
10, Request renewal of this Permit on Division -approved forms no later than I8t1 day s prior to expiration.
11. Sign and provide a Change of Oij`nership application to any future owner of the single -faro ily residence wastewater
treatment and irrigation system for their completion and submission to the Division of (hater Resources.
We understand the above requirements aid a ree to these terms as part of the issued permit -
Signature: _ _ _ Datc: ;2-92 —a0Z0
Signature: �� _ Date: � I —zo;—o
Signature: _ Date,
Signature: Date:
I All deeded ,ro eriN owners shall sign this O ieration and Maintenance A Lreement
i
j FORM: SFRWWlS-O&M 09-18
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