WQ0006946_Application_20210712

Pursuant to 15A NCAC 02T.0107(b), if the application does not include all required information and tile necessary supporting
documentation, the application shall be returned. "rhe application and attachments shall be prepared in accordance with 15A
NCAC 02T .0100, 15A NCAC 02T .0500, and Division Policies. For more information, visit the Water Quality Permitting
Scetion'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 littl)s://edocs.de(4.iic.gov/Forins/NoiiDischai-ge-Braijeii-Stibiiiittal-
Fo rm -Vcr2, or em ailed to Nora-Discliai-ile.ilei)ortsannedeiii-.gov if less than 20 rnegabytes (MB).
MXTION j,/-'APII*L(CANT 'I'N�ORMATlbN
1.. Applicant: Larry K. Neal, JR
1 Permit Na.: 4w Q0006946
3. Signature authority: Larry K. Neal, Jr. Title: Site Manger
Phone number: (704) 72 1-4653 Office Email: [e-mail]
4, Mailing address: 9621 Reed Mine Rd,
City: Midland State: NC Zip: 28 107-9673
5. Contact person: Larry K. Neal Email: larry.neal@ncdci-,gov
Primary phone number: [phone] Office Secondary phone number: (704) 223-736 Cell
. ........ . . . . . . . ....... . . . . . ........ ........................ ..... ............ ... ..... . . . . .. ..... . .... .... . . .... . ........ . . . ... . ......... .. ............... ....................................................................... .. . . ........ --.- . ...... . . ..... ............ . ........................... . ............ ............. . .....................................................................
+CTTC)N'TT
1. Physical address: 9621 Reed Mine Rd. County. Cabarrus Parcel No : I I
City: Midland State- NC Zip: 28107-9673
2. Treaftnent facility coordinates to the sixth decinial degree:
Latitude: 35-286554' Longitude: -80.465874' Method.- Navigation quality CPS
. .......... . . . . . ......... . .................. - ----------- - ----- - . . . . . . . . . .................................. . .. . .. . ... . . ...... . . . . .............. . . . . ............................
1. Permitted flow: 4000 GPD (The incryhnuni allowableflow based on what has been I)erinitted)
2. As -built floNv:4650GPD(Ttieiiicixiiiit;iii(41loiicible.floti,ba,sedran ivhtithet.vbeeticoisli,itc,te(P
........... .
4. Hydrau lie capacity: 0 % (Divide the average low in Rem 3 1)), 1he,4s-hnd1,11oiv in 11ein 2)
5. Wastewater coniposition: Domestic : 100 % Industrial: 0 % Stormwater: 0 %
..................................... .......... . . ... 1 -1 1-1-11,11, . . . ...................... .. . . . .... . .... ........ . ........ . . . ........ . ...... . . .... . .. . ... . ... . . . ... . .. ................................... -1-1111111111 -- ---- ---- . ..... . ............
SECTIGNIV-BiLLN I GiNrTORMATION
1. Billing address: N.C. DNCR 4605 Mail Service Center
City: Raleigh State: NC Zip: 27699-4620
2. Verify the Applicant does not have any overdue annual fees:
litaps://decl.rac.gov/abotit/divisions/w
Pursuant to 15A NCAC 02T .0120c), permits for renewing facilities shall not be granted if the Applicant or any affiliation has
an unpaid annual fee.
FORM: WWIS-R 02-21 Page I of 6

SECTION V —, OPE)RATORIN RESJi0N81,BLftHA`RGE, (O:Rt) WFORMAtWN
1. ORC: Robert L. Garner
Grade: N/A Certification No.: 1000781
Mailinc, address., 9621 Reed Mine Rd.
City: Midland
State: NC Zip: 28 1 O'7-9673
P11011C slumber: (704) 43 1-2372 Cell
Email: lce.garner@),ncdcr.gov
2. Back -Up ORC: Mason Ivy
Grade: N/A Certification No.: 1006239
Mailing address: 9621 ReedMine Rd.
City: Midland
State: NC Zip: 28107-9673
Phone number- [phone] Office
............................ . . . . . .......... . . .. . .. ... . ...... .... .......................
Email: i-nasoii,[e-mail]
SkTION VI O1?EN4TMOSPHtRE STRUCTURES
................ .. .......... .......... . . .......
1. List all open -atmosphere treatment and storage structures associated with the renewing permit. Attach additional sheets if
necessary.
..... . . . . .... . .............. . . ........
. .... . .. ... . ..... . ...... . . ............. . . . . .............. .. .. . . ............ ... ..... . . ...... . . .
Type
Pat -eel No.
V0111111c (gal)
Liner Type
Freeboard (ft)
Latitude
Lotigitude
Storage
1
280000
Apron, concrete
2
35.2865540
-80.465874^'
Select
Select
Select
. .... . — -- --------
Select
Select Select
...... . . . . . . .......... . ......................................................................................................... . . ........................................ . ................
. . ........................................................................................................ .. . . ................... . . . . . ........................................................... . . ... ... ............................. . . . ................ ........................
... . . ............... . . . . . . . . .. . . ..... . .... .
SECTION'VII—kEL,' hi) PERMITS
AT
....... . ..
1. List all wastewater permits (i.e.—sewer, collection system, NPDES,
residuals) that have interactions with tile renewing pernlit,
Attach additional sheets if necessary,
. ..... ............ . ...
------- -- ------ -- . .. . ........ . ..... . .... ... .... . . ..... . . . .. . ...... . .... . . . . . .............. . . ......... ----- . . . . ..... . ................. . ................................. -
Permit Type
Permit No.
Itelationship Type
Select
Select
Select
Select
Select
Select
Select
. . ......... ..... . .. . .. . . ........................ . .. .. . . . ..... ..... . . ..... .. .... . . ..... . ....... .
Select
. . . . . . . ............. . . .... . .............. . . .. . . . . . . . . ................. . .. . . ......... . ....... . . . . . . . . . . . . . ........... . . . . . . . . ... . ................... . ..... . ............. .. .. . . .. ..
-- ----------
SECTION VIII,- MONITORING WELLS
1, List all groundwater monitoring wells associated with the renewing
.... . ............................... ..... . .. ........
-Parcel-No
permit. Attach additional sheets, if necessary.
.. .... ..... . ...... ....... . . ..... ........... ",,­,,­­, " ,
Well Namel-
Status
Gradient
Location
1""'
Latitude Longittide
mW4l
. .............. . .......
Active
Select
Inside Review Boundary
35.2864910 -80.4662280
MW#2
I I
Active
Select
Inside Review BOLIndary
35.2864670
-80A656320
MW#3
I I
Active
Select
Inside Review Boundary
35,2875540
-80A65072"
Select
Select
Select
Select
Select
Select
C,
0
Select
Select
Select
0
Select
Select
Select
0
Select
Select
Select
a Q
Select
Select
Select
Select
Select
Select
..... . ........... . ............ ...
Selectselect
Select . . . ................. .................... .....
. . ..... . .. ...... .. .. . . ......... . . ....... . ......... . . ........ . . . ........... .
. . ............................. . ....... . ..
.......... . ... . ................ . ...........
FORM- WWIS-R 02-21
Page 2 of 6

- -- - ----------- ­­­ -- ----
SECTION,IX — IR I R1'GkTJO""N FIELDS
List all irrigation fields associated with the renewing permit, Attach additional sheets if necessary,
_F Field Cu onty ] PatNo -eel . Deeded Owner F Area -Fume—c rrop TLatittmde L 01�11itude_ -
4 1 Cabarrus 11 NC: ANC 1 1.06 Pine 13 5.2 87 532 -1- 80 A6609 5
Caban-us I I NCDNCR 1.06 pine 35.287141 -80.466009'
. . . . . ................... . . . . . . ........... . ..... .........
7_7
. ..... .. .......
0
0
11
0 0
0 0
. .........
es rr
. . .... ... .... ...... ...
0 0
0 0
0 0
.. . . ..........
. . . ................
0 0
0
. ....... . ..... ...........
0
0
. .... --------------
C7 Ca
Total Acreage. I 2.12
. . ......... ..... . .....
F'ORM: WWIS-R 02-2 1 Page 3 of 6

Was the facility originally permitted or had a major modification, issued after September 1, 2006?
F1 Yes - Pursuant to 15A NCAC 02T .0105(d , submit a site map pursuant to tyre requirements in 15A NCAC 021" .0504(d). These
requirements are:
El A, scaled map ofthe site with topographic contour intervals not exceeding 10 feet or 25 percent oftotaI site re I iefand showing
all facility -related structures and fences within the wastewater treatment, storage, and irrigation areas.
• Soil mapping units shown oil all irrigation sites.
• The location of all Wells (illClUding Usage and construction details if available), streams (epherneral, intermittent, and
perennial), springs, lakes, ponds, and other surface drainage fleaturcs within 500 feet of all wastewater treatment, storage,
and irrigation sites.
• Delineation of (lie compliance and review boundaries per 15A NCAC 021, O 1.07 and .0 108, and 15A NCAC 02T .0506(c
il'applicable.
• Setbacks as required by 15A NCAC 02T.0506,
El Site property boundaries within 500 feet or all wastewater treatment, storage, and irrigation sites.
El All habitable residences or places of'public assembly within 500 feet of all treatment, storage, and irrigation sites.
No - Skip Attachment A.
ATTAq1MENTB, RELEGATION
Does the signature authority in Section 1, Item 3 meet tile requirements pursuant to 15A NCAC 02T.0 1��b ?
El Yes - Skip Attachment B.
Ej No -- Submit a delegation letter pursuant to 15A NCAC 02'r.0106(c authorizing the signature authority to sign.
ATTACHMENT C - FLOW REDUI�TION
Does the eNisting permit include an approved flow reduction'?'
El Yes - Submit a copy of the flow reduction approval letter, as well as the measured monthly average amount ofwastewater flow
Z�
cotitribLitedpei-iiiiiti'oi~tlie 12 months prier to permit renewal. If any of these monthly averages are within 20% of the approved
flow reduction value, the Permittee shall provide a reevaluation ofthe reduced flow value pursuant to the requirements in 15A
NCAC 02T.0114W.
No - Skip Attachment C_
ATITIA,C,'ilMEN' T"D� C,F,RTI,PDA,TE,OF.O,'U]L,I,C,,,C,O,NVENJ'ENCEi AND NEtE11T'Y
Is the Applicant a Privately -Owned Public Utility?
❑ Yes - Pursuant to 15.E NCAC Q2T .01j 5La.Klj,, submit the Certificate or Public Convenience and Necessity from the North
_
il Commission demonstrating the Applicant is authorized to hold the utility franchise.
No - Skip Attachment D.
ATTACH mr!.NT,,F, - 6,PE'jkATioN'AL AGWEEMENT
Is the Applicant a Horne/Property Owners'Association or Developer of Lots to be Sold?
F� Yes (Home/Property Owners" Association)— Pursuant to 15A NCAC 02T .O I 15(a)(2), submit an executed
(FORM: 140A). Pursuant to 15A NCAC 02T .91 L5Oc , if the applicant is a legally formed Homeowners' or Property Owner's
Association, submit a copy of the Articles of Incorporation, Declarations, and By-laws.
F-1 Yes (Developer of Lots to be Sold) - Pursuan t to 15 A NC A C 02T 115 L )L2 , submit an executed Operational Agreenlent
Pursuant to 15A NCAC 02T 01 15(b , ifthe applicant is a developer of lots to, be sold, submit a copy of tile
Articles of Incorporation, Declarations, and By-laws.
No - Skip Attachment E.
FORM: WWIS-R 02-21 PmyZ,c 4 of 6

ATtAc MEN
Is the applicant a municipality, county, sanitary district, Or public utility?
0 Yes - Proceed to the next question.
Ej No ­ Skip Attachment F.
Does the hydraulic capacity in Section I H, Item 4 exceed 70%?
El Yes (the hydraulic capacity is greater than 70%, but less than 80%) -- Pursuant to 15A NCAC 02T.0 1180), prior to exceeding
80 percent of" the system's permitted hydraulic capacity (based oil the average flow during the last calendar year), the perinittee
shall Submit an engineering evaluation of their future wastewater treatment, utilization, and disposal needs. This evaluation shall
outline plans for inecting Future wastewater treatment, utili7ation, or disposal needs by either expansion of the existing system,
elimination or reduction of extraneous flows, or, water conservation and, shall include the source offunding for the improvements.
Ifexpansion is not proposed or is proposed kir a later date, a justification shall be made that wastewater treatment needs will be
met based on past growth records and future growth prQjections, and as appropriate, shall include conservation plans or other
measures to achieve waste flow reductions.
n Yes (the hydraulic capacity greater than 80%) - Proceed to, the next question,
E No - Skip Attachment F.
If answered Yes above, does the hydraulic capacity in Section 111, Item 4 exceed 80%?
❑ Yes (die hydraulic capacity is greater- than 80%) -- Pursuant to 15A N'CAC 02T .0118(2), prior to exceeding 90 percent of the
system's permitted hydraulic capacity (based on the average flow during the last calendar year), the pertnittee shall obtain all
permits needed for the expansion of the wastewater treatment, utilization, or disposal system and, if construction is needed,
submit final plans and specifications for expansion, including a construction schedule. If expansion is not proposed or is proposed
for a later date, ajustification shall be made that wastewater treatnient needs will be stet based on past growth records and future
growth prQjections, and as appropriate, shall include conservation plans or other specific measures to achieve waste flow
reductions.
No - Skip Attachment F,
. ...... . .... __ ....... ........... . ....... . . . . ................ . . . . ... . . . .
ATTA"MEN7_r I G,-'EA'SEMENT,,JZNCRQACHM ENT AND LEASE'AGREEMENT'
Does the Permittee own all of the land associated with the wastewater collection, treatment, conveyance, and irrigation system?
E Yes - Skip Attachment. G.
El No Pursuant to 15A NCAC 02'r t11_j6 Lc agreernents ), provide a copy of all easements, lease agreements, and encroach
allowing the Permittee to operate and maintain the wastewater collection, [TCRUllent, conveyance, and irrigation system on
property not owned by the Permittee.
ATTACHMENT H-7,AFF11LIATjONS
Are the Rennittee's affiliations, of record correct? Check affiliations.
Z Yes - Skip Attachment H.
n No - Provide the corrected affiliations and their contact information,
ATTACHMENT I -COMPLIANCE SCHtbU'LVS
Does the existing permit include any Compliance Schedules? (See Section I ofthe most recently issued permit)
f-1 Yes - Submit docuilientation that the compliance schedules have been met..
El No -- Skip Attachment 1.
. . ... ........ . .........
AtTACII-I'M"ENT J­ CIVILVENALTIESAND, O0T8TAND1NG­VIOLATtONS
Does the Permittee have any existing civil penalties or Outstanding violations?
Ej Yes (civil penalties) - Submit payment for the civil penalty, or proof of remission request.
E] Yes (violations) - Submit a copy ofyour response to the Notice of Violation.
No -- Skip Attachment J.
FORM: WWIS-R 02-21 Page 5 of 6

ItR
Does the wastewater composition in Section [it, Item 5 include any industrial wastewater?
E] Yes - Proceed to the next question.
Z No - Skip Attachment K.
Has the nature of tile industrial wastewater changed since the last pen -nit issuance (i,e., changes in industrial process, introduction of
new materials or chernicals, etc.)?
El Yes - Provide a chemical analysis of the wastewater pursuant to the requirements in 15A NCAC 021" .05LAJDA Provide an
overview of the manufacturing process; an inventory of all chemical and biological materials used ill the lllal'ILIf�icttiriiigpi-occ�.S.S;
4D 1
and an overview of the cleaning and treatment methodology.
ED No -- Provide ail overview of the in all UfaCtUring process; ail inventory of all the laical and biological materials used in the
manufacturing process; and an overview of the cleaning and treatment methodology.
W 'tA't T t NT'U—SETBACK WAIV E,RS
Does the existing permit include setback waivers?
D Yes - Pursuant to 15A It (j 021. Q.596 (1, provide setbacks waivers that have been written, notarized, signed by all parties
n
involved, and recorded with tile county Register of Deeds. Waivers involving the compliance boundary shall be in accordance,
with 15A NCAC 021-0107.
0 No, - Skip Attachment L.
APF
attest that this application
(Signature authority's name as noted in Section 1, peon 3)
has been reviewed by ine and is accurate and complete to the best of clay knowledge. I understand that if all required parts of this
C�
application package are not completed, and that il' all required supporting information and attachments area not included, this
application package will be returned as incomplete. I rurther certify pursuant to 15A NCAC 02T .0120(b,, that the applicant, or any
Parent, Subsidiary, or other affiliateofthe applicant has: not been convicted ofenvironmental crimes under; not previously abandoned
a wastewater treatment racility without properly closing the facility; not paid acivil penalty, not been compliant with any compliance
schedule in a permit, settlement agreement, ororder; not paid an annual fee.
Note: 'I'lie Applicant's Certification shall be signed pursuant to 15A NCAC 02T .0106,(W. All alternate person may be delegated as
the signing official if a letter is provided pursuant to 15A NCAC 02T 1?1& O(L :). Pursuant to § 143-2 15.6A and § 141'-215,-B_ ally
person who knowingly makes ally false statement, representation, or certification in any application package shall be guilty of Class
2 Ill iSdenTeall0T, which rn�ay include a, finc,,rlot to exce9d"S 10,000 as well as civil penalties Lip to $25,0,00,per violation.
Signature- Date.
THE COMPLETED APPLICATION AND ATTACHMENTS SHALL BE SUBMITTED AS A SINGLE PDF FILE VIA:
Email,: Laserfiche Upload:
Noii-Discliarge.Reports(iOncdenr.gov hitl)s://cdoes.deg.iic.l!/ovFornis/NonDiscliarpe-Ri-atiell-
Submittal-Forni-Vei-2
FORM: WWIS-R 02-21 Page 6 of 6