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Home My WebLink AboutWQ0019566_Application_20210521DocuSign Envelope ID: 33F2208C-9A27-45DA-8D76-74EFF98F7DCF ROY COOPER Governor DIONNE DELLI-GATTI Secretary S. DANIEL SMITH Director JEFFREY S. AND DEBRA D. LEE 281 ROSEMONT DRIVE DURHAM, NORTH CAROLINA 27713 Dear Mr. and Mrs. Lee: NORTH CAROLINA Environmental Quality April 5, 2021 Subject: Permit Change of Ownership Permit No. WQ0019566 281 Rosemont Dr. SFR Single -Family Residence Wastewater Irrigation System Chatham County It has come to the Division of Water Resources' attention that the subject single-family residence wastewater irrigation facility has changed ownership. The Chatham County Register of Deeds indicates that Jeffrey S. and Debra D. Lee purchased the subject property (Parcel No. 0078183) from William B. Jamieson and Helga I. Doeblin on January 8, 2020 (Deed Book: 2088 / Page: 0071). The wastewater treatment and irrigation system associated with this property are covered under an individual State -issued non -discharge permit (Permit No. WQ0019566). Accordingly, please complete and submit the attached Non -Discharge Permit Ownership/Name Change application (Form: NDPONC) and the Single -Family Residence Wastewater Irrigation System Operation and Maintenance Agreement (Form: SFRWWIS O&M). These forms have been prefilled for your convenience. Once the application is received, Raleigh Regional Office staff will conduct a site visit and provide an overview of the treatment and disposal system. Upon completion of the site visit and review of the application, a new non -discharge permit will be issued for a length of up to eight years. There is a $60 annual fee associated with this permit, which is not due at this time. Please comiflete and submit the attached forms within 30 days of receiving this notification.. Failure to provide these forms shall result in a Notice of Deficiency for operating the subject facilities without a valid permit, which is a violation of G.S. 143-215.1, and may subject you to a Notice of Violation and appropriate enforcement actions pursuant to G.S. 143-215.6A-6C. Civil penalties of up to $25,000 per day per violation may be assessed for failure to secure a valid permit. If you need additional information concerning this letter, please contact Chloe Lloyd at chloe.l loydgncdenr.gov. Sincerely, OoauSlgned 6y: Na> t aun it,�, ` _U b bWll q8�' hornburg, Branch Chief Division of Water Resources cc: Raleigh Regional Office, Water Quality Regional Operations Section (Electronic Copy) Laserfiche Nile (Electronic Copy) D � North Carolina Department of Environmental Quality I Division of Water Resources 512 North Salisbury Street 11617 Mail Service Center I Raleigh, North Carolina 27699-1617 ocpenmrnl otErnknnnuaW qulMy 919.707.9000 DocuSign Envelope ID: 33F2208C-9A27-45DA-8D76-74EFF98F7DCF DWR State of North Carolina Department of Environmental Quality Division of Water Resources Division of Water Resources 15A NCAC 02T .0600 — SINGLE-FAMILY RESIDENCE WASTEWATER IRRIGATION SYSTEM — CHANGE OF OWNERSHIP FORM: SFRWWIS-CO 03-21 Pursuant to 15A NCAC 02T .0107(b), if the application does not include all required information and the necessary supporting documentation, the application shall be returned. The application and attachments shall be prepared in accordance with 15A NCAC 02T .0100, 15A NCAC 02T .0600, and Division Policies. For more information, visit the Water Quality Permitting Section's Non -Discharge Branch website. The Applicant shall submit an electronic copy of the application and attachments uploaded as a single Portable Document Format (PDF) file to htt s://edocs.de .ne. ov/Forms/NonDischar e-Branch-Submittal- Form-Vert, or emailed to Non-Discharge.Reports(&ncdenr.gov if less than 20 megabytes (MB). SECTION I — APPLICANT INFORMATION 1. Applicant: Jeffrey S. and Debra D. Lee 2. Permit No.: WQ0019566 3. Signature authority: Jeffrey S. and Debra D. Lee Title: Owners 4. Mailing address: City: doF, �� State: Zip: - a2 l 5. Contact person: Primary phone number: C" i� " P• - Select Email: Secondary phone number: ( ) - Select 6. Secondary Contact person: Primary phone number. ('X) Select Email: Secondary phone number: ( ) - Select SECTION II -- FACILITY INFORMATION 1. Physical address: 281 Rosemont Dr. County: Chatham�� City: Durham State: NC Zip: 27713- SECTION III —BILLING INFORMATION 1. Billing address: City: 21V r, iVI AY , State: IV Zip: SECTION IV —.GEED INFORMATION Has a deed been executed and recorded in the County Register of Deeds pursuant to 15A NCAC 02T .0604(e)(11? ® Yes — Complete Items 1 through 4 below. ❑ No — See Attachment B on Page 3. 1 1. Parcel No.: 0078183 12. Date of Purchase: January 8, 2020 1 13. Deed Book: 2088 14. Deed Page Nos.: 0071 - 0072 1 FORM: SFRWWIS-CO 03-21 Page 1 of 3 DocuSian Envelope ID: 33F220BO-SA27-45DA-8D76-74EFF$SF7DCF SECTION V — OPERATION AND MAINTENANCE AGREEMENT Permit No.: WQ0019566 County: Chatham Permittee: Jeffrey S. and Debra D. Lee (i.e., all deeded property owners) The Permittee agrees to operate and maintain the single-family residence wastewater treatment and irrigation system as follows: 1. Inspect the septic tank annually, and pump out solids as needed. 2. Inspect and clean the septic tank effluent filter annually. (if applicable) 3. Inspect the tablet chlorinator weekly. Add wastewater grade chlorine tablets (e.g., calcium hypochlorite) as needed. Swimming pool grade chlorine tablets are not acceptable. (if applicable) 4. Inspect the ultraviolet disinfection unit weekly. Clean or replace the lamps and quartz sleeves as needed. (if applicable) 5. Inspect all storage tanks, pumps, and alarms monthly. Remove the floating scum layer in all pump/storage tanks when pumping 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. (ifapplicable) 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 wastewater is not ponding in or running off the designated irrigation area; and that there are no objectionable odors. (if applicable) 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 180 days prior to expiration. 11. Sign and provide a Change of Ownership application_ to any future owner of the single-family residence wastewater treatment and irrigation system for their completion and submission to the Division of Water Resources. I/We understand the above requirem is and agree to these terms as part of the issued permit. Signature: Date: �5 i) V12 J Signature: Date . . - "? Signature: Signature: Date: Date: All deeded property owners shad sign this Operation and Maintenance Agreement FORM: SFRWWIS-CO 03-21 Page 2 of 3 DocuSign Envelope ID: 33F22080-9A27-45[]A-8D76-74F-FF98F7DGF ATTACHMENT A — SIGNATURE AUTHORITY DELEGATION Does the signature authority in Section 1, Item 3 meet the requirements pursuant to 15A NCAC 02T .0106(b)? ® Yes — Skip Attachment A. ❑ No — Submit a delegation letter pursuant to 15A NCAC 02T .0106(cl authorizing the signature authority to sign. ATTACHMENT B — PROPERTY OWNERSHIP DOCUMENTATION Has a deed been executed and recorded in the County Register of Deeds pursuant to 15A NCAC 02T .0604(f)(1)? ® Yes Complete Items 1 through 4 in Section IV on Page 1. ❑ No ❑ Submit a written notarized intent to purchase agreement sign by both parties with a plat or survey map pursuant to 15A NCAC 02T .0604(e)(2); or ❑ Submit a written notarized lease agreement that specifically indicates the intended use of the property and has been signed by both parties, as well as a plat or survey map pursuant to 15A NCAC 02T .0604(e)(3). Lease agreements shall adhere to the requirements of 15A NCAC 02L .0107. APPLICANT'S CERTIFICATION I, attest that this application (Signature authority's name as noted in Section I, Item 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 package are not completed, and that if all required supporting information and attachments are not included, this application package will be returned as incomplete. I further certify pursuant to 15A NCAC 02T .0120(b), that the applicant, or any parent, subsidiary, or other affiliate of the applicant has: not been convicted of environmental crimes under; not previously abandoned a wastewater treatment facility without properly closing the facility; not paid a civil penalty; not been compliant with any compliance schedule in a permit, settlement agreement, or order; not paid an annual fee. Note: The Applicant's Certification shall be signed pursuant to 15A NCAC 02T .0106(b). An alternate person may be delegated as the signing official if a letter is provided pursuant to 15A NCAC 02T .0106(c). Pursuant to § 143-215.6A and § 143-215.6B, any person who knowingly makes any Plse statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, wh' i 1 e q4ne not to exceed $-1+0,GW as well as civil penalties up to $45,000 per violation. r Signature: Date: THE COMPLETED APPLICATION AND ATTACHMENTS SHALL BE SUBMITTED AS A SINGLE PDF FILE VIA. - Email: Non-Discharge.Ret)orts a��ncdenr.gov Laserfiche Upload: htt s:lledoes.de .ne. ov/Forms/NonDischar e-]3ranch- Submittal-Form-Vert FORM: SFRWWIS-CO 03-21 Page 3 of 3