WQ0015712_Application_20211115

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 —RENEWAL
FORM: SFRWWIS-R 02-21
Pursuant to 15A NCAC 02T .0107(b?, if the application does not include all required information and the necessary supporting
documentation, the application shall he returned. The application and attachments shall be prepared In accordance with 15A
NCAC 02T .0100, I5A NCAC 02'r .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 http://odors.deg.nc.t[ov/Furnts/Nonl7isehartr-Brunch-Suhniittal-
Form-Ver2, or emailed to Non-Discharge_Reporta(a�nctten. r.pov if less than 20 megabytes (MB).
Applicant: Qiang Dai & Hong Fang
2. Permit No.: WQ0u15712
3. Signature authority: Hong Fang Title: Ms
4. Mailing address: 262 WILLOWBEN DR
City: CHAPEL HILL State: NC zip: 27517-
5. Contact person: HONG FANG Email: [e-mail]
gmail.com
Primary phone number: (919) 360-191& Select Secondary phone number: ( ) - Select
6. Secondary Contact person: Qiang Dai Email: [e-mail]
Primary phone number: (919) 360-191 a Select Secondary phone number: ( ) Select i
N II •- F'ACILrry INFORMATIONMENNEN"
71.Physical address: 262 Willowbend Dr County: Chatham
ity: Chapel Hill State: NC zip: 27517- j
TION III -- BILLING INFORMATION
I. Billing address: 262 Willowbend Dr
City: Chapel Hill State: NC Zip: 27517-
2. Verify the Applicant does not have any overdue annual tees:
htts:L/dec .nc. ov/about(livisians/water-rescn!!LL: /water resnurccs- erntils/w menu
Pursuant to I SA NCAC 027`(11'
an unpaid annual fee. Q(c), permits for renewing facilities shall not be granted if the Applicant or any affiliation has
FORM: SI kWW1S-R 02-21 Page 1 of

Permit No.: WQ0015712
Permittee: Qiang Dai & Hong Fang (i.e., all deeded property owners)
County:
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'applivable)
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'applic•able)
4. Inspect the ultraviolet disinfection unit weekly. Clean or replace the lamps and quartz sleeves as needed. (if
applicable)
S. 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.
b. 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. (if applicable)
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. (ifapplicable)
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 ('hanj:r + I I )�� iarrship Aolica(ion 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.
IIWe understand the requiremen)s and agree to these terms as part of the issued permit.
5ignatur / �� ��� Date: C�-f
Signature: Date: IJO U- 1 2,2'
Signature:
Signature:
Date:
Date:
All deeded Property owners shall sign this Operation and Maintenance A reenwnt
DORM: SI` R W W IS-R 02-21 Page 2 of 4

ATTACHMEN'1 A - sin MAI'
Was the facility originally permitted or had a major modjhL ation issued al ,,i Septenthci 1, 2006?
❑ Yes - Pursuant to 15A NCAC02T .0105 d , submit a sitc map pursuant to the requirements in I; u71' .0h114_(d1. These
requirements are: --
❑ A scaled map ofthe site with topographic contour intervals not exceeding 10 feet or 25 percent of Iota) site relief and showing
all facility -related structures and fences within the wastewater treatment, storage, and irrigation areas,
❑ Soil mapping units shown on all irrigation sites.
❑ The location of all wells (including usage and construction details it' available), streams (ephemeral, intermittent, and
perennial), springs, lakes, ponds, and other surface drainage features within 500 feet of all wastewater treatment, storage,
and irrigation sites.
❑ Delineation of the compliance and review boundaries per I511Ni'AC' 021-01117 and ,0108, and 11A NCAC 02 f .n601.
❑ Setbacks as required by 15A NCAC 021- .0606, --
❑ Site property boundaries within 500 feet of all wastewater treatment, storage, and irrigation sites.
❑ All habitable residences or places of public assembly within 500 feet oral] treatment, storage, and irrigation sites,
® No - Skip Attachment A,
A.TTACHMgNTB-51[;h�i, TURF: AUTHORITY Dy J%TTION
Does the signature authority in Section I, item 3 meet the requirements pursuant to 1.5A NCAC (i 1 .0106(bl'!
® Yes - Skip Attachment B.
❑ No - Submit a delegation I,•, ier pursuant to 15A NCAC: 02T .0106(c) authorizing the signature authority to sign..
ATTACHMENT C- FLOW REDUCTION
Does the existing permit include an approved flow reduction?
❑ Yes - Submit a copy of the flow reduction approval letter, as well as the measured monthly average amount ofwastewater flow
contributed per unit for the 12 months prior to permit renewal. If any of these monthly averages are within 20% of the approved
flow reduction value, the I ermittce shall provide a reevaluation of the reduced flow value pursuant to the requirements in 15A
NCAC 021' .01 14(t).
® No - Skip Attachment C.
Does the Permittee own all of the land associated with the wastewater collection, treatment, conveyance, and irrigation system?
® Yes - Skip Attachment D.
❑ No - Pursuant to 15A NCAC 021 .r11 I.. c,), provide a copy of all easements, lease agreements, and encroachment agreements
allowing the Permittee to operate and maintain the wastewater collection, treatment, conveyance, and irrigation system on
property not owned by the Permittee.
Are the Permittec's affiliations of record correct? Chock gfilliations..
® Yes -Skip Attachment H
❑ No - Provide the corrected affiliations and their contact information.
7TACHMENT F' - C;OMPL.IANC'I". SCFIIA)tlLFS
Does the existing; permh include any Compliance Schcdulcs? (Sce Section I of [hc ntnst recently issued permit)
® Yes- Submit documentation that the compliance schedules have been rnel.
❑ No - Skip Attachment f,
FORM; SFR W WlS-R 02-21_J lace ; ot'S

ATTACI[ME,NT G -CIVIL PENALTIES AND OUTSTANDING VIOLATK
Does the Permittee have any existing civil penalties or outstanding violations?
❑ Yes (civil penalties) - Submit payment for the civil penalty, or proof of remission request,
❑ Yes (violations) - Submit a copy of your response to the Notice of Violation.
® No - Skip Attachment G.
Does the existing permit include setback waivers?
❑ Yes - Pursuant to 15A NCAC 02T .0606 e , provide setbacks waivers that have been written, notarized, signed by all parties
involved, and recorded with the county Register of Deeds. Waivers involving the compliance boundary shall be in accordance
with 15A NCAC 02L .0107.
® No - Skip Attachment H.
ono FAN
that this application
(Signature autlfority's name as noted in Section 1, 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 NC"AC_021 .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 .010 (h). An alternate person may be delegated as
the signing official if a letter is provided pursuant to 15A NCAC 02T .0106(c). Pursuant to § 143-2 15.6A and § 143-215.6B, any
person who knowingly makes any false statement, representation, or certification in any application package shall be guilty of aClass
2 misdemeanor, which may include 91ne not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
t Signature: , _ _ _ Date: M - tq - -2'0 z
THE COMPLETED APPLICATION AND ATTACHMENTS SHALL BE SUBMITTED AS A SINGLE PDF FILE VIA:
Email: Laserfiche Upload:
lrltpsalcdacs.dctt.nc.�uvlhortrtslNOil Discharge-Branch-
Nan-Disrhar e.Rc ortga]nrdcnr. env
tiu hm ittnl-Fnrm-1'cr2
FORM: SFRWWIS-R 02-21 Page 4 of 4

nw•. � 100, 1.0, lum
u.y
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
RALEIGH
SINGLE-FAMILY RESIDENCE WASTEWATER IRRIGATION SYSTEM PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules and Regulations
PERMISSION IS HEREBY GRANTED TO
Qiang Dai and Hong Fang
Chatham County
FOR THE
continued operation of a 600 gallon per day (GPD) single-family residence wastewater treatment and
irrigation facility consisting of:
a 1,250 gallon baffled septic tank; a 144 square -foot W) pressure -dosed recirculating surface sand filter
served by an 18.3 gallon per minute (GPM) pump; a 20 GPM ultraviolet (UV) disinfection unit, a 3,000
gallon storage/pump tank with a 17.9 GPM pump, and audible/visual high-water alarms; 0.37 acres of drip
irrigation area with 5,360 linear feet (LF) of drip irrigation line, and 2,680 emitters; a soil moisture sensor;
a precipitation sensor; and all associated piping, valves, controls, and appurtenances
to serve the single-family residence at 262 Willowbend Dr., Chapel Hill, NC 27517, with no discharge of
wastes to surface waters, pursuant to the application received December 15, 2016, and subsequent
additional information received by the Division of Water Resources, and in conformity with the project
plans, specifications, and other supporting data subsequently filed and approved by the Department of
Environmental Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until March 31, 2022, shall void Permit No.
WQ0015712 issued February 9, 2009, and shall be subject to the following specified conditions and
limitations:
L SCHEDULES
No later than six months prior to the expiration of this permit, the Permittee shall request renewal of
this permit on official Division forms. Upon receipt of the request, the Division will review the
adequacy of the facilities described therein, and if warranted, will renew the permit for such period of
time and under such conditions and limitations as it may deem appropriate. Please note Rule 15A
NCAC 02T .0I05(d) requires an updated site map to be submitted with the permit renewal application.
[15A NCAC 02T .0105, 02T .0109, 02T .0l 15(c)]
2. If a public or community sewage system is or becomes available, the subject single-family residence
wastewater treatment and irrigation facilities shall be closed and all wastewater shall be discharged into
the public or community sewage system within 180 days of its availability. Prior to the initiation of
these connection activities, appropriate Division approval shall be received. [15A NCAC 02T .0607]
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