NCG551342_permit issuance_20060629

Michael R Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P-E. Director
Division of Water Quality
June 29, 2006
Mrs. Peggy K. Tyndall, Owner
410 Oakmont Drive
Morehead City, NC 28557
Subject: General Permit No. NCG550000
Certificate of Coverage NCG551342
1614 Clearwater Lake Road
Orange County
Dear Mrs. Tyndall:
In accordance with your application for discharge, the Division is forwarding herewith the subject Certificate of
Coverage to discharge under the subject state-NPDES general permit. This permit is issued pursuant to the
requirements of North Carolina General. Statue 143-215.1 and the Memorandum of Agreement between North
Carolina and the US Environmental Protection agency. dated May 9, 1994 (or as subsequently amended).
The following information is included with your permit package:
• A copy of the Certificate of Coverage for your treatment facility
■ A copy of General Wastewater Discharge Permit NCG550000
• A copy of a Technical Bulletin for General Wastewater Discharge Permit NCG550000
If any parts, measurement frequencies or sampling requirements contained in this general permit are unacceptable
to you, you have the right to request an individual permit by submitting an individual permit application. Unless
such demand is made, the certificate of coverage shall be final and binding.
Please take notice that this Certificate of Coverage is not transferable except after notice to the Division of Water
Quality. The Division of Water Quality may require modification or revocation and reissuance of the certificate
of coverage. This permit does not affect the legal requirements to obtain other permits which may be required by
the Division of Water Quality or permits required by the Division of Land Resources, Coastal Area Management
Act or any other Federal or Local governmental permit that may be required.
If you have any questions concerning this permit, please contact Agyeman Adu-Poku at telephone number
919/733-5083, extension 508.
Sincerely,
/"^?Al. W. Klimek, P.E.
cc: Central Files
NPDES General Permit Files
Raleigh Regional Office/Surface Water Protection
One
N Caro ina
turalil;
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh; NC 27699-1617 Phone [phone] Customer Service
Internet: www.ncwateraualitv.ora Location: 512 N. Salisbury St. Raleigh, NC 27604 Fax [phone]
An Equal Opportunity/Affirmative Action Employer-500% Recyded/10% Post Consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG551342
TO DISCHARGE DOMESTIC WASTEWATERS FROM SINGLE FAMILY RESIDENCES AND OTHER
DISCHARGES WITH SIMILAR CHARACTERISTICS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards
and . regulations promulgated and adopted by the North Carolina Environmental Management
Commission, and the Federal Water Pollution Control Act, as amended, the
Peggy K. Tyndall
is hereby authorized to operate a wastewater treatment facility that includes a septic tank, primary sand
filters, chlorine disinfection and associated appurtenances with the discharge of treated wastewater from
1614 Clearwater Lake Rd
Chapel Hill
Orange County
to receiving waters designated as unnamed tributary to Big Branch, classified WS-IV waters in the Cape Fear
River Basin in accordance with the effluent limitations, monitoring requirements, and other conditions set forth
in Parts I, II, III and IV hereof.
This certificate of coverage shall become effective June 29, 2006.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day June 29, 2006.
J, -
64
t7— Ian W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

Peggy K.
Tyndall
State Grid/Ouad:
D 22 SE Farrington, NC Permitted Flow:
360 GPD
Latitude:
35' 52' 05" N
Longitude:
79' 02' 22" W
Receiving Stream:
UT to Big Branch
Sub -Basin:
03-06-06
Drainage Basin:
Cape Fear River Basin
Stream Class:
WS-IV
Facility
Location
not to scale
NOY'tj2 NPDES Permit No. NCG551342
Orange Count

STATE OF NORTH CAROLINA
D EPA RTM EN T OF EN VI RON M EN T, HEALTH,AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG550000
TO DISCHARGE DOMESTIC WASTEWATERS FROM SINGLE FAMILY RESIDENCES
AND OTHERDOMESTIC DISCHARGESWITH SIMILAR CHARACTERISTICS
UNDERTHE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In comp Iiancewith the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission,
and the Federal Water Pollution Control Act, as amended, this permit is hereby issued to all owners or
operators, hereafter permittees, which are covered by this permit as evidenced by receipt of a Certificate
of Coverage by the Environmental Management Commission to allow the discharge of treated domestic
wastewater in accordance with the effluent limitations, monitoring requirements, and other conditions set
forth in Parts I, 11, III and IV hereof.
This permit shall become effective August 1, 2002.
This permit shall expireat midnight on July 31, 2007.
Original signed by Gregory J Thorpe Date: 05131102
Gregory J. Thorpe, Ph.D., Acting Director
Division of Water Quality
By Authority of the Environmental Management Commission

General Permit NCG550000
PART I
MONITORING, CONTROLS, AND LIMITATIONS FOR PERMITTED DISCHARGES
Page 1 of 12 Pages

General Permit NCG550000
A. EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS - FINAL
During the period beginning on the effective date of the permit and lasting until expiration, the Permittee is authorized to discharge domestic wastewaters from outfall 001.
Such discharges shall be limited and monitored by the Permittee as specified below:
EFFLUENT CHARACTERISTICS
LIMITS
MONITORING REQUIREMENTS
Monthly
Average
Weekly
Average
Daily
Maximum
Measurement
Frequency
Sample
Type
Sample
Location
Flow— see note 1
Annually
Estimate
Effluent
BOD, 5-Day, 20oC
30.0 mg/I
45.0 mg/I
Annually
Grab
Effluent
Total Suspended Residue
30.0 mg/I
45.0 mg/I
Annually
Grab
Effluent
Fecal Coliform (geometric mean)
200 / 100 ml
400 / 100 ml
Annually
Grab
Effluent
Total Residual Chlorine— see note 2
1
1
Annually
Grab
Effluent
1: The permitted flow of this facility may not in any case exceed 1000 gallons per day.
2: Facilities discharging into surface waters with the Trout Stream jr) supplemental classification shall provide a demonstrated alternate method of disinfection other than
chlorination, or provide dechlorination if chlorine disinfection must be used.
Treatment system requirements for existing (previously constructed) systems: a septic tank, sand filter and disinfection apparatus.
Treatment system requirements for new (not yet constructed) systems: a septic tank, primary & secondary (or recirculating) sand filters, disinfection and post -aeration apparatus.
The tablet chlorinator and dechlorinator, if applicable, shall be inspected weekly to ensure there is an adequate supply of tablets for continuous & proper operation.
The permittee must conduct and document the following maintenance activities:
• Septic tanks shall be maintained at all times to prevent seepage of sewage to the surface of the ground.
• Septic tanks will be checked at least yearly to determine if solids must be removed or if other maintenance is necessary.
• Septic tanks shall be pumped out within three to five years of the issuance date on the Certificate of Coverage.
• Contents removed from septic tanks shall be disposed at a location and in a manner compliant with all local and state regulations.
• Surface sand filters, disinfection apparatus and (if applicable) dechlorination apparatus shall be inspected weekly to confirm proper operation.
There shall be no discharge of floating solids or visible foam in other than trace amounts.
Page 2 of 12 Pages

General Permit NCG550000
PART
SECTION B. SCHEDULE OF COMPLIANCE
1. The permittee shall comply with Final Effluent Limitations by the effective date of the Certificate of Coverage.
2. Permittee shall at all times provide the operation and maintenance necessary to operate the existing facilities in
accordance with section II.C.2 of this permit.
SECTION C. APPLICABILITY
This permit is applicable to the following types of discharges:
1. Wastewater from single family residence treatment facilities at flows not exceeding 1000 gallons per day.
2. Wastewater from other similar domestic treatment facilities not exceeding 1000 gallons per day, as decided by the Division.
SECTION D. NOTICE OF INTENT
Individuals who intend to obtain coverage under this general permit, shall submit a Notice of Intent (NOI) applicable to this
general permit. A current version of the NOI for this general permit can be obtained by contacting the Stormwater and
General Permits Unit at 919/733-5083 or can be downloaded from the internet at:
hqp://h2o.enr.state.nc.us/su/stonnwater.html NOIs must be signed and submitted to the Stormwater and General
Permits Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617. Applicants who have submitted a completed NOI are not
authorized to discharge until a Certificate of Coverage is issued. In general, the NOI shall include the following information:
1. The mailing address and telephone number for the owner and/or operator.
2. The facility name, address and telephone number where the discharge will occur.
3. The permit number of any NPDES permit(s) for any discharge(s) from the site.
4. A description of the discharge, including the number of discharge points, the volume of discharge, the frequency of
discharge and any treatment methods applied prior to discharge.
5. The name of the receiving waters and the stream classification (if known).
6. An analysis of non -discharge alternatives, including connection to a regional sewer collection system, subsurface disposal
and spray irrigation.
7. A 7.5 minute series USGS topographic map with the discharge location clearly indicated.
8. Final plans and specifications for the treatment system and all major components (if applicable).
9. A certification that the information contained in the NOI is true, complete and accurate.
PART II
STANDARD CONDITIONS FOR NPDES PERMITS
SECTION A. DEFINITIONS
1. Permit Issuing Authority: The Director of the Division of Water Quality.
2. DWQ or Division: Division of Water Quality, Department of Environment, Health and Natural Resources.
3. EMC: North Carolina Environmental Management Commission.
4. Permittee: The entity who obtains coverage under this general permit by subsequent issuance of a "Certificate of
Coverage" by the Division of Water Quality.
Page 3 of 12 Pages

General Permit NCG550000
5. Act or "the Act": The Federal Water Pollution Control Act, also known as the Clean Water Act, as amended, 33 USC
1251, et. seq.
6. Concentration Measurements
a. Average Monthly Concentration: The sum of the concentrations of all daily discharges sampled and/or measured
during a calendar month on which daily discharges are sampled and measured, divided by the number of daily
discharges sampled and/or measured during such month (arithmetic mean of the daily concentration values). The
daily concentration value in the case of grab samples is the arithmetic mean (weighted by flow value) of all the
samples collected during that calendar day.
b. Average Monthly Concentration for Fecal Coliform: The geometric mean of the counts for samples collected during
a calendar month. This limitation is identified as "Monthly Average" in Part I of the permit.
b. Maximum Daily Concentration: The concentration of a pollutant discharge during a calendar day. If only one
sample is taken during any calendar day the concentration of pollutant calculated from it is the "Maximum Daily
Concentration". It is identified as "Daily Maximum" in Part I of the permit.
7. Other Measurements
Flow (MGD): The 24 hours average flow, averaged monthly. It is determined as the arithmetic mean of the total daily
flows recorded during the calendar month.
8. Grab Samples: Individual samples of at least 100 ml collected over a period of time not exceeding 15 minutes. Grab
samples can be collected manually.
9. Calculation of Means
a Arithmetic Mean: The summation of the individual values divided by the number of individual values.
b. Geometric Mean: The Nth root of the product of the individual values where N is equal to the number of individual
values. The geometric mean is equivalent to the antilog of the arithmetic mean of the logarithms of the individual
values. For purposes of calculating the geometric mean, values of zero (0) shall be considered to be one (1).
c. Weighted by Flow Value: The summation of each concentration times its respective flow divided by the summation
of the respective flows.
10. Calendar DU: The period from midnight of one day until midnight of the next day. However, for purposes of this
permit, any consecutive 24-hour period that reasonably represents the calendar day may be used for sampling.
11. Hazardous Substance: Any substance designated under 40 CFR Part 116 pursuant to Section 311 of the Clean Water
Act.
12. Toxic Pollutant: Any pollutant listed as toxic under Section 307(a)(1) of the Clean Water Act.
13. Bypass: The intentional diversion of waste streams from any portion of a treatment facility (including the collection
system). The permittee may allow any bypass to occur which does not cause effluent limitations to be exceeded, but only
if it also is for essential maintenance to assure efficient operation.
14. Severe property damage: Substantial physical damage to property, damage to the treatment facilities which causes them
to become inoperable, or substantial and permanent loss of natural resources which can reasonably be expected to occur
in the absence of a bypass. Severe property damage does not mean economic loss caused by delays in production.
15. Upset: An exceptional incident in which there is unintentional and temporary noncompliance with technology -based
permit effluent limitations because of factors beyond the reasonable control of the permittee. An upset does not include
noncompliance to the extent caused by operational error, improperly designed treatment facilities, inadequate treatment
facilities, lack of preventive maintenance, or careless or improper operation.
Page 4 of 12 Pages

General Permit NCG550000
SECTION B. GENERAL CONDITIONS
1. Duty to Comply
The permittee must comply with all conditions of this general permit. Any permit noncompliance constitutes a violation
of the Clean Water Act and is grounds for enforcement action; for permit termination, revocation and reissuance, or
modification; or denial of a permit upon renewal application.
a. The permittee shall comply with standards or prohibitions established under section 307(a) of the Clean Water Act
for toxic pollutants within the time provided in the regulations that establish these standards or prohibitions, even if
the permit has not yet been modified to incorporate the requirement.
b. The Clean Water Act provides that any person who violates section 301, 302, 306, 307, 308, 318 or 405 of the Act,
or any permit condition or limitation implementing any such sections in a permit issued under section 402, is subject
to a civil penalty not to exceed $27,500 per day for each violation. Any person who negligently violates such
sections, or any permit condition or limitation is subject to criminal penalties of $2,500 to $25,000 per day of
violation, or imprisonment for not more than 1 year, or both. In the case of a second or subsequent conviction for a
negligent violation, a person shall be subject to criminal penalties of not more than $50,000 per day of violation, or
by imprisonment of not more than 2 years, or both. Any person who knowingly violates such sections, or any permit
conditions or limitations is subject to criminal penalties of $5,000 to $50,000 per day of violation, or imprisonment
for not more than 3 years, or both. In the case of a second or subsequent conviction for a knowing violation, a
person shall be subject to criminal penalties of not more than $100,000 per day of violation, or imprisonment of not
more than 6 years, or both. Any person who knowingly violates such sections, or any permit conditions or
limitations, and who knows at that time that he thereby places another person in imminent danger of death or serious
bodily injury, shall , upon conviction, be subject to a fine of not more than $250,000 or imprisonment of not more
than 15 years, or both. In the case of a second or subsequent conviction for a knowing endangerment violation, a
person shall be subject to a fine of not more than $500,000 or by imprisonment of not more than 30 years, or both.
An organization (as defined in section 309 of the Clean Water Act) shall, upon conviction of violating the imminent
danger provision, be subject to a fine of not more than $1,000,000 and can be fined up to $2,000,000 for second or
subsequent convictions. Also, any person who violates a permit condition may be assessed an administrative penalty
not to exceed $11,000 per violation with the maximum amount not to exceed $137,500. [Ref: Section 309 of the
Federal Act 33 USC 1319 and 40 CFR 122.41(a).]
c. Under state law, a daily civil penalty of not more than twenty-five thousand dollars ($25,000) per violation may be assessed
against any person who violates or fails to act in accordance with the terms, conditions, or requirements of a permit. [Ref -
North Carolina General Statutes 143-215.6A]
d. Any person may be assessed an administrative penalty by the Director for violating section 301, 302, 306, 307, 308,
318, or 405 of the Act, or any permit condition or limitation implementing any of such sections in a permit issued
under section 402 of the Act. Administrative penalties for Class I violations are not to exceed $11,000 per violation,
with the maximum amount of any Class I penalty assessed not to exceed $27,500. Penalties for Class II violations
are not to exceed $11,000 per day for each day during which the violation continues, with the maximum amount of
any Class II penalty not to exceed $137,500.
2. Duty to Mitigate
The permittee shall take all reasonable steps to minimize or prevent any discharge in violation of this permit.
3. Civil and Criminal Liability
Except as provided in permit conditions on 'Bypassing" (Part II, CA.) and "Power Failures" (Part II, C.7.), nothing in
this permit shall be construed to relieve the permittee from any responsibilities, liabilities, or penalties for
noncompliance pursuant to NCGS 143-215.3, 143-215.6 or Section 309 of the Federal Act, 33 USC 1319. Furthermore,
the permittee is responsible for consequential damages, such as fish kills, even though the responsibility for effective
compliance may be temporarily suspended.
4. Oil and Hazardous Substance Liability
Nothing in this permit shall be construed to preclude the institution of any legal action or relieve the permittee from any
responsibilities, liabilities, or penalties to which the permittee is or may be subject to under NCGS 143-215.75 et seq. or
Section 311 of the Federal Act, 33 USG 1321. Furthermore, the permittee is responsible for consequential damages, such
as fish kills, even though the responsibility for effective compliance may be temporarily suspended.
Page 5 of 12 Pages

General Permit NCG550000
5. Property Rights
The issuance of this permit does not convey any property rights in either real or personal property, or any exclusive
privileges, nor does it authorize any injury to private property or any invasion of personal rights, nor any infringement of
Federal, State or local laws or regulations.
6. Onshore or Offshore Construction
This permit does not authorize or approve the construction of any onshore or offshore physical structures or facilities or
the undertaking of any work in any navigable waters.
7. Severability
The provisions of this permit are severable, and if any provision of this permit, or the application of any provision of this
permit to any circumstances, is held invalid, the application of such provision to other circumstances, and the remainder
of this permit, shall not be affected thereby.
8. Duty to Provide Information
The permittee shall furnish to the Permit Issuing Authority, within a reasonable time, any information which the Permit
Issuing Authority may request to determine whether cause exists for modifying, revoking and reissuing, or terminating
this permit or to determine compliance with this permit. The permittee shall also furnish to the Permit Issuing Authority
upon request, copies of records required to be kept by this permit.
9. Duty to Reapply
If the permittee wishes to continue an activity regulated by this permit after the expiration date of this permit, the
permittee must apply for and obtain a new permit.
10. Permit Termination
After public notice and opportunity for a hearing, the general permit and Certificates of Coverage issued under this
general permit may be terminated for cause.
11. When an Individual Permit may be Required
The Division may require any owner authorized to discharge under this permit to apply for and obtain an individual
permit. Cases where an individual permit may be required include, but are not limited to, the following:
a. The discharger is a significant contributor of pollution.
b. Conditions at the operating facility change altering the constituents and/or characteristics of the discharge such that
the discharge no longer qualifies for a General Permit.
c. The discharge violates the terms or conditions of this permit.
d. A change has occurred in the availability of demonstrated technology or practices for the control or abatement of
pollutants applicable to the point source.
e. Effluent limitation guidelines are promulgated for the point sources covered by this permit.
f. A water quality management plan containing requirements applicable to such point sources is approved after the
issuance of this permit.
This permit may be terminated as to an individual owner for any of the reasons set forth above after appropriate notice in
accordance with N.C.G.S. 143-215. 1.
12. When an Individual Permit may be Requested
Any permittee operating under this permit may request to be excluded from coverage by applying for an individual
permit. When an individual permit is issued, the applicability of this general permit is automatically terminated on the
effective date of the individual permit.
13. Si ng atory Requirements
All applications, reports, or information submitted to the Permit Issuing Authority shall be signed and certified.
a. All permit applications shall be signed as follows:
(1) For a corporation: by a responsible corporate officer. For the purpose of this Section, a responsible corporate
officer means: (a) a president, secretary, treasurer or vice president of the corporation in charge of a principal
business function, or any other person who performs similar policy or decision making functions for the
corporation, or (b) the manager of one or more manufacturing production or operating facilities employing more
Page 6 of 12 Pages

General Permit NCG550000
than 250 persons or having gross annual sales or expenditures exceeding 25 million (in second quarter 1980
dollars), if authority to sign documents has been assigned or delegated to the manager in accordance with
corporate procedures.
(2) For a partnership or sole proprietorship: by a general partner or the proprietor, respectively; or
(3) For a municipality, State, Federal, or other public agency: by either a principal executive officer or ranking
elected official.
b. All reports required by the permit and other information requested by the Permit Issuing Authority shall be signed by
a person described above or by a duly authorized representative of that person. A person is a duly authorized
representative only if:
(1) The authorization is made in writing by a person described above;
(2) The authorization specified either an individual or a position having responsibility for the overall operation of
the regulated facility or activity, such as the position of plant manager, operator of a well or well field,
superintendent, a position of equivalent responsibility, or an individual or position having overall responsibility
for environmental matters for the company. (A duly authorized representative may thus be either a named
individual or any individual occupying a named position.); and
(3) The written authorization is submitted to the Permit Issuing Authority.
c. Certification: Any person signing a document under paragraphs a. or b. of this section shall make the following
certification:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system,
or those persons directly responsible for gathering the information, the information submitted is, to the best
of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
14. Permit Actions
This permit may be modified, revoked and reissued, or terminated for cause. The filing of a request by the permittee for
a permit modification, revocation and reissuance, or termination, or a notification of planned changes or anticipated
noncompliance does not stay any permit condition.
15. Permit Modification, Revocation and Reissuance, or Termination
The issuance of this permit does not prohibit the permit issuing authority from reopening and modifying the permit,
revoking and reissuing the permit, or terminating the permit as allowed by the laws, rules, and regulations contained in
Title 40, Code of Federal Regulations, Parts 122 and 123; Title 15A of the North Carolina Administrative Code,
Subchapter 2H .0100; and North Carolina General Statute 143-215.1 et. al.
SECTION C. OPERATION AND MAINTENANCE OF POLLUTION CONTROLS
Certified Operator
Pursuant to Chapter 90A-44 of North Carolina General Statutes, the permittee shall employ a certified wastewater
treatment plant operator in responsible charge (ORC) of the wastewater treatment facilities. Such operator must hold a
certification of the grade equivalent to or greater than the classification assigned to the wastewater treatment facilities.
The permittee shall notify the Division's Operator Training and Certification Unit within thirty days of any change in the
ORC status. NOTE: This requirement does not apply until the permittee receives a letter notifying them of
classification of the facility. Currently, facilities are not being classified for this purpose, but may at some time in the
future.
2. Proper Operation and Maintenance
The permittee shall at all times properly operate and maintain all facilities and systems of treatment and control (and
related appurtenances) which are installed or used by the permittee to achieve compliance with the conditions of this
permit. Proper operation and maintenance also includes adequate laboratory controls and appropriate quality assurance
procedures. This provision requires the operation of back-up or auxiliary facilities or similar systems which are installed
by a permittee only when the operation is necessary to achieve compliance with the conditions of the permit.
Page 7 of 12 Pages

General Permit NCG550000
3. Need to Halt or Reduce not a Defense
It shall not be a defense for a permittee in an enforcement action that it would have been necessary to halt or reduce the
permitted activity in order to maintain compliance with the conditions of this permit.
4. Bypassing of Treatment Facilities
a. Bypass not exceeding limitations.
The permittee may allow any bypass to occur which does not cause effluent limitations to be exceeded, but only if it
also is for essential maintenance to assure efficient operation. These bypasses are not subject to the provisions of
Paragraphs b. and c. of this section.
b. Notice
(1) Anticipated bypass. If the permittee knows in advance of the need for a bypass, it shall submit prior notice, if
possible at least ten days before the date of the bypass; including an evaluation of the anticipated quality and
affect of the bypass.
(2) Unanticipated bypass. The permittee shall submit notice of an unanticipated bypass as required in Part II.E.6 of
this permit. (24-hour notice).
c. Prohibition of Bypass
(1) Bypass is prohibited and the Permit Issuing Authority may take enforcement action against a permittee for
bypass, unless:
(a) Bypass was unavoidable to prevent loss of life, personal injury or severe property damage;
(b) There were no feasible alternatives to the bypass, such as the use of auxiliary treatment facilities, retention
of untreated wastes or maintenance during normal periods of equipment downtime. This condition is not
satisfied if adequate backup equipment should have been installed in the exercise of reasonable engineering
judgment to prevent a bypass which occurred during normal periods of equipment downtime or preventive
maintenance; and
(c) The permittee submitted notices as required under Paragraph b. of this section.
(2) The Permit Issuing Authority may approve an anticipated bypass, after considering its adverse affects, if the
Permit Issuing Authority determines that it will meet the three conditions listed above in Paragraph c. (1) of this
section.
5. Upsets
a. Effect of an upset.
An upset constitutes an affirmative defense to an action brought for noncompliance with such technology based
permit effluent limitations if the requirements of paragraph b. of this condition are met. No determination made
during administrative review of claims that noncompliance was caused by upset, and before an action for
noncompliance, is final administrative action subject to judicial review.
b. Conditions necessary for a demonstration of upset.
A permittee who wishes to establish the affirmative defense of upset shall demonstrate, through properly signed,
contemporaneous operating logs, or other relevant evidence that:
(1) An upset occurred and that the permittee can identify the cause(s) of the upset;
(2) The permitted facility was at the time being properly operated; and
(3) The permittee submitted notice of the upset as required in Part ILE.6.b.2 of this permit.
(3) The permittee complied with any remedial measures required under Part II.B.2 of this permit.
c. Burden of proof.
In any enforcement proceeding the permittee seeking to establish the occurrence of an upset has the burden of proof.
6. Removed Substances
Solids, sludges, filter backwash, or other pollutants removed in the course of treatment or control of wastewaters shall be
disposed of in accordance with NCGS 143-215.1 and in a manner such as to prevent any pollutant from such materials
Page 8 of 12 Pages

General Permit NCG550000
from entering waters of the State or navigable waters of the United States. The permittee shall comply with all existing
federal regulations governing the disposal of sewage sludge. Upon promulgation of 40 CFR Part 503, any permit issued
by the Permit Issuing Authority for the disposal of sludge may be reopened and modified, or revoked and reissued, to
incorporate applicable requirements at 40 CFR Part 503. The permittee shall comply with applicable 40 CFR Part 503
Standards for the Use and Disposal of Sewage Sludge (when promulgated) within the time provided in the regulation,
even if the permit is not modified to incorporate the requirement. The permittee shall notify the Permit Issuing Authority
of any significant change in its sludge use or disposal practices.
7. Power Failures
The permittee is responsible for maintaining adequate safeguards as required by DWQ Regulation, Title 15A, North
Carolina Administrative Code, Subchapter 2H, .0124 Reliability, to prevent the discharge of untreated or inadequately
treated wastes during electrical power failures either by means of alternate power sources, standby generators or retention
of inadequately treated effluent.
SECTION D. MONITORING AND RECORDS
1. Representative Sampling
Samples collected and measurements taken, as required herein, shall be characteristic of the volume and nature of the
permitted discharge. Samples collected at a frequency less than daily shall be taken on a day and time that is
characteristic of the discharge over the entire period which the sample represents. All samples shall be taken at the
monitoring points specified in this permit and, unless otherwise specified, before the effluent joins or is diluted by any
other wastestream, body of water, or substance. Monitoring points shall not be changed without notification to and the
approval of the Permit Issuing Authority.
2. Flow Measurements
Appropriate flow measurement devices and methods consistent with accepted scientific practices shall be selected and
used to ensure the accuracy and reliability of measurements of the volume of monitored discharges. The devices shall be
installed, calibrated and maintained to ensure that the accuracy of the measurements are consistent with the accepted
capability of that type of device. Devices selected shall be capable of measuring flows with a maximum deviation of less
than 10% from the true discharge rates throughout the range of expected discharge volumes.
Test Procedures
Test procedures for the analysis of pollutants shall conform to the EMC regulations published pursuant to NCGS 143-
215.63 et. seq., the Water and Air Quality Reporting Acts, and to regulations published pursuant to Section 304(g), 33
USC 1314, of the Federal Water Pollution Control Act, as Amended, and Regulation 40 CFR 136. To meet the intent of
the monitoring required by this permit, all test procedures must produce minimum detection and reporting levels that are
below the permit discharge requirements and all data generated must be reported down to the minimum detection or
lower reporting level of the procedure. If no approved methods are determined capable of achieving minimum detection
and reporting levels below permit discharge requirements, then the most sensitive (method with the lowest possible
detection and reporting level) approved method must be used.
4. Penalties for Tampering
The Clean Water Act provides that any person who falsifies, tampers with, or knowingly renders inaccurate, any
monitoring device or method required to be maintained under this permit shall, upon conviction, be punished by a fine of
not more than $10,000 per violation, or by imprisonment for not more than two years per violation, or by both. In the
case of a second or subsequent conviction, punishment is a fine of not more than $20,000 per day of violation, or by
imprisonment of not more than 4 years, or both.
5. Records Retention
The permittee shall retain records of all monitoring information, including all calibration and maintenance records and all
original strip chart recordings for continuous monitoring instrumentation, copies of all reports required by this permit, for
a period of at least 3 years from the date of the sample, measurement, report or application. This period may be extended
by request of the Director at any time.
6. Recording Results
For each measurement or sample taken pursuant to the requirements of this permit, the permittee shall record the
following information:
Page 9 of 12 Pages

General Permit NCG550000
a. The date, exact place, and time of sampling or measurements;
b. The individual(s) who performed the sampling or measurements;
c. The date(s) analyses were performed;
d. The individual(s) who performed the analyses;
e. The analytical techniques or methods used; and
f. The results of such analyses.
7. Inspection and Entry
The permittee shall allow the Director, or an authorized representative, upon the presentation of credentials and other
documents as may be required by law, to;
a. Enter upon the permittee's premises where a regulated facility or activity is located or conducted, or where records
must be kept under the conditions of this permit;
b. Have access to and copy any records that must be kept under the conditions of this permit;
c. Inspect any facilities, equipment (including monitoring and control equipment), practices, or operations regulated or
required under this permit; and
d. Sample or monitor, for the purposes of assuring permit compliance or as otherwise authorized by the Clean Water
Act, any substances or parameters at any location.
SECTION E. REPORTING REQUIREMENTS
1. Submission of Reports
Submission of standardized monitoring forms or other monitoring reports to the Division is not required. All monitoring
information and copies of any reports required by this permit, must be retained on site for a period of at least 3 years from
the date of the sample, measurement, report or application. This period may be extended by request of the Director at
any time. The permittee shall furnish to the Permit Issuing Authority upon request, copies of records required to be kept
by this permit.
2. Change in Discharge
All discharges authorized herein shall be consistent with the terms and conditions of this permit. The discharge of any
pollutant identified in this permit more frequently than or at a level in excess of that authorized shall constitute a violation
of the permit.
3. Planned Changes
The permittee shall give notice to the Director as soon as possible of any planned physical alterations or additions to the
permitted facility. Notice is required only when:
a. The alteration or addition to a permitted facility may meet one of the criteria for determining whether a facility is a
new source in 40 CFR Part 122.29 (b); or
b. The alteration or addition could significantly change the nature or increase the quantity of pollutants discharged.
This notification applies to pollutants which are subject neither to effluent limitations in the permit, nor to
notification requirements under 40 CFR Part 122.42 (a) (1).
4. Anticipated Noncompliance
The permittee shall give advance notice to the Director of any planned changes in the permitted facility or activity which
may result in noncompliance with permit requirements.
5. Transfers
This permit is not transferable to any person except after notice to and approval by the Director. The Director may
require modification or revocation and reissuance of the permit and incorporating such other requirements as may be
necessary under the Clean Water Act.
Page 10 of 12 Pages

General Permit NCG550000
6. Duty to Report Noncompliance
a. The permittee shall report to the central office or the appropriate regional office any noncompliance which may
endanger health or the environment. Any information shall be provided orally within 24 hours from the time the
permittee became aware of the circumstances. A written submission shall also be provided within 5 days of the time
the permittee becomes aware of the circumstances.
(1) The written submission shall contain a description of the noncompliance, and its cause; the period of
noncompliance, including exact dates and times, and if the noncompliance has not been corrected, the
anticipated time it is expected to continue; and steps taken or planned to reduce, eliminate, and prevent
reoccurrence of the noncompliance.
b. The following shall be included as information which must be reported within 24 hours under this paragraph.
(1) Any unanticipated bypass which exceeds any effluent limitation in the permit.
(2) Any upset which exceeds any effluent limitation in the permit.
(3) Violation of a maximum daily or monthly average discharge limitation for any of the pollutants listed by the
Director in the permit to be reported within 24 hours.
c. The Director may waive the written report on a case -by -case basis for reports under paragraph b. above of this
condition if the oral report has been received within 24 hours.
7. Other Information
Where the permittee becomes aware that it failed to submit any relevant facts in a permit application, or submitted
incorrect information in a permit application or in any report to the Director, it shall promptly submit the correct facts or
information.
8. Noncompliance Notification Procedure
The permittee shall report by telephone to either the central office or the appropriate regional office of the Division as
soon as possible, but in no case more than 24 hours or on the next working day following the occurrence or first
knowledge of the occurrence of any of the following:
a. Any occurrence at the water pollution control facility which results in the discharge of significant amounts of wastes
which are abnormal in quantity or characteristic, such as the dumping of the contents of a sludge digester; the known
passage of a slug of hazardous substance through the facility; or any other unusual circumstances.
b. Any process unit failure, due to known or unknown reasons, that render the facility incapable of adequate wastewater
treatment such as mechanical or electrical failures of pumps, aerators, compressors, etc.
c. Any failure of a pumping station, sewer line, or treatment facility resulting in a by-pass directly to receiving waters
without treatment of all or any portion of the influent to such station or facility.
Persons reporting such occurrences by telephone shall also file a written report in letter form within 5 days following first
knowledge of the occurrence.
9. Availability of Reports
Except for data determined to be confidential under NCGS 143-215.3(a)(2) or Section 308 of the Federal Act, 33 USC
1318, all reports prepared in accordance with the terms shall be made available for public inspection at the offices of
DWQ or at the site of the discharge within a reasonable time period, not to exceed five (5) days. As required by the Act,
effluent data shall not be considered confidential. Knowingly making any false statement on any such report may result
in the imposition of criminal penalties as provided for in NCGS 143-215.1(b)(2) or in Section 309 of the Federal Act.
10. Penalties for Falsification of Reports
The Clean Water Act provides that any person who knowingly makes any false statement, representation, or certification
in any record or other document submitted or required to be maintained under this permit, including monitoring reports
or reports of compliance or noncompliance shall, upon conviction, be punished by a fine of not more than $10,000 per
violation, or by imprisonment for not more than two years per violation, or by both.
Page 11 of 12 Pages

General Permit NCG550000
PART III
OTHER REQUIREMENTS
1. Previous Permits
All previous State water quality permits issued to this facility for this particular discharge, whether for construction or
operation or discharge, are hereby revoked by issuance of this permit and subsequent issuance of a Certificate of
Coverage. The conditions, requirements, terms, and provisions of this permit authorizing discharge under the National
Pollutant Discharge Elimination System govern discharges from this facility.
2. Construction
No construction of wastewater treatment facilities or additions thereto shall be begun until Final Plans and Specifications
have been submitted to DWQ and approval has been granted by the Division. Design and operation of facilities and/or
treatment works shall be in accordance with the application and supporting information. If facility deficiencies, design
and/or operational, are identified in the future which could affect the facility performance or reliability, it is the
responsibility of the permittee to correct such deficiencies.
3. Limitations Reopener
This permit shall be modified or alternatively, revoked and reissued, to comply with any applicable effluent guideline or
water quality standard issued or approved under Sections 302(b) (2) (c), and (d), 304(b) (2), and 307(a) (2) of the Clean
Water Act, if the effluent guideline or water quality standard so issued or approved:
a. contains different conditions or is otherwise more stringent than any effluent limitation in the permit; or
b. controls any pollutant not limited in the permit.
The permit as modified or reissued under this paragraph shall also contain any other requirements in the Act then
applicable.
PART IV
ANNUAL ADMINISTERING & COMPLIANCE MONITORING FEE
The permittee must pay the annual administering and compliance monitoring fee (if any such fee is assessed) within 30 days
after being billed by the Division. Failure to pay such fees in a timely manner in accordance with 15 NCAC 21-1.0105(b)(4)
may cause the Division to initiate action to revoke the Certificate of Coverage.
Page 12 of 12 Pages

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
June 15, 2006
MEMORANDUM
To: Michael Douglas
NC DENR / DEH / Regional Engineer
Raleigh Regional Office
From: Agyeman Adu-Poku
NPDES Western Program
Subject: Review of Draft NPDES Permit NCG551342
Peggy K. Tyndall
Orange County
Please indicate below your agency's position or viewpoint on the draft permit and return this
form by July 16, 2006. If you have any questions on the draft permit, please contact me at
the telephone number or e-mail address listed at the bottom of this page.
§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§
RESPONSE: (Check one)
10 Concur with the issuance of this permit provided the facility is operated and maintained
properly, the stated effluent limits are met prior to discharge, and the discharge does not
contravene the designated water quality standards.
F-1
Concurs with issuance of the above permit, provided the following conditions are met:
❑ Opposes the issuance of the above permit, based on reasons stated below, or attached.
Signed �ittkk, Date ka
No thCarolina
NWA( ily
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone [phone] Customer Service
Internet: www.ncwateruualitv.ore Location: 512 N. Salisbury St. Raleigh, NC 27604 Fax [phone]
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper

NPDES REGIONAL WATER QUALITY
STAFF REPORT AND RECOMMENDATIONS
(This form is best filled out on computer, rather than hard copy)
Date: 06/07/06 County: Orange
To: NPDES Discharge Permitting Unit Permitee: Pe22v K. Tyndall
Attn. NPDES Reviewer: A.gyeman Adu-Poke Application/ Permit No.: NCOONCG551342
Staff Report Prepared By: Mack Wiggins
Project Name: Peggy K. Tyndall Residence
SOC Priority Project? (Y/N) N If Yes, SOC No.
A. GENERAL INFORMATION
1. This application is (check all that apply): ® New ❑ Renewal
❑ Modification
2. Was a site visit conducted in order to prepare this report? ® Yes or ❑ No.
a. Date of site visit: 06/05/2006
b. Person contacted and telephone number: Peggy Tyndall, 252-726-8081
c. Site visit conducted by: Mack Wiggins
d. Inspection Report Attached: ❑ Yes or ® No.
DECEC W
J U N 14 2006
DENR - WATER QUALITY
POINT SOURCE BRANCH
3. Keeping BIMS Accurate: Is the following BIMS information (a. through e. below) correct?
® Yes or ❑ No. If No, please either indicate that it is correct on the current application or the
existing permit or provide the details. If none can be supplied, please explain:
Dischar a Point: Fill this section only if BIMS or Application Info is incorrect or missin
(If there is more than one discharge pipe, put the others on the last page of this form.)
a. Location OK on Application El
OK on Existing Permit ❑, or provide Location:
b. Driving Directions OK on Application ®,
OK on Existing Permit ❑, or provide Driving Directions (please be accurate):
c. USGS Quadrangle Map name and number OK on Application ❑,
OK on Existing Permit ❑, or provide USGS Quadrangle Map name and number: D22SE
d. Latitude/Longitude OK on Application ❑, (check at ht_tp://www.topozone.com These are often
inaccurate) OK on Existing Permit ❑, or provide Latitude: 3552205 Longitude: 790222
e. Receiving Stream OK on Application ❑,
OK on Existing Permit ❑, or provide Receiving Stream or affected waters: Unnamed Tributary
to Big Branch
a. Stream Classification: WS IV NSW
b. River Basin and Sub basin No.: 030606
c. Describe receiving stream features and downstream uses: B. Everett Jordan Lake

NPDES REGIONAL WATER QUALITY
STAFF REPORT AND RECOMMENDATIONS
For NEW FACILITIES Proceed to Section C Evaluation and Recommendations
For renewals or modifications continue to section B
B. DESCRIPTION OF FACILITIES AND WASTES (renewals and modifications only)
I. Describe the existing treatment facility:
2. Are there appropriately certified ORCs for the facilities? ❑ Yes or ❑ No.
Operator in Charge: Certificate #
Back- Operator in Charge: Certificate #
(Available in BIMS or Certification Website)
3. Does the facility have operational or compliance problems? Please comment:
Summarize your'BIMS review of monitoring data (Notice(s) of violation within the last permit cycle;
Current enforcement action(s)):
Are they currently under SOC, ❑ Currently under JOC, ❑ Currently under moratorium ❑? Have
all compliance dates/conditions in the existing permit, SOC, JOC, etc. been complied with? ❑ Yes
or ❑ No. If no, please explain:
4. Residuals Treatment: PSRP ❑ (Process to Significantly Reduce Pathogens, Class B) or
PFRP ❑ (Process to Further Reduce Pathogens, Class A)?
Are they liquid or dewatered to a cake?
Land Applied? Yes ❑ No ❑ If so, list Non -Discharge Permit No.
Contractor Used:
Landfilled? Yes ❑ No❑ If yes, where?
Other?
Adequate Digester Capacity? Yes ❑ No ❑ Sludge Storage Capacity? Yes ❑ No ❑
Please comment on current operational practices:
5. Are there any issues related to compliance/enforcement that should be resolved before issuing this
permit? ❑ Yes or ❑ No. If yes, please explain:
C. EVAL UATIONAND RECOMMENDATIONS
1. Alternative Analysis Evaluation: has the facility evaluated the non -discharge options available? Give
regional perspective for each option evaluated:
Spray Irrigation:
Connect to Regional Sewer System: Not available
Subsurface:
Other Disposal Options:
FORM: NPDES-RRO 06/03, 9/03 2

NPDES REGIONAL WATER QUALITY
STAFF REPORT AND RECOMMENDATIONS
2. Provide any additional narrative regarding your review of the application: This is an existing
unpermitted sandfilter discharging system without disinfection.
3. List any items that you would like NPDES Unit to obtain through an additional information
request. Make sure that you provide a reason for each item:
Recommended Additional Information Reason
DEH I WS IV NSW
4. List specific Permit requirements that you recommend to be removed from the permit when
issued. Make sure that you provide a reason for each condition:
Recommended Removal I Reason
5. List specific special requirements or compliance schedules that you recommend to be included in
the permit when issued. Make sure that you provide a reason for each special condition:
Recommended Addition I Reason
6. Recommendation: ❑ Hold, pending receipt and review of additional information by regional office;
® Hold, pending review and approval of required additional information by NPDES permitting
office; ❑ Issue; ❑ Deny. If deny, please state reasons:
Reminder: attach inspection r
7. Signature of report preparer:
Signature of WQS regional su
Date: L
FORM: NPDES-RRO 06/03, 9/03 3

NPDES REGIONAL WATER QUALITY
STAFF REPORT AND RECOMMENDATIONS
D. ADDITIONAL REGIONAL STAFF REVIEW ITEMS
This is an existing unpermitted sandfilter discharge for a three bedroom home. The applicant has
installed a chlorinator and chlorine contact tank with rip rap reaeration. Once DEH has approved the
discharge, the Raleigh Regional Office recommend that the certificate of coverage be issued for this
site.
If this page is .not used, PLEASE set printer for pages 1 through x to avoid wasting paper.
Use this a e for facilities with more than one Discharge Pipe
Discharge Point: Fill this section only if BIMS or Application Info is incorrect or missing)
a. Location OK on Application ®,
OK on Existing Permit ❑, or provide Location:
b. Driving Directions OK on Application ❑,
OK on Existing PermitEl, or provide Driving Directions (please be accurate):
c. USGS Quadrangle Map name and number OK on Application ❑,
OK on Existing PermitEl or provide USGS Quadrangle Map name and number:
d. Latitude/Longitude OK on Application ❑, (check at http://topozone.com These are often
inaccurate) OK on Existing Permit ❑, or provide Latitude: Longitude:
e. Receiving Stream OK on Application ❑,
OK on Existing Permit ❑, or provide Receiving Stream or affected waters:
a. Stream Classification:
b. River Basin and Sub basin No.:
c. Describe receiving stream features and downstream uses:
Discharge Point: Fill this section only if BIMS or Application Info is incorrect or missing)
a. Location OK on Application ❑,
OK on Existing Permit ❑, or provide Location:
b. Driving Directions OK on Application ❑,
OK on Existing Permit ❑, or provide Driving Directions (please be accurate):
c. USGS Quadrangle Map name and number OK on Application ❑,
OK on Existing Permit ❑, or provide USGS Quadrangle Map name and number:
d. Latitude/Longitude OK on Application ❑, (check at http://topozone.com These are often
inaccurate) OK on Existing PermitEl, or provide Latitude: Longitude:
e. Receiving Stream OK on Application ❑,
FORM: NPDES-RRO 06/03, 9/03 4

NPDES REGIONAL WATER QUALITY
STAFF REPORT AND RECOMMENDATIONS
OK on Existing Permit ❑, or provide Receiving Stream or affected waters:
a. Stream Classification:
b. River Basin and Sub basin No.:
c. Describe receiving stream features and downstream uses:
d.
FORM: NPDES-RRO 06/03, 9/03

Markers
Name: Discharge Point-NCG551342
Short Name: Dschrg
Coordinates: 035' 52' 04.65" N, 079° 02' 21.64" W
Comment: Peggy K. Tyndall Property, Subbasin 030606, Cape Fear River Basin, Orange
County, unnamed tributary to Big Branch, Class WS IV NSW, Quad D22SE

{� '
Division of Water Quality / Water Quality Section
®EN F. National Pollutant Discharge Elimination System
*O� GwOtW.
Oh MCMNM+ AND NAIMAL ftWU4GE3
NCG550000
(NOTICE OF INTENT
Natio041 Pollutant Discharge Elimination System application for coverage under General Permit
NCG550000: Single Family Domestic Units and/or facilities discharging less than 1000 gallons per
day of domestic wastewater and similar point source discharges
Owner Name:
Street Address:
City:
Telephone No:
V State: A Jc ZIP Code: a 91SS 7
(Home) _ 5 ,Z,a Ce_ Y o S 1 (Work)
3) Location of facility producing discharge:
Contact Person (if different than above):
Street Address: !p / 4 e.- L- E w g iiz) A'Igg
City: 1-a-14'4/o L Wr L K
County:
Telephone No:
State:
Fax
C ZIP Code: .,7, ? T I r%
4) Permit Contact{complete this section* if.permit contact is different from facility contact)
5)
Contact Person:
StreetAddress:
City:
County:
Telephone No:
Physical location information -
State: ZIP Code:
Fax
A copy of an USGS quad map or county trap with the facility clearly located on the map IS
REQUIRED to be submitted with this application.
Please provide a narrative description of how to get to the facility. (use street names, state road
numbers, and distance and direction from a roadway intersection). s F /i-7Tj e 4 p
SVW-216-080102
Page 1 of 4

NCG550000. N.O.I.
6) This NPOES permit application applies to which of the following :
❑ New or Proposed (system not constructed)
❑ Existing (system constructed); If previously permitted by local or county health department,
please provide the permit number and issue date
fid Modification; please describe the nature of the modification:
i N 5 71-4 (_ L E" V I c 4 L© e, 1 dl '4 -r-6 0.
6) Description of Discharge:
a) Amount of wastewater to be discharged:
i) Please check the components that comprise the wastewater treatment system:
10"Septic tank ❑ Dosing tank
OR", Primary sand filter ❑ Secondary sand filter ❑ Recirculating sand filter(s)
&(Chlorination ❑ Dechlorination ❑ Other form of disinfection:
❑ Post Aeration (specify type):
8) For new or proposed systems only -Please address the feasibility of alternatives to
discharging for the following options in the cover letter for this application:
a) Connection to a Regional Sewer Collection System.
b) Letter from local or county health department describing the suitability or non -suitability of the site
for all types of wastewater ground adsorption systems,
c) Investigate land Application such as spray irrigation or drip irrigation.
9) Receiving waters:
Is"i3re.name ofitle body''orbodies bf water (creek, stream, rarer, i
wastewater discharges end up in?
b) Stream Classification (WS4V, C, NSW, etc., if known):
10) The application must include the hollowing or it will be returned:
a) For Certificates of Coverage:
► t at th0 401l1
❑ An original letter and two (2) copies requesting a general permit.
❑ A signed and completed original and two (2) copies of this document.
❑ A check or money order for the permit fee of $60.00 made payable'to NCDENR.
❑ Invoice showing that the septic tank has been pumped and serviced within the last 2 years
(for existing facilities only).
Page 2 of 4
SWU-216-080102

NCG550000 N.O.I.
New or proposed facilities must also include:
❑ Letter from the county health department evaluating the proposed site for all types of ground
absorption systems.
❑ Evaluation of connection to a regional sewer system (approximate distance & cost to connect).
b) For an Authorization to Construct {ATC only:
❑ A letter requesting an ATC
❑ Three sets of plans and specifications of proposed treatment system (see Permit Application
Checklist and Design Criteria for Single Family Discharge)
❑ Invoice showing that the septic tank has been pumped and serviced (for existing septic
tanks).
Note: There is ro fee when requesting an Authorization to Construct
11) Additional Application Requirements:
a) If this application is being submitted by a consulting engineer (or engineering firm), include
documentation from the applicant showing that the engineer (or firm) submitting the application
has been designated an authorized Representative of the applicant.
b) If this application is being submitted by a consulting engineer (or engineering firm), final plans for
the treatment system must be signed and sealed by a North Carolina registered Professional
Engineer and stamped - "Final Design - Not released for construction".
c) If this application is being submitted by a consulting engineer (or engineering firm), final
specifications for all major treatment components must be signed and sealed by a North Carolina
registered Professional Engineer and shall include a narrative description of the treatment system
to be constructed.
12) Certification:
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing:
Titre: .
(Signature of Applicant)
North Carolina General Statute 143-216.6 b (i) provides that:
/�L
S f -a (a
(Date Signed)
Any person who knowingly makes any false statement, representation, or certifrcatioon in any application, record, report,
plan or other document filed or required to be maintained under Article 21 or regulations of the Environmental
Management Commission implementing that Article, or who falsifies, tampers with or knowingly renders inaccurate any
recording or monitoring device or method required to be operated or maintained under Article 21 or regulations of the
Environmental Management Commission implementing that Article, shall be guilty of a misdemeanor punishable by a fine
not to exceed $f0,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001 provides a
punishment by a fine of not more than $10, 000 or imprisonment not more than 5 years, or both, for a similar offense.)
Page 3 of 4
SWU-216-080102

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3.2 mi
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15.8 mi
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3.1 mi
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2 mi
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0.3 mi
9:
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0.3 mi
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