NCG551602_Permit (Issuance)_20130919

ARRA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Water Quality Programs
Pat McCrory Thomas A. Reeder John Skvarla, III
Governor Director Secretary
September 19, 2013
David Paletta, Owner
8201 S Crestwyck Court
Raleigh, North Carolina 27615
Subject: Issuance of Certificate of Coverage NCG551602
and Authorization to Construct
Under General Permit NCG550000
for Single -Family Residence located at
4178 Hwy 421 N, Vilas 28692
Watauga County
Dear Mr. Paletta:
General Permit Coverage. Upon application for discharge, DWR instructed you to apply for an
individual NPDES permit due to legal issues preventing coverage under General Permit
NCG550000. Having resolved these issues, DWR hereby forwards a Certificate of Coverage
(COC) under the subject 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 October 15, 2007 (or as subsequently amended). Your permit package
includes:
• A copy of the Certificate of Coverage (COC) for your treatment facility
▪ A copy of Plans and Specifications signed September 4, 2013
• A copy of General Wastewater Discharge Permit NCG550000
• A copy of a Technical Bulletin for General Wastewater Discharge Permit NCG550000
• Engineer's Certification form (to be completed and returned to DWR).
According to your application, the existing subsurface septic -system will be replaced with a
surface -discharge Septitech treatment system for a single-family residence (4 bedrooms, 120 gpd
/ bedroom). Your authorized consultant, Lash Engineering, notes that the Town of Boone
provides the nearest sanitary sewer service, but that costs to connect are prohibitive due to the
distance from the project [-2.7 miles (14, 256 feet) southeast].
Operation and Maintenance. As Permittee you are responsible to maintain all components in
the approved treatment system, and the system will be held accountable to meet Surface Water -
Quality Standards. Compliance includes following manufacturer's guidelines, conducting and
documenting inspections, establishing sources for OEM spare parts and supplies, making
necessary repairs, and documenting said maintenance for the duration of the permit.
N. C. Division of Water Resources / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
Internet: h2o.enr.state.nc.us
Phone: [phone]
fax: [phone]
DENR Customer Service Center: 1 800 623-7748

Upon DWR's request, the Permittee must provide records and demonstrate efforts to maintain
the approved system. The Division recommends that the Permittee seek manufacture -certified
training, or a qualified contractor service to regularly inspect and maintain the treatment system.
This effluent discharges to State Surface Waters, Class C. Please note that if this stream
classification changes, the Division may revisit this discharge and adjust the COC according to
the stream's designated uses. This COC is not transferable except after written notice to the
Division of Water Resources. The Division may modify, or revoke and reissue this COC. This
permit does not affect your legal responsibility to obtain other permits required by the Division
of Water Resources, the Division of Land Resources, the Coastal Area Management Act, or any
other Federal or local government.
If any parts, measurement frequencies or sampling requirements contained in this general permit
are unacceptable, you have the right to request an individual permit by submitting an individual
permit application. Unless such demand is made, this Certificate of Coverage (COC) shall be
final and binding.
Authorization to Construct (ATC) Permit.
Compliance under this COC restricts discharge flow to 100%-domestic, not to exceed 1,000
gallons per day. Treated effluent shall be routed into a roadside ditch draining to Brushy Fork
[Stream Segment 8-15-10], a waterbody currently classified C within Subbasin 04-02-01 of the
Watauga River Basin. In accordance with the application and the attached approved plans and
specifications, DWR hereby authorizes installation and operation of:
• [existing] 1,000-gallon septic tank with inspection risers and effluent filter
• 1,000-gallon Septitech treatment pod with inspection risers [Fralo Plastic
Tank, 2-compartment RMT 1060]
• UV disinfection unit (Smart UV, single bulb w/ alarm)
• treatment system control panel
• effluent piping and sample point
• discharge to outfall, erosion -controlled (riprap)
This system shall be installed at least 15 feet from the dwelling foundation, 50 feet from the
property lines [hereby waved to 5 feet from the roadside right-of-way due to restrictive lot size],
and 100 feet from water supply wells onsite or offsite [hereby waved to 65 feet down -gradient
of existing well, do to restrictive lot size], as approved by DWR's Asheville Regional Office
(ARO). The system shall be located and constructed above any designated 100-year flood line.
Treatment -system cleanouts are required and should be installed between the septic tank and
treatment -system transition points and elbows, as well as any transition points in the 4-inch
gravity discharge line. All cleanouts must be housed in meter boxes below grade. All piping
elbows must conform to the long -sweeping type.
This ATC permit is issued in accordance with Part III, Paragraph 2 of NPDES General Permit
NCG550000, and is subject to revocation unless wastewater treatment facilities are constructed
in accordance with the conditions and limitations specified in this General Permit. In the event
that the facilities fail to perform satisfactorily, including creating nuisance conditions, the
Permittee shall take immediate corrective action as may be required by this Division, such as the
construction of additional or replacement wastewater treatment(s) or disposal facilities. Failure to

•
abide by the requirements of this A to C permit may subject the Permittee to an enforcement
action by the Division of Water Resources in accordance with North Carolina General Statute
143-215.6A to 143-215.6C.
The Permittee or responsible Engineer shall notify DWR's Asheville Regional Office (828-296-
4500) a minimum of three (3) working days in advance of operating the installed facilities. This
will serve to provide DWR an opportunity to inspect facilities as built. Such notification to the
Regional Office staff shall be made during normal office hours from 8:00 a.m. until 5:00 p.m.
Monday through Friday, excluding State holidays.
Upon completing construction and prior to operating this permitted facility, a North
Carolina -registered engineer shall sign and submit to DWR the attached Engineer's Certification
form certifying that the permitted facility has been installed in accordance with the NPDES
Permit, the Certificate of Coverage, this Authorization to Construct, and the approved plans and
specifications.
Compliance with the above shall include a leakage test performed on the septic tank and the
pump /dosing tank to insure that any exfiltration occurs at a rate not to exceed twenty (20)
gallons per twenty-four (24) hour per 1,000 gallons of tank capacity. The Engineer's Certification
shall serve as proof of compliance with this condition. Mail the completed Engineer's
Certification to:
DENR / DWR/ NPDES Program
1617 Mail Service Center
Raleigh, NC 27699-1617
The Permittee shall maintain on site for the life of the treatment facility, a copy of the
approved plans and specifications.
NPDES Contact. If you have any questions concerning the requirements of this Certificate of
Coverage or the Authorization to Construct permit, please contact Joe R. Corporon, L.G. at
telephone [phone] or email [e-mail].
Thomas A. Reeder
Attachments: Engineer's Certification form
hc: Central Files
Asheville Regional Office, Attn: Jeff Menzel, Environmental Specialist
NPDES General Permit Files
ec: Lash Engineering, Attn: Mike Lash, P.E. [[e-mail]]
ARO Attn: Jeff Menzel/Chuck Cranford

[This page intentionally left blank]

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER RESOURCES
CERTIFICATE OF COVERAGE - NCG551602
Under GENERAL PERMIT NCG550000
TO DISCHARGE 100% DOMESTIC WASTEWATERS FROM A SINGLE-FAMILY
RESIDENCE AND OTHER DISCHARGES WITH SIMILAR CHARACTERISTICS
UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
(NPDES)
In compliance with the provisions 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,
David Paletta — Owner
is hereby authorized to operate a wastewater treatment facility consisting of a, septic tank, Septitech POD
treatment system with single -bulb ultraviolet (UV) disinfection, control panel and associated
appurtenances, effluent discharge pipe with outfall rip -rap erosion protection;
discharging treated 100% domestic wastewater from a facility located at
Single -Family Residence
4178 Hwy 421 N., Vilas 28692
Watauga County
to receiving waters designated as Brushy Fork [stream segment 8-15-10], a waterbody currently
Classified C within Subbasin 04-02-01 of the Watauga River Basin, in accordance with the effluent
limitations, monitoring requirements, and other conditions set forth in Parts I, II, III and IV of General
Permit NCG550000 as attached.
This certificate of coverage shall become effective September 19, 2013.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day September 19, 2013.
T ► • as Reeder, Director
vision of Water Resources
By Authority of the Environmental Management Commission

Outfall 001
(flows west)
David Paletta — Owner
4178 NC Hwy 421 N, Vilas 28692
State Grid/USGS Ouad:
Drainage Basin:
Receiving Stream:
Stream Segment:
Latitude:
C12NW / Boone, NC
Watauga River Basin
Brushy Fork
8-15-10
36° 14' 09" N
Sub -Basin: 04-02-01
HUC: 06010103
Stream Class: C
Longitude: 81° 44' 32" W
North
Linville Creek Road
General Permit COC NCG55 1602
Watauga County

Fact Sheet
NPDES New Permit Development - Complex Expedited
FOR: Single -Family Residence
Application / Permit History
This is a new WWTP permit. The Applicant proposes to install wastewater treatment technology as
alternative to conventional sandfilter; a Septitech treatment system [M400D-UV-fiberglass]. The
application for discharge suggests that this system provides treatment comparable or better than a
conventional sand filter system for100% -domestic discharges < 1,000 gallons per day (gpd). However,
this treatment alternative is not specified in currently -active General Permit NCG550000 and is not
permittable.
Therefore, the Division will issue the Applicant an individual NPDES permit, NC0089362 SFR for a time
period only until General Permit NCG55000 may specify alternative technology (in progress).
n1 C�sS��a 2
^~ Facility Information
Applicant/Facility Name
David Paletta - Single -Family Residence
Applicant Address
8201 S. Crestwyck Court, Raleigh 27615
Facility Address
4721 NC Hwy 421 N, Vilas 28692
Permitted Flow
4-bedroom @120 gpd = 480 gpd
Type of Waste
100% Domestic — sanitary sewer
Facility / Permit Status
Minor / NEW
Basin / County
Watauga River Basin / Watauga County
Miscellaneous
Receiving Stream
Brushy Fork
[8-15-10]
Regional Office:
Asheville
Stream Classification
C
State Grid /
USGS Topo Quad:
C12NW / Boone, NC
303(d) Listed?
Not listed
Permit Writer:
Joe R. Corporon, L.G.
Subbasin
04-02-01
Date:
July 22, 2013
Drainage Area (mil)
. . ,
LAT: 36° 14' 09- LONG: 81° 44' 32"
Summer 7Q 10 (cfs)
0.0
Winter 7Q10 (cfs)
0.0
30Q2 (cfs)
0.0
Average Flow (cfs)
0.0
IWC (%)
100

Effluent Limit Development — Permit Requirements and Dates
This permit's expiration date is established to be consistent with neighboring individual NPDES permits
within Subbasin 04-02-01 of the Watauga River Basin. Although the Division would not ordinarily permit
a single-family residence as an individual NPDES permit, this temporary exception is issued pending
renewal of General Permit NCG550000. When/if transferred to a Certificate of Coverage under
NCG550000, its expiration will be re -dated to reflect renewal of the General Permit.
This single-family residence (SFR) discharge is hereby assigned secondary permit limits and monitoring
frequencies as:
• BOD 5-day, (30 mg/L Monthly Average; 45 mg/L Daily Maximum);
• Total Suspended Solids (30 mg/L Monthly Average; 45 mg/L Daily Maximum);
• Fecal Coliform (200 m1/L and 400m1/L);
• Total Residual Chlorine (TRC), not -to -exceed 50 ug/L [if used as backup to proposed UV
disinfection; see permit Section A. (1.)] and
• pH.
The Permittee is governed by the permit and Authorization to Construct (ATC) based on DWQ's review
and approval of plans and specifications submitted by a North Carolina -Certified Engineer. This permit
requires response in the form of an Engineer's Certification, and the Permittee's regular operation,
maintenance, and record -keeping in compliance with North Carolina surface water -quality Standards, as
specified in the ATC.
PROPOSED SCHEDULE FOR PERMIT ISSUANCE:
Draft Permit to Public Notice: July 27, 2013
Permit Scheduled to Issue: September 23, 2013
STATE CONTACT:
If you have any questions on any of the above information or on the attached permit, please
contact Joe R. Corporon at [phone].
PERMIT WRITER: DATE:

NORTH CAROLINA
FORSYTH COUNTY
AFFIDAVIT OF PUBLICATION
Before the undersigned, a Notary Public of said County and State, duly
commissioned, qualified, and authorized by law to administer oaths, personally
appeared D.H. Stanfield, who being duly sworn, deposes and says: that he is
Controller of the Winston-Salem Journal, engaged in the publishing of a
newspaper known as the Winston-Salem Journal, published, issued and
entered as second class mail in the City of Winston-Salem, in said County and
State: that he is authorized to make this affidavit and sworn statement: that the
notice or other legal advertisement, a true copy of which is attached hereto,
was published in the Winston-Salem Journal on the following dates:
August 2, 2013
and that the said newspaper in which such notice, paper document, or legal
advertisement was published was, at the time of each and every such
publication, a newspaper meeting all the requirements and qualifications of
Section 1-597 of the General Statutes of North Carolina and was a qualified
newspaper within the meaning of Section 1-597 of the General Statutes of
North Carolina.
This 2nd day of August, 2013
(signature df pe �ji' making affidavit)
Sworn to and subscribed before me, this 2nd day of August, 2013
My Commission expires: September 28, 2015
KIMALEY JOHNSON
NOTARY PUBLIC
FORSYTH COUNTY
STATE OF NORTH CARQQLI A
MY COMMISSION EXPIRE ai1 '
:'-(T5C(&0`
PUBLIC NOTICE
North Carolina Environmental
Management Commisslon/NPDES Unit
1617 Mail Service Center
Raleigh NC 27699-1617
Notice of Intent to Issue a
NPDES Wastewater Permit
The North Carolina Environmental Management
Commission proposes to issue a NPDES wastewa-
ter discharge permit to the person(s) listed below.
Written comments regarding the proposed permit
will be accepted until 30 days after the publish
date of this notice. The Director of the NC Division
of Water Quality (DWQ) may hold a public hearing
should there be a significant degree of public in-
terest. Please mail comments and/or information
requests to DWQ at the above address. Interested
persons may visit the DWQ at 512 N. Salisbury
Street, Raleigh, NC to review information on file.
Additional information on NPDES permits and this
notice may be found on our website: http://por
tal.ncdenr.org/web/wq/swp/ps/npdes/calendar,
or by calling [phone]. David P letta 201
Crest ch Court Raleigh) alitilfed o isc arge
treated o-omestic wastewater from a single-
family residence, 4178 Hwy 421 N, Vilas, Watauga
County.
WSJ: August 2, 2013

US 32rp1
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B00/7E
VICINITY MAP - NOT TO SCALE
PROJECT:
David Paletta
Residence at:
4178 Hwy. 421N
Vilas, NC 28692
DESCRIPTION:
Direct Discharge Wastewater
Treatment System for up to
4 Bedroom House
Submittal: 6-07-13
SI'
n�111111
LASH
ENGINEERING
Consulting Civil Engineer/Planner
1104 Cindy Carr Drive
Matthe+vs, N.C. 28105
Phone: [phone]
emati: mikeltDlashengineering.com

Lash Engineering, Inc.
Civil/Consulting/Wastewater/Planning
1 104 Cindy Carr Drive
Matthews, NC 28105
Phone: [phone]
mikelaLashEngineering.com
Lash Engineering, Inc.
David Paletta Wastewater System
Direct Discharge, NC.DWQ Application Submittal
Table of Contents
1. Cover Sheet
2. Basic Site Plan
3. Paletta Transmittal
4. Paletta Request Letter
5. Engineer's Project Summary
6. Authorization from Mr.Paletta to begin process
7. Copy of Checks for Permit ($860.00)
8. Application
9. Setback Variance Letter
10. UV Light Letter
11. UV Light Specification (Cutsheet)
12. UV Light Headloss Calculation
13. Gould Pump (Cutsheet)
14. Town of Boone, Available Sewer — email
15. Boone Map of Public Sewer
16. Watershed Classification (email from State)
17. Lash Engineering as Authorized Designer (Septitech)
18.Appalachian District Health Dept.) for Repair of Existing System
19. Paletta USGS Topo Map
Also: 3 Sets of Plans and original checks are included in this submittal.

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Residence at:
4178 Hwy. 421 N
Vilas, NC 28692
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TRANSMITTAL
Date: June 5, 2013
LASH
ENGINEERING Attention of: Joe Corporon
Consulting Engineers
-� Civil, Planning, Wastewater Company: NPDES-DWQ
1104 Cindy Carr Drive
Matthews, NC 28105 From: Michael Lash, PE.
Phone: [phone]
mikel(c�lashenoineering.com Project: Dave Paletts - Wastewater
Application
• Special Instructions:
AMA
non
MIN
Please find enclosed for the initial review are the following:
1. 3 sets of plans
2. An Application Fee check for $660.00 (Individual Permit) and an additional of $200 for
$860.00 total.
3. Email showing Approval by Septitech (Pretreat Manufacturer-TS II with UV and Denite).
4. 1 original set and 2 copies of the submittal package.
Thank you for the assistance that you have provided with this project.
If you have any questions, please call me at: 704-847-3031.
Thanks,
Michael Lash,

Me
Lash Engineering, Inc.
Lash Engineering, Inc.
CivilConsulting/Wastewater/Planning
1104 Cindy Carr Drive
Matthews, NC 28105
Phone: [phone]
[e-mail]
Project Summary for:• zQ� "SEAL "
Paletta 4178 Hwy.#421 North r 428;no
1
Town of Vilas, NC. ''y40,�`�C#1140,
0i AEL W • 0\`
The project is located at 4178 Hwy.#421 North, NC close to the town Or'ilas, NC.
in Watauga County. There is one home existing for this system. The existing 3
bedroom home is owned by Dave Paletta. There is a house on the right side of this
residence that shares the use of the water well. This is shown on the plan. A direct
discharge system for the wastewater effluent was proposed because of the failure
of the existing system (many years old) and the lack of adequate available soils
either on or offsite. The Watershed Classification for this Area is "C", Brushy
Fork. The system will consist of a new 1,000 gal septic tank, a new Septitech
PreTreat unit, and an Ultraviolet disinfection unit inside the Septitech unit to
sterilize the effluent before it is discharged into the lake. The Septitech effluent
pump is adequate for this discharge. There is no need for a pump tank.
A copy of the Health Department's findings is included in this application. They
have determined that there are no available onsite soils. The neighbor (with better
(but not good soil) is unwilling to grant an easement. The local Health Department
has granted a Repair Permit so that a system can be permitted and put into service.
The Health Department (Alan McKinney) has indicated that his preference is a
diredt discharge. After reviewing the site, I feel that this is the appropriate
decision. Karen Wallace (Regional Soil Scientist) has also indicated her
preference for a direct discharge.
The proposed system will be designed for 4 bedrooms each at 120 gallons per day.
This will give a total flow of 480 gallons per day. The system will utilize a
proposed 1,000 gallon septic tank and a proposed Septitech unit (M400D-UV-
fibreglass) with a UV light for the removal of pathogens. A cleanout is also
proposed at the exit of the effluent pipe to assist with cleaning. The UV light is

located on the discharge side of the Septitech unit so the treated effluent is passing
through the light. The UV light is the last stage the effluent passes prior to being
. discharged. The head losses of the effluent passing through the UV light are very
minor (negligible). I have included these calculations. Should the UV light fail to
operate, a voltage signal is sent to the control panel and the system is shut down
until the light is operational. This protects the side ditch against the possibility of
treated effluent that has not had the pathogens killed from entering the ditch
system.
The system utilizes a Septitech Control Panel that has been designed to work for
this unit. The panel is housed within a NEMA 4X enclosure that is setup for the
floats, pumps and internal monitoring of the system. A programmable micro -logic
controller (PLC) activates the recirculation and discharge pumps through a
program that self -adjusts these operations based on actual wastewater flow into the
,., processor (as monitored by the PLC). The processor constantly evaluates the water
usage and meters out the effluent discharge to the disposal area at the appropriate
interval to assure proper effluent treatment.
M,
The proposed septic tank is made of precast concrete and the proposed Septitech
unit is made of fiberglass. Floatation of the tank is not a factor as the unit is being
installed in Paletta's front yard approximately 6' above the highway.
FIR
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Ile
Lash Engineering, Inc.
June 7, 2013
- Joe Corporon
NPDES Permitting Program
Division of Water Quality
•, Raleigh, NC. 27699-1617
Re: Paletta Property, Watauga County
Letter of Authorization
Gentlemen:
Lash Engineering, Inc.
Civil/Consulting/Wastewater/Planning
1104 Cindy Carr Drive
Matthews, NC 28105
Phone: [phone]
[e-mail]
w•
I have engaged Michael Lash, PE. With Lash Engineering, Inc. to assist me in preparing and
filing a National Pollution Discharge Elimination System application for the above captioned
"" single family lot.
This letter will serve to certify that I have designated him as my authorized representative for this
application.
Very truly yours,
c-RGLizEL,
we David Paletta

MEM
NMI
NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
Mail the complete application to:
N. C. DENR / Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit INCOO 'X't/ l/ 2,
If you are completing this form in computer use the TAB key or the up - down arrows to moue from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise, please print or type.
1. Contact Information:
Owner Name
Facility Name
Mailing Address
City
State / Zip Code
Telephone Number
Fax Number
e-mail Address
David Paletta
Paletta WWTP
8201 S. Crestwyck Court
Raleigh
NC 27615
[phone]
(N/A)
[e-mail]
2. Location of facility producing discharge:
Check here if same address as above El
Street Address or State Road 4178 Highway 421 N
City
State / Zip Code
County
3. Operator Information:
Vilas
NC 28692
Watauga
Name of the firm, public organization or other entity that operates the facility. (Note that this is not
referring to the Operator in Responsible Charge or ORC)
Name
Mailing Address
City
State / Zip Code
Telephone Number
Fax Number
e-mail Address
David Paletta
8201 S. Crestwyck Court
Raleigh
NC 27615
[phone]
(N/A)
[e-mail]
1 of 3 Form-D 11/12

NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
4. Description of wastewater:
,.� Facility Generating Wastewater(check all that apply):
Industrial 0 Number of Employees
FM Commercial 0 Number of Employees
Residential ® Number of Homes
School 0 Number of Students/Staff
lzgl Other ❑ Explain:
1
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Residential 100% - Up to 4 Bedroom House at 480gpd
pal
Number of persons served: 4 bedrooms
5. Type of collection system
® Separate (sanitary sewer only) ❑ Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points 1
Outfall Identification number(s) 1
Is the outfall equipped with a diffuser? 0 Yes ® No
7. Name of receiving stream(s) (NEW applicants: Provide a map showing the exact location of each
outfall):
Side Ditch of Hwy. #321 / 421
8. Frequency of Discharge: ® Continuous ❑ Intermittent
ram, If intermittent:
Days per week discharge occurs: Duration:
9. Describe the treatment system
List all installed components, including capacities, provide design removal for BOD, TSS, nitrogen and
phosphorus. If the space provided is not sufficient, attach the description of the treatment system in a
separate sheet of paper.
An existing 1,000 gallon septic tank is capable of handling 480 gallons per day. The
Septitech Unit will be installed with the Ultra Violet disinfectant light and a pump
capable of handling the 7 feet of pressure head needed for direct discharge to the side
ditch. The Septitech Unit is designated as an M400D-UV.
2 of 3 Form-D 11 /12

NPDES APPLICATION - FORM D
For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.00048 (480 gpd) MGD
Annual Average daily flow 0.1752 (480*365/1,000,000)
MGD (for the previous 3 years)
Maximum daily flow 0.00048 (480 gpd) MGD (for the previous 3 years)
11. Is this facility located on Indian country?
�, ❑ Yes ® No
011111,
12. Effluent Data - TS II Treatment
NEW APPLICANTS: Provide data for the parameters listed. Fecal Coliform, Temperature and pH shall be grab
samples, for all other parameters 24-hour composite sampling shall be used. If more than one analysis is reported,
report daily maximum and monthly average. If only one analysis is reported, report as daily maximum.
RENEWAL APPLICANTS: Provide the highest single reading (Daily Maximum) and Monthly Average over
the past 36 months for parameters currently in your permit. Mark other parameters "N/A".
Parameter
Daily
Maximum
Monthly
Average
Units of
Measurement
Biochemical Oxygen Demand (BOD5)
10
mg/L
Fecal Coliform
400
colonies/ 100m1
Total Suspended Solids
10
mg/L
Temperature (Summer)
N/A
Temperature (Winter)
N/A
pH
N/A
13. List all permits, construction approvals and/or applications:
Type
Permit Number Type
Hazardous Waste (RCRA) N/A
UIC (SDWA) N/A
NPDES N/A
PSD (CAA) N/A
Non -attainment program (CAA) N/A
14. APPLICANT CERTIFICATION
Permit Number
NESHAPS (CAA) N/A
Ocean Dumping (MPRSA) N/A
Dredge or fill (Section 404 or CWA) N/A
Other
N/A
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
7) RV/ D PRL.'✓ ( A
Owner
Printed name of Person Signing Title
` n Vc
Q.M �/ al.
6ky(i3
Signature of Applicant Date
North Carolina General Statute 143-215.6 (b)(2) states: Any person who knowingly makes any false statement representation, or certification in any
application, record, report, plan, or other document files 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 $25,000, 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 $25,000 or imprisonment not more than 5 years, or both, for a similar offense.)
3 of 3 Form-D 11/12

Lash Engineering, Inc.
•
June 7, 2013
• Joe Corporon
NPDES Permitting Program
Division of Water Quality
•
Raleigh, NC. 27699-1617
Re: Paletta Property Setback Requirements
Lash Engineering, Inc.
civil/Consulting/Wastewater/Planning
1104 Cindy Carr Drive
Matthews, NC 28105
Phone: [phone]
[e-mail]
• This site is located along Highway 421N, approximately 1.2 miles west of Boone, NC in Watauga
County. The existing house has an ancient septic system that has failed and through the years there were
lot lines established that placed the existing disposal system off property. The lot goes uphill from the
• highway. The land above the house (away from the highway) is fill dirt. The soil below the house
(toward the highway) is very poor. The owner has not been able to obtain an easement from the neighbor
to put a septic system in to the west of the property. The land to the east of the property is mostly fill dirt,
• except near the highway.
•
NM
•
•
•
En
There is an existing ditch along the highway in front of the property; with a NC.DOT maintainable right
of way to the top of side ditch. We included a 5' property line offset from this line.
Alan McKinney and Karen Wallace have both reviewed the site and have requested that a direct discharge
permit be requested. He has indicated his support for the water well setback to be reduced to 50' so that
the system can be placed on the property in close proximity to the side ditch outfall.
It appears from our site visit that a direct discharge system is the best option. 1 have located the new
wastewater system in the front yard; outside of the right of way and the requested setback from the
existing water well. The effluent will be pumped uphill and discharged directly into the existing grassed
ditch where it will travel roughly 100' before being collected into the existing driveway culvert and
conveyed to an existing storm drainage drop inlet and routed to a ditch across the highway.
If I can be of any further service, please do not hesitate to call.
Sincerely,
Michael Lash, PE.

PM
•
L
Lash Engineering, Inc.
June 5, 2013
Joe Corporon
NPDES Permitting Program
Division of Water Quality
Raleigh, NC. 27699-1617
- Re: Paletta Property UV Light Analysis
Lash Engineering, Inc.
civil/Consulting/Wastewater/Planning
1104 Cindy Carr Drive
Matthews, NC 28105
Phone: [phone]
[e-mail]
UV lights of a low flow nature are typically a low pressure type, short wave, mercury vapor discharge
tube that produces ultraviolet wavelengths lethal to microorganisms. The low pressure allows the
units to run with less power and thereby generating less heat for longer life of the bulbs. The Emperor
Aquatics UV "High Output" Light has been specified for this project.
The spectrum of UV light that is lethal is called UV-C. This includes a wavelength range within 240-
280 nm. A wavelength around 254 to 264 is considered ideal. This lamp is set to 254 nm.
Different microorganisms are extinguished at different doses. The larger "pests" take longer. Fecal
Coliforms are extinguished at near 6600 µWs/cm. This lamp has a range up to 30,000 µWs/cm.
Although there is a wide spectrum of bacteria, viruses and protozoa, most of the "pests" are
extinguished between 2,000 and 20,000. Having a range up to 30,000 µWs/cm, assures that the
germicidal action is most effective across this wide range. For this application, fecal coliforms are
•
most important, which have a dose requirement of about 6600 µWs/cm. This is well within range.
The glass plays an important function in the effectiveness of the lamp in that the glass can absorb the
UV-C wavelength. The hard quartz glass is most effective and is utilized in the "high output" unit.
An additional coating "L" is added to the glass that adds resistance to "solarization" so that the bulb
remains highly effective for longer periods.
The Emperor Smart HQ UV Light has been submitted for review because of its ability to be installed
,., in the vertical or horizontal position. It clearly has the UV qualifications to be effective. The
requirements for vertical placement are spelled out in the installation guidelines with a warning to
insure the power head is above the water line. The power unit cannot be submerged. This note has
been added to the plans. This unit is acceptable for use in this application and is accepted for use on
this project.
Sincerely,
Michael Lash, PE.

Sofa,;. Wir.tewater Prablemi with 'Trani) kw
ULTRAVIOLET DISIFECTION SYSTEM
System Description
SeptiTech has made a recent change in the preferred manufacturer of ultraviolet (UV)
disinfection system for use in systems that require disinfection prior to discharge. The
reason for the recent change is that the manufacturer of the UV unit previously used
(Siemens Sunlight Systems UV) has been discontinued by the manufacturer and is no
longer available.
Therefore, SeptiTech has chose to use the Emperor Aquatics Smart High Output UV
Sterilizer model 025050/50. This unit is rated at the following specifications:
Water Flow Rate:
Ouput:
Operating pressure:
Voltage:
No. Lamps / Watts:
1,560 —1,980 gph (26 — 33 gpm)
30,000 µWs/cm2
20 psi
120 VAC @ 60Hz
1 lamp @ 50 watts
The UV unit is rated for 26-33 gpm at 20 psi operating pressure. SeptiTech will provide
a flow restrictor and pressure regulator on the discharge of the pump in order to ensure
that the operating parameters and not exceeded during operation.
A technical cut sheet, installation guide and operation and maintenance manual from the
manufacturer have been provided as part of this memo.
Control and Alarm
The operation of the UV unit is the same as it was previously for the Siemens Sunlight
Systems product. The control panel is outfitted to provide power to the UV unit along
with a current sensor. Power to the UV unit is on all the time as long as power to the
control panel is provided. The current sensor is used to detect that current is being drawn
from the UV bulb. If the bulb was to fail to operate, current would no longer flow to the
bulb, and an alarm would be triggered at the control panel as the current sensor would no
longer detect current flow.

RIR
Frictional Losses
Frictional losses through the UV unit are minimal since the UV chamber is larger than
the discharge piping used with the discharge assembly. The UV unit has 2-inch inlets
and a 5-inch chamber. Based on calculations using factors from Cameron Hydraulic Data
handbook, the total frictional head loss assuming a flow rate of 30 gpm is 0.00856 ft
(assumed to be negligible). Head loss calculations are attached.
ATTACHMENT A:
Technical Cut Sheet
ATTACHMENT B:
Installation and Operation & Maintenance Manual
ATTACHMENT C:
Friction Loss Calculations
Fog

NMI
WO
Section Three
UV
Equipment
Applications:
Fish Culture
Live Seafood Holding Systems
o Aquarium/Exhibits
• ItAarnmal/Reptile/Avian Bathing Pools
Water Features
Fllnctic:irs:
, Clarification (Waterborne Algae Control)
• Harmful Pathogen Disinfectant
Ozone Destruction
SiiRTllVPerlormanco
Pcv0,71, /r1q&i -i rlt.l lit, 4�"'.!1'Ef�S?i: ? s^,:iar(=h Pt Aquacultu e
SMART UV...The Professional's Choice!
More animal husbandry and aquatic professionals choose SMART UVs over
competing UV brands because of our substantiated performance information,
effective product design and overall quality. With over thirty models to choose
from, Emperor Aquatics, Inc. has the right SMART UV to fit your application.
Size —Our SMART UV design always considers the lamp's UV C output and
length, while most competitors ignore these critical performance factors. This
▪ explains why, in most cases, our equipment is physically larger.
RON
AMP
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•
Models shown with '"
optional mounting damps
SWARTINSterilizer
s T ° Sterilizer
SWING UV Sterilizer
Lamp Position — Our lamps are always positioned entirely between the inlet and
outlet water ports, utilizing the lamp's full arc length to its maximum potential.
Lamp Life — Long -Lasting GPH/T5 (Low-Pressure/Standard-Output) & T5 (Low
Pressure/High-Output) UV lamps offer 9,000 hours of continual operation equals
>80% efficiency at end of lamp life. These lamps use a specially coated "L" type hard
quartz glass that extends the life of the lamp while preventing the build-up of nitrogen
by-products (scaling) on the lamp's outer surface (Scaling diminishes UV C transmit-
tance). These nitrogen by-products are a problem commonly associated with ozone
producing "VH" type glass UV lamps.
Water Flow Rates — SMART UV flow rates represent the equipment's true capacity,
which considers the lamp's UV-C output, lamp length, exposure chamber's inside
diameter, and UV transmissibility for specified UV dosages as per our specification
charts.
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14 *1

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Section I hree
SMANTUVLite
rL
Models for Small Ponds, Aquariums,
Model No.
/Watts
Maximum Maximum
Pond Size Aquarium Size
and Research Applications
Water Flow Rate Water Flow Rate
No. Algae & Bacteria Protozoa • UV-C
Lamps 30,000 pWs/cm2 - 180,000 pWs/cm2 Input Output Dim.
/Watt Suggested/Maximum Suggested/Maximum Watts Watts (Inches)
Inlet
/Outlet
Input
Voltage
02218/18
02225/25
02240/40
02280/80
1,100 Gal.
1,700 Gal.
2,900 Gal.
5,900 Gal.
60 Gal.
90 Gal.
-
160 Gal.
330 Gal.
1/18
• 1/25
1/40
2/40
219 GPH/356 GPH
332 GPH/554 GPH
589 GPH/983 GPH
1,178 GPH/1,967 GPH
37 GPH/60 GPH 18
55 GPH/92 GPH 25
98 GPH/164 GPH 40
196 GPH/328 GPH 80
5 21,75"x 2.5" 1.5' Union 120VAC 50/60Hz
8 • 29,75" x 2.5" 1.5" Union 120VAC 50/60Hz
14 44.75" Z2.5" ---1.5" Union 120VAC 50/60Hz
28 44.75"x 14" 1.5" Union 120VAC 50/60Hz
it} Indicates popular models Also Available with Quara Sleeve Wipers
SINIMMISterilizer
:t" rliairiet*r Housing,
Models -for Moderately Sized Ponds, Aquariums, and Exhibit/Research Applications
Model No.
/Watts
02025/25
02040/40
02065/65
02080/80
02130/130
FM.
PIM
PM.
Maximum Maximum
Pond Size Aquarium Size
Water Flow Rate _.. -
Water Flow Rate _
No. Algae & Bacteria Protozoa - - UV-C
Lamps 30,000 pWs/cm.2 - • 180,000 pWs/cm2 Input Output Dim,
/Watt Suggested/Maximum Suggested/Maximum Watts Watts (Inches)
2,400 Gal. 130 Gal. 1.25 472 GPH/788 GPH 79 GPH/131 GPH 25 8 29- x 35'
4,700 Gal. 260 Gal. 1/40 943 GPH/1,574 GPH 157 GPH/262 GPH _ _ 40 14 43.75"x 35"
8,600.Gal.-- - 480 Gal. 1/65 1,710 GPH/2,855 GPH 285 GPH/476 GPH '65 - • . 25 705" x 35'
--9:400 Gal. 530 Gal. 2/40 1,885 GPH/3,148 GPH 314 GPH/525 GPH 80 28. 44.5 Lx.15.5"
17,100 Gal. 960 Gal. 2/65 3,420 GPH/5,711 GPH 570 GPH/952 GPH 130 50 71.5" x15.5- 15" Union
g.t- Indicates popular models Also Avallable with Quartz Sleeve Wipers
SKIBT110 UVSterillzer
Models for Large Ornamental Ponds, Water Features, and Exhibit/Research/Aquaculture Applications
Model No.
/Watts
025050/50
025080/80
025120/120
025150/150
Maximum Maximum
Pond Size Aquarium Size
5,900 Gal.
10,800 Gal.
13,800 Gal.
19,100 Gal.
330 Gal.
600 Gal.
770 Gal.
1,060 Gal.
No.
Lamps
/Watt
Water Flow Rate
Algae & Bacteria
30,000 pWs/cm2
Suggested/Maximum
1/50 1,560 GPH/1,980 GPH
1/80 2,700 GPH/3,600 GPH
1/120 3,840 GPH/4,600 GPH
1/150 5,040 GPH/6,360 GPH
Water Flow Rate
Protozoa UV-C
180,000 pWs/cm2 Input Output Dim.
Suggested/Maximum Watts Watts (Inches)
260 GPH/330 GPH
450 GPH/600 GPH
640 GPH/767 GPH
840 GPH/1,060 GPH
50
80
120
150
16
26
36
47
28" x5.75"
43" x 5.75"
56" x 5.75"
70" x 5.75"
0 Indicates popular models Also Available with Quartz Sleeve Wipers
SMITH') AIL eti Sterilizer'
.cf.,E1
Models for Large Ornamental Ponds, Water Features, and Exhibit/Research/Aquaculture Applications
Model No.
/Watts
Maximum Maximum
Pond Size Aquarium Size
•
No.
Lamps
/Watt
Water Flow Rate
Algae & Bacteria
30,000 pWs/cm2
Suggested/Maximum
Water Flow Rate
Protozoa UV-C
180,000 pWs/cm2 Input Output Dim.
Suggested/Maximum Watts Watts (Inches
Adapter Fittings are not included
Inlet
/Outlet
Input
Voltage
1.5" Union 120VAC 50/60Hz
13° Union 120VAC 50/60Hz
13" Union 120VAC 50/60Hz
1.5" Union 120VAC 50/60Hz
120VAC 50/60Hz
All models Include Adapter Fittings
Inlet
/Outlet
2'Union
2" Union
2" Union
2" Union
Input
Voltage
120VAC 50/60Hz
120VAC 50/60Hz
120VAC 50/60Hz
120VAC 50/60Hz
Adapter Fittings are not include
Inlet
/Outlet
Amps
Max Load @
120/230 VAC
0250100/100
0250160/160
0250240/240
0250300/300
7,700 Gal.
16,200 Gal.
21,800 Gal.
36,000 Gal.
430 Gal.
900 Gal.
1,210 Gal.
2,000 Gal.
2/50 2,040 GPH/2,580 GPH
2/80. 4,320 GPH/5,400 GPH
2/120 5,820 GPH/7,260 GPH
2/150 9,600 GPH/12,000 GPH
340 GPH/430 GPH
720 GPH/900 GPFI
970 GPH/1,210 GPH
1,600 GPH/2,000 GPH
100
160
240
300
26 37'' x 11° 3" Union
52 54" x 11" 3" Union
70 66" x 11° 3" Union
110 80° x11" 3" Union
1.15/0.5
1.15/05
1.15/05
1.85/0.85
Water Flow Rates are based on: 90% UV Transmissibility
Suggested = UV Lamp @ 80% efficiency (after 9,000 hours of continuous operation)
Maximum = UV Lamp Power @ 100% efficienq (new condition)
Input Voltage on all models = 120/230VAC 50/60Hz
Aquarium & Fond Sizing is based on:
Maximum Aquarium = single pass/1 hour @ "Maximum" flow rate for Protozoa
Maximum Pond = single pass/3 hours @ "Maximum" flow rate for Algae & Bacteria
0015
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EMPEROR AQUATICS, wo•
Sterilizers
NM
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1111.111
NMI
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OPERATING AND SERVICE INSTRUCTIONS
ITEM #02934-INS-SMARTUV
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T. U Sterilizer-
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Tillhire-
1000 EMPEROR AQUATICS, INC:"
www.emperoraquatics.com

Mil
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SMART�lite ISMRT�Sterifizer /SMART ISteriiizer
OPERATING AND SERVICE INSTRUCTIONS
Congratulations on the purchase of your new SMART UV, we
want you to be safe and successful with our equipment so please,
read our instructions prior to installing and operating this equipment!
Section One: SAFETY RULES FOR ALL SMART UV MODELS - pg. 1- 2
Section Two: UV STERILIZATION FEATURES AND SPECIFICATIONS - pg. 2 - 5
Section Three: WHAT IS ULTRAVIOLET STERILIZATION - pg. 6
Section Four: PRE -INSTALLATION INSPECTION - pg. 6 - 8
., Section Five: QUARTZ SLEEVE/UV LAMP INSPECTION - pg. 9 - 11
Section Six: THE QUARTZ SLEEVE ASSEMBLY - pg. 11 - 13
•
Section Ten: UV LAMP INSTALLATION- pg. 16 - 17
Section Seven: MOUNTING YOUR SMART UV - pg. 13 - 14
Section Eight: MANDATORY SMART UV WATER TESTING - pg. 14 - 15
Section Nine: ELECTRICAL REQUIREMENTS - pg. 15 - 16
IMPOR'I,ANT!
Must Read!
till
Section Eleven: QUARTZ SLEEVE WIPERS - pg. 17 - 19
Section Twelve: SMART UV INSTALLATION/OPERATION - pg. 20 - 25
Section Thirteen: SMART UV WINTERIZING - pg. 26
Section Fourteen: SMART UV MAINTENANCE - pg. 26 - 27
Section Fifteen: SMART UV REPLACEMENT PARTS - pg. 28 - 31
Section Sixteen: TROUBLESHOOTING - pg. 32
Section Seventeen: CONTACT INFO - pg. 32
active
tlghdrq lfype
SY�111 Sclencel
Warranty - pg. 33
Other Emperor Aquatics, Inc. Products - pg. 34 - 35
For pond calculating measurements and essential water quality parameters please
visit us at: www.emperoraquatics.com

Section One: SAFETY RULES FOR ALL SMART UV MODELS
Ing
R
IMPORTANT SAFETY INSTRUCTIONS PLEASE READ PRIOR TO
INSTALLATION AND OPERATION
WARNING TO GUARD AGAINST INJURY. BASIC SAFETY PRECAUTIONS
SHOULD BE OBSERVED. INCLUDING THE FOLLOWING:
Water and electricity can be a dangerous combination.
Help us ensure your safety
PLEASE READ AND FOLLOW ALL SAFETY INSTRUCTIONS.
DANGER: WARNING -Ultraviolet light is damaging to your eyes and skin!
fowl Do not handle or stare at an operating UV Tamp. Note that the UV Tight rays are
invisible to the human eye and precautions should be taken to prevent UV energy
from entering the eyes.
1.1
IMPORTANT: READ AND OBSERVE ALL IMPORTANT NOTICES AND LABELS
ON THE UNIT.
IMPORTANT: For Your Safety - The quartz sleeve and or the UV Tamp in this
product may have been broken or damaged during transit! It is therefore
ESSENTIAL that the unit be CAREFULLY INSPECTED BEFORE CONNECTING
TO ELECTRIC POWER (See Section Five)
WARNING: Do NOT exceed 20 PSI (Pounds Per Square Inch)
DANGER: To avoid possible electric shock, special care should be taken since
water is employed in the use of this aquarium and pond equipment. For each of
the following situations, do not attempt repairs yourself. Call EMPEROR
AQUATICS, Inc. customer service department at 610-970-0440 Ext. 0 for
services or discard the appliance.
DANGER: If the unit falls into the water, DO NOT REACH FOR ITT First unplug
it and then retrieve it. If the internal electrical components of the unit get wet,
unplug the unit immediately.
DANGER: If the unit shows any sign of water leakage, immediately unplug it from
1.1 the power source.
IMPORTANT: Carefully examine the unit after installation. It should not be
plugged in if there is water on any part not intended to be wet.
DANGER: Do not operate this unit if it has a damaged cord or plug, if it is mal-
functioning, or if it has been dropped or damaged in any manner.
1

IMPORTANT: Close supervision is necessary when any appliance is used by or
near children, and our equipment is no exception.
IMPORTANT: Always unplug the unit from an electrical outlet when not in use,
before servicing, cleaning or removing parts. Never yank the cord to pull the plug
from the outlet. Grasp the plug and pull to disconnect.
- IMPORTANT: SMART UVs are designed for low-pressure water applications with
or without aquatic livestock. DO NOT use the EMPEROR AQUATICS, Inc.
SMART UV for any application other than its intended use. The use of
attachments not recommended or sold by Emperor Aquatics Inc. may
cause unsafe conditions and possibly void any warranty.
IMPORTANT: This unit must be wired in conjunction with a properly
grounded, ground fault interrupter circuit (GFI).
Only (3) three wire grounded cables suitable for outdoor use should be used to
connect this unit. If joining cables for outdoor use, a suitable watertight cable
connector must be used. If an extension cord is necessary, a cord with a proper
rating should be used. A cord rated for less amperes or watts than the
appliance's rating may overheat. Care should be taken to arrange the cord so that
it will not be tripped over or pulled. (If in doubt consult a qualified electrician)
Section Two: UV STERILIZATION FEATURES AND SPECIFICATIONS
Our GPH T 5 and T-6 low pressure mercury vapor germicidal lamps, convert
approximately 40% of their electrical input watts into UV-C output watts within the
germicidal action spectrum (meaning 40% of electricity used is converted into use-
ful germicidal UV light), the highest UV-C output conversion among all UV lamps.
SMART UV FEATURES
• UL listed for indoor and outdoor use, fresh and salt water use.
• Long lasting GPH/T5 and GPH/T6 UV lamps (9,000 hours to 80% efficiency).
• Protective Quartz Sleeve (maximizes UV lamp output and safety)
• Watertight Design
• Easy -to -Remove Power Assembly
• Remote Power Supply
• UV Resistant High Density
Plastic UV Housing
(Lifetime warranty against UV degradation)
i� C n7 K `a: pti y a
• Utilizes the UV Tamp to its maximum potential SMART UV
(maximum UV exposure) Specifications Charts
• Non -UV Transmitting Clear Lamp Viewing Ports (See pages 3, 4, and 5)

1
1 1
1 1 1
itfteg
01
SMART High -Output UV Sterilizer Models
HihQutut
SUsteriiizor
MART �
Model No.
/Watts
025050/50
025080/80
025120/120
025150/150
025050-W/50
025080-W/80
025120-W/120
025150-W/150
Maximum Maximum
Pond Size Aquarium Size
5,900 Gal.
10,800 Gal.
13,800 Gal_
19,000 Gal.
5,900 Gal.
10,800 Gal.
13,800 Gal.
19,000 Gal.
500 Gal.
900 Gal.
1,200 Gal.
1,600 Gal.
500 Gal.
900 Gal.
1,200 Gal.
1,600 Gal.
Water Flow Rate
No. Algae & Bacteria
Lamps 30,000 pWs/cm2
/Watt Suggested/Maximum
Water Flow Rate
Protozoa
90,000 pWs/cm
Suggested/Maximum
UV-C
Input Output Dim. Inlet
Watts Watts (Inches) /Outlet
Input
Voltage
1/50
1/80
1/120
1/150
1/50
1/80
1/120
1/150
1,560 GPH/1,980 GPH
2,700 GPH/3,600 GPH
3,840 GPH/4,600 GPH
5,040 GPH/6,360 GPH
1,560 GPH/1,980 GPH
2,700 GPH/3,600 GPH
3,840 GPH/4,600 GPH
5,040 GPH/6,360 GPH
540 GPH/720 GPH
900GPH/1,200 GPH
1,260 GPH/1,560 GPH
1,680 GPH/2,100 GPH
540 GPH/720 GPH
900 GPH/1,200 GPH
1,260 GPH/1,560 GPH
1,680 GPH/2,100 GPH
50
80
120
150
50
80
120
150
16
26
36
47
16
26
36
47
28" x 5.75"
43" x 5.75"
56" x 5.75"
70" x 5.75"
28" x 5.75"
43" x 5.75"
56" x 5.75"
70" x 5.75"
2" Union
2" Union
2" Union
2" Union
2" Union
2" Union
2" Union
2°' Union
120VAC 50/60Hz
120VAC 50/60Hz
120VAC 50/60Hz
120VAC 50/60Hz
120VAC 50/60Hz
120VAC 50/60Hz
120VAC 50/60Hz
120VAC 50/60Hz
WARNING: Do NOT exceed 20 PSI (Pounds Per Square Inch)
Note: PVC Adapter Kits not included (but available separately)
"Suggested" Water Flow Rates are based on UV Lamp End of Useful Lamp Life, 9,000 hrs. @ 80% output. Maximum Water Flow Rates
are based on New Lamp Condition. All water flow rates incorporate a 90% UV transmittance factor, considering "Green Water" conditions.

EMPEROR AQUATICS, INC.
SMART HO UV filEi.ZP.IZERS EXPLODED PARTS VIEW DIAGRAM
FOR MODEL #'s 025050, 025080, 025120, & 025150 UV STERILIZERS &
FOR MODEL #'s 025050-W, 025080-W, 025120-W, & 025150-W UV STERILIZERS
�1 JJ---
r
1. UV Lamp
2. 4-Pin Lamp Connector
3. Black Power Supply Jamb Nut
4. Gray Power Supply Adapter
5. Power Supply Cord
6. Power Supply Module Assembly
7. Black Retaining Nut
8. Power Supply Gasket
9. Clear Quartz Sleeve Retaining Module
10. 0-Ring for Clear Quartz Sleeve
Retaining Module
11. Quartz Sleeve 0-Ring
12. Quartz Sleeve Gasket
SMART I-10 UV UV Lamp Quartz Sleeve
Watts/Model No. Part No. Part No.
Ei
071 ■(6)
L•
13. White Quartz Sleeve Gasket/O-Ring
Retaining Nut
14. Quartz Sleeve
15. UV Sterilizer Housing
16. Water Inlet/Outlet Union 0-Ring
17. Water Inlet/Outlet Union Socket Half
18. Water Inlet/Outlet Union Retaining Nut
19. Quartz Sleeve Wiper Module (w/ wiper only)
20. C-Clips (w/ wiper only)
21. Quartz Sleeve Wiper Rod (w/ wiper only)
22. Wiper Rod Handle Stop Nut (w/ wiper only)
23. Wiper Rod Handle (w/ wiper only)
■
Pcwer Supply
Part No.
Lamp Connector
Part No.
Gasket Service
Kit Part No.
50 Watt/025050
80 Watt/025080
120 Watt/025120
150 Watt/025150
20050
20080
200120
200150
20325
20340
203120
20365
20105/20250-1
20105/202120.1
20105/202120-1
202150-1
20077
20077
20077
20077
20375
20375
20375
20375
NOTE:ClearQuartz Sleeve Retaining Module 20603,White Quartz Sleeve Retaining Nut 20079, both fit all
SMART UV Sterilizer Models a5 well as all SMART NO IN Sterilizers.
31

1 1 1
1 1 l 1 1 1 1 1 1 1
CAMERON
UYDHAULIC DATA
A hate&dy n e3ei'elnce on the subject of hydraulics,
and steam
Edited by
C. C. Heald
Eighteenth Edition
Third Printing
Price
$30.00
1).
Ingersoll -Dresser Pumps
Liberty Corner, NJ 07938
Visit rnu• wet -mite at www.idpump.cout 1

MEI
MEN
IOW
Note: Fittings are standard with full openings.
Fitting
L0
Nominal pipe size
1/2
3/4
1
1'/4
11/2
2
2/2-3 4
6
8-10
12-16
18-24
K value
Butterfly Valve
.-J.UL,-
irir
.
0.86
0.81
0.77
0.68
0.63
0.35
0.30
Plug Valve straightway
18
0.49
0.45
0.41
0.40
. 0.38
0.34
0.32
0.31
0.27
0.25
0.23
0.22
Plug
Valve 3-way thru-flo
30
0.61
0.75
0.69
, 0.66
0.63
0.57
0.54
0.51
0.45
0.42
0.39
0.30
a
Jag
Plug
Valve branch-llo
90
2.43
2.25
2.07
1.98
1.89
1.71
1.62
1.53
1.35
1.26
1.17
1.08
I
1111.
l•'
Standard elbow
1-1;-1
1
90'
30
0.81
0.75
0.69
0.66
0.63
0.57
0.54
0.51
0.45
0.42
0.39
0.36 '
45°
16
0.43
0.40
0.37
0.35
0.34
0.30
0.29
0.27
0.24
0.22
0.21
0.19
long
radius
16
0.43
040
0.37
0.35
0.34
0.30
0.29
0.27
0.24
0.22
0.21
0.19
Calculated from data in Crane Co., Technical Paper No. 410.
Note: Fittings are standard with full openings.
Fitting
Type of
bend
L/0
Nominal pipe size
72 3/41 1'/4 15'2 2 27z-3 4 6 8-10 12-16 18-24
K value
Close Return
50
1.35
1.25
1.15
1.10
1.05
0.95
0.90
ti
0.65
0.75
0.70
0.65
0.60
Standard
Tee
J I
Ihru flo
20
0.54
0.50
0.46
0.44
0.42
.38
. 6
0.34
0.30
0.28
0.26
0.24
Ihru branch
60
1 52
1 50
1.36
1.32
1.26
1.14
.08
1.02
0.90
0.84
0.78
0.72
eniii.iinssi
90'
Bends. Pipe bends, flanged
elbows, butt welded elbows
_ _
i I
(----- d
,�:10;j
�I
r/d = 1
20
0.54
0.50
0.46
0.44
0.4
0.38
0.36
0.34
0.30
0.28
0.26
0.24
r/d = 2
12
0.32
0.30
0.28
0.26
0.25
0.23
0.22
0.20
0.18
0.17
0.16
0.14
r/d = 3
12
0.32
0.30
0.28
0.26
0.25
0.23
0.22
0.20
0.18
0.17
0.16
0-14
rid 4
14
0.38
0.35
0.32
0.31
0.29
0.27
0.25
0.24
0.21
0.20
0.18
0.17
rid = 6
17
0.46
0.43
0.39
0.37
0.36
0,32
0.31
0.29
0.26
0.24
0.22
0.20
rid 6
24
0.65
0.60
0.55
0.53
0.50
0.46
0.43
0.41
0.30
0.34
0.31
0.29
r/d - 10
30
0.81
0.75
0.69
0.66
0.63
0.57
0.54
0.51
0.45
0.42
0.39
0.36
rid = 12
34
0.92
0.65
0.78
0.75
0.71
0.65
0.61
0.58
0.51
0.48
0.44
0.41
r/d - 14
38
1.03
0.95
0.87
0.84
0.80
0.72
0.68
0.65
0.57
0.53
0.49
0.46
r/d = 16
42
1.13
1.05
0.97
0.92
0.88
0.80
0.76
0.71
0.63
0.59
0.55
0.50
r/d - 18
46
1.24
1.15
1,06
1.01
0.97
0.87
0.83
0.78
0.69
0.64
0,60
0.55
r/d = 20
50
1.35
1.25
1.15
1.10
1.05
0.95
0.90
0.85
0.75
0.70
0.65
0.60
Mitre
Bends
a = 0°
2
0.05
0.05
0.05
0.04
0.04
0.04
0.04
0.03
0.03
0.03
0.03
0.02
Calculated from data in Crane Co. Technical Paper No. 410.
re
3
3
T
C7
0
1t1
7
N
0
c
2
d
II
A
aI<
03 03LIEIS!S91:1
f0
NI'

raulic Data
r Steel Pipe
itinued)
emi
iedule 160-steel
-.438' inside dia
msr y
If
MIMI
Ve-
locity
head
ft
Head
loss
It per
100 ft
91 .007 .074
4 .017 .154
.8 .030 .258
'3 .046 .387
17 .067 .540
.2 .091 .691
'7 .119 .885
1 .150 1.10
n1A 16 .185 1.34
10 .224 1.61
w
15 .267 1.89
19 .313 2.20
34 .363 2.53
IB .417 2.89
53 .475 3.28
38 .536 3.86
22 .601 4.09
57 .669 4.53
)1 .742 5.00
- 50 .897 6.00
30 1.07 7.09
99 1.25 8.27
68 1.45 9.55
37 1.67 10.9
06 1.90 12.4
75 2.14 13.9
44 2.40 15.5
13 2.68 17.3
82 2.97 19.1
52 3.27 21.0
21 3.59 22.9
90 3.92 25.0
59 4.27 27.2
28 4.64 29.5
00 5.61 35.5
74 6.67 42.1
46 7.83 49.2
19 9.08 57.0
92 10.4 65.2
.65 11.7 74.1
a .38 13.4 83.4
10 15.0 93.A
.83 16.7 104
.56 18.5 115
.02 22.4 139
'oo condition of interior
equirements of each
safety factor of 15 to
MIN
157
VIM
Friction
Friction of Water *New Steel Pipe (Continued)
(Based on Darcy's Formula)
5 Inch
Standard wt steel-sch 40
Extra strong steel-sch 80
Schedule 160-steel
5.047- ins' a dia
4.813' inside dia
4.313' inside dia
Flow
Head
Head
Head
U S
gal
Velocity
Velocity
1085
Velocity
Velocity
loss
Velocity
Velocity
loss
per
ft per
head
per
ft per
head
ft per
ft per
head
ft per
min
sec
It
00..ft��,���
sec
ft
100 ft
sec
ft
100 ft
30
.451
OOpgg
O AO to
_II
.53
.00
.030
.659
.007
.051
40
.641
;•�re
d$lj
.71
.01
.051
.878
.012
.086
50
.802
.060
.88
.01
.075
1.10
.019
.128
60
.962
.083 •
1.06
.02
.105
1.32
.027
.178
70
1.12
.110
1.23
.02
.130
1.54
.037
.236
80
1.28
.026
.140
1.41
.03
.176
1.76
.048
.301
90
1.44
.032
.173
1.59
.04
.218
1.98
.061
.373
100
1.60
.040
.210
1.76
.05
.265
2.20
.075
.453
120
1.92
.058
.293
2.11
.07
.370
2.64
.109
.612
140
2.25
.078
.389
2.47
.09
.491
3.07
.147
.816
160
2.57
.102
.480
2.82
.12
.607
3.51
.192
1.05
180
2.B9
.129
.598
3.17
.16
.757
3.95
.243
1.31
200
3.21
.160
.728
3.52
.19
.922
4.39
.299
1.60
220
3.53
.193
.670
3.88
.23
1.10
4.83
.352
1.91
240
3.85
.230
1.03
4.23
.26
1.30
5.27
.431
2.25
260
4.17
.270
1.19
4.58
.33
1.51
5.71
.506
2.63
280
4.49
.313
1.37
4.94
.38
1.74
6.15
.587
3.02
300
4.81
.360
1,56
5.29
.43
1.99
6.59
.674
3.45
320
5.13
.409
1.77
5.64
.49
2.25
7.03
.766
3.91
340
5.45
.462
1.98
5.99
.56
2.52
7.47
.865
4.39
360
5.77
.516
2.21
V V V 0 01
V A O J W
D7O NOUI
.63
2.81
7.91
.970
4.90
380
6.09
.577
2.45
.70
3.12
8.35
1.08
5.43
400
6.41
.639
2.71
.77
3.44
8.78
1.20
6.00
420
6.74
.705
2.97
.85
3.78
9.22
1.32
6.59
440
7.06
.774
3.25
.94
4.13
9.66
1.45
7.21
460
7.38
.846
3.54
8.11
1.02
4.50
10.10
1.58
7.85
480
7.70
.921
3.84
8.46
1.11
4.08
10.5.1
1.73
8.53
500
8.02
.999
4.15
8.82
1.21
5.28
10.98
1.87
9.23
550
8.132
1.21
4.99
9.70
1.46
6.35
12.08
2.26
11.1
600
9.62
1.44
5.90
10.6
1.7
7.51
13.18
2.70
13.1
650
10.4
1.69
6.89
11. 5
- v N
NNN0)t7
8.77
14.27
3.16
15.4
700
11.2
1.96
7.95
12.3
10.1
15.37
3.67
17.8
750
12.0
2.25
9.09
13.2
11.6
16.47
4.21
20.3
800
12.8
2.56
10.3
14.1
13.1
17.57
4.79
23.0
850
13.6
2.89
11.6
15.0
14.8
18.67
5.41
25.9
900
v NO N0)
O N tC I� Oi
3.24
13.0
15.9
3.9
16.5
19.76
t01001t0O
O 0 V O tD tD A 01 fJ
29.0
950
3.61
14.4
16.7
4.3
18.4
20.86
32.3
1000
4.00
15.9
17.6
4.8
20.3
21.96
36.7
1100
4.84
19.2
19.4
5.8
24.5
24.16
43.0
1200
5.76
22.7
21.1
6.9
29.0
26.35
51.0
1300
20.8
6.7526.6
22.9
8.2
34.0
28.55
12.65
59.8
1400
22.5
7.83
30.7
24.7
9.5
39.3
30.74
14.67
692
1500
24.1
8.99
35.2
26.4
10.8
45.0
32.94
16.84
79.2
1600
25.7
10.2
40.0
28.2
12.4
51.1
35.14
19.16
90.0
1700
27.3
11.6
45.1
30.0
14.0
57.6
37.33
21.63
101
' Cast Iron not commercially available In this size.
Note: No allowance has been made for age, difference in diameter, or any abnormal condition of interior
surface. Any factor of safety must be estimated from the local conditions and the requirements of each
particular installation. It is recommended that for most commercial design purposes a safety factor of 15 to
20% be added to the values in the tables -see page 3-5.
3-21
;1

r
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k - ''9/i 2 ( (oo / - 6,00056
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, `r fr+ �= K r S / �!G � cr, , 44Z—

- ITT
OM
NMI
Min
MISR
PEW
Goulds Pumps
LS P03/LS P07
LSPO3AV
LSPO7
GOULDS PUMPS
Goulds Pumps is a brand of ITT
Residential and Commercial Water.
www.goulds.com
Engineered for life
Wastewater
Submersible
Sump Pumps
FEATURES
• Corrosion -resistant construction.
• Stainless Steel motor casing and fasteners.
■ Glass -filled thermoplastic impeller and
casing.
■ Upper and lower heavy duty ball bearing
construction.
■ Motor is permanently lubricated for
extended service life and is powered
for continuous operation. All ratings are
within the working limits of the motor.
• Hard coated 400 series stainless steel
shaft for improved corrosion resistance.
• Float switch is adjustable for various
liquid levels. Easily removed for direct
pump operation or switch replacement.
■ Complete unit is lightweight, portable
and easy to service.
■ Available in manual and automatic ver-
sions. See next page for specific order
numbers.
■ A double labyrinth lip seal system pro-
tects the motor. It consists of three lip
seals and a V-ring in addition to an im-
peller counterblade system which keeps
solid particles away from the seal unit.

Inn
ITT
APPLICATIONS
Specially designed for the following uses:
• Basement draining
• Water transfer
• Dewatering
SPECIFICATIONS
• Discharge size: 11" NPT.
• Capacities: to 57 GPM.
• Maximum head: 34 feet TDH.
• Max. solids: 3/s" spherical
• Temperature: 104°F (40°C) maximum liquid
temperature.
• Maximum pump submergence is 10 ft. for LSP03;
16 ft. for LSP07.
MOTOR
• Single phase, 3450 RPM, 60 Hz
• LSP03, 1/3 HP 115 V, 2.9 maximum amps.
• LSP07, 3/4 HP 115 V (7.1 amps) or 230 V (3.5 amps).
• Built-in thermal overload protection with automatic
reset.
• Permanent -split -capacitor type.
MODEL INFORMATION
GOULDS PUMPS
Wastewater
• Class B insulation.
• Stainless steel shaft.
• Air filled design.
• Power cord length: LSP03; 10 feet standard, 20 feet
optional, LSP07; 20 feet.
FLOAT SWITCH OPTIONS
• Models are available with a float switch. Several op-
tions for automatic operation.
• "AV" models are supplied with a vertical float switch.
• "A" models are supplied with a built in float switch.
• "AT" models are supplied with a piggy -back replace-
able float switch.
AGENCY LISTING
SA=
C US
Canadian Standards Assodation
File #LR114251
Underwriters Laboratories
Re #83318
Goulds Pumps is ISO 9001 Registered.
Order No.
HP
Volts
Amps
Minimum
Circuit
Breaker
Phase
Float
switch Style
Cord
Length
Discharge
Connection
Min.
On
Level
Min.
off
Level
Minimum
Basin
Diameter
Maximum
Solids
Size
Shipping
Weight
Ibs/kg
11/5
L5P0311
ya
115
2.9
10
1
Plug / No Switch
10,
1 /2'
Manual
Manual
9"
3/a"
LSP0311A
Built -In Wide Angle
11"
5"
12"
LSP0311AT
Piggyback Wide Angle
11"
5"
12"
ISP0311 AV
Piggyback Vertical
8.5"
2°
12"
LSP0311 F
Plug / No Switch
20'
Manual
Manual
9"
LSP0311AF
Built -In Wide Angle
11"
5"
12"
LSP0311ATF
Piggyback Wide Angle
11"
5°
12°
LSP0711 F
3A
115
7.1
10
1
Plug / No Switch
20'
1' '
Manual
Manual
9"
Y"
15 / 6.8
LSP0711AF
Built -In Wide Angle
12.5"
6.5"
12"
LSP0711 ATF
Piggyback Wide Angle
12.5"
6.5"
12"
LSP0712F
230
3.5
Plug / No Switch
Manual
Manual
9"
LSP0712AF
Built -In Wide Angle
12.5"
6.5"
12"
LSP0712ATF
Piggyback Wide Angle
12.5"
6.5"
12"

- 4? ITT
FEET
35
LSPO7
30
25
Q 20 LSPO3
15
0
f-
10
5
00
COMPONENTS
10 20 30
CAPACITY
Item No.
Description
1
Casing
2
Impeller
3
Suction strainer
4
Shaft seal with cover
5
Motor
6
Ball Bearing
7
Capacitor
8
0-ring
3
GOULDS PUMPS
Wastewater
MODEL: LSP03, LSPO7
SIZE: 3/8" SOLIDS MAX.
RPM: 3450
HP: '/3and3/4
40 50 GPM

AM
- ITT
am
lin
DIMENSIONS
Wastewater
(All dimensions are in inches and weights in Ibs. Do not use for construction purposes.)
F
H
LSPO3
93/4
75h
LSP07
11'/+
9%
LSPO3AV
93/4
75/8
POWER CORD:
16/3 SJTW WITH THREE PRONG
GROUNDING PLUG
6'A" DIA.
1
2'
1'/" NPT
DISCHARGE
F
nn n n
nnn
GOULDS PUMPS
Goulds Pumps and the ITT Engineered Blocks Symbol are
registered trademarks and tradenames of ITT Corporation.
SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE.
BLSPO3 August, 2006
© 2006 ITT Corporation
Engineered for life
O
LSPO3AV
nnnnnnnni
H
F
12"

r.
EMI
OM
Town of Boone
Department of Public Utilities
June 11, 2013
To Whom It May Concern:
This is in regard to the availability of public water and sanitary sewer services
to property located in the Vilas NC community. Water and sanitary sewer services are not accessible to this
area and the Town of Boone has no plans to expand its services there. I have included a map depicting our
current system for your reference.
If I can be of any further assistance please feel free to contact me at 828-268-6250 or
.. josh.eller(a)townofboone.net
GNI
aft
NO
Sincerely,
t4-
Josh Eller
Utilities Service Technician
Cc; Mr. Greg Young, Town Manager
Mr. Rick Miller, Director of Public Utilities
foNvn of Boone
Department of Public Utilities
P.O. Box 192 Boone. NC 28607

\TE ti5
b (✓'F !vl � p
-eS
Legend
'tiCcnterlines
oft... Wastewater Gravity Main
tiWater Main
l�! xivF,
Prepared by l‘,ah Eller
6/11/13
Boone Water & Sewer
0 6001,200 2,400 3,600 4,800
Feet
1 1 1

RE: Paletta Residence mailbox:///C:/Users/Owner/AppData/Roaming/Thunderbird/Pro...
MEW
Subject: RE: Paletta Residence
From: "Mcnees, Jamie" <[e-mail]>
Date: 6/10/2013 8:02 AM
To: "Michael Lash, PE." <[e-mail]>
Hi Mike,
Sorry, I was out of the office on Friday too.
Its Brushy Fork and class C.
Let me know if you need any more help!
Jamie
Jamie McNees
Environmental Specialist
Classifications & Standards Unit
NC DENR Division of Water Quality
Tel: [phone] FAX: [phone]
www.ncwaterquality.org/CSU
E-mail correspondence to and from this address may be subject to the NC Public Records Law and may be disclosed to third parties.
From: Michael Lash, PE.[mailto:[e-mail]]
Sent: Friday, June 07, 2013 10:47 AM
To: Mcnees, Jamie
Subject: Paletta Residence
Jamie, sent this to Adriene and it came back that she is on vacation again. I was hoping that you could
look it up for me. I've included a USGS map and the coordinates are below.
Here is the Northing and Easting.
36° 14' 08.71" N
81° 44' 23.58" W
Thanks for your help,
Mike
L
(_ash E igireering, Inc.
Michael Lash, PE.
704-847-3031
[e-mail]
No virus found in this message.
Checked by AVG - www.avg.com
1 of 2 6/11/2013 1:56 PM

Tim Barbee
Driller Service, Inc. — Hickory
1800 Highland Ave
NE Hickory, NC 28601
March 3, 2009
Dear Mr. Barbee:
I am writing this letter to inform you that Michael Lash. P.E of Lash Engineering. Inc is
certified to design treatment and disposal systems using the SeptiTech, LLC line of
pretreatment processors.
Regards,
Joshua Cobb, P.E.
Design Engineer
70 Commercial Street, Suite 3
Lewiston, Me 04240
[phone]

MI
MCI
Fax
[phone]
[e-mail]
www.paletta.org
DAVID R. PALETTA Phone
ATTORNEY AT LAW [phone]
8201 S. Crestwyck Court
Raleigh, North Carolina 27615-3212
via email only to [e-mail]
November 23, 2012
'°`' Appalachian District Health Department
126 Poplar Grove Connector
Boone, NC 28607
MI
Re: 4178 Hwy 421 N, Vilas, NC
,., Application for a repair permit
MI
Dear Sir or Madam:
I own a rental house at 4178 Hwy 421 N, Vilas, NC. The septic system is having some
issues. I am exploring my repair options.
I have enclosed an application for a repair permit. My authorized agent is
pm Bobby Plemons [phone].
If you have any questions, please feel free to contact me via email or cell phone
�+ [phone].
Ion
PEI
ruhl
MI
Sincerely yours,
'a.41;c0R 94.------
David R. Paletta
Attorney at Law
DRP/gh

APPALACHIAN DISTRICT HEALTH DEPARTMENT
ASHE COUNTY
P.O. BOX 208
JEFFERSON, NC 28640
[phone] (fax)
[phone]
ALLEGHANY COUNTY
P.O. BOX 309
SPARTA, NC 28675
[phone](fax)
(336) 372- 8813
WATAUGA COUNTY
126 POPLAR GROVE CONNECTOR
BOONE, NC 28607
[phone] (fax)
[phone]
APPLICATION FOR WELL AND ON -SITE WASTEWATER PERMITS
SECTION I
INITIAL THE APPROPRIATE LINE(S) FOR WHAT THIS APPLICATION IS FOR:
NEW WELL CONSTRUCTION PERMIT
I WELL ABANDONMENT or CAMERA INSPECTION
WELL CAMERA INSPECTION
✓ I REPAIR ( Well
RELOCATION OF SEPTIC TANK
NAME CHANGE
SECTION 2
Owner of Property I aV;C( jPajp 0.) i.LSte e Phone:
- Mailing Address: gaol S. evesiwiCk C. tWeicsht NC- 91'6/
Applicant: JGw «Q ?a.k It a.. l uS-te e Phone:
Date Received:
Health Department Use Only
1 ANEW SEPTIC SYSTEM (Improvement Permit)
AUTIIORIZA'TION to CONSTRUCT (Septic permit required to get a building permit)
l COMPLIANCE INSPECTION (for proposed construction location only)
RENEWAL OF PERMIT ( Septic- non -expired only) (Well - -Expired / Non -expired )
I. ---[EXPANSION OF AN EXISITNG SEPTIC SYSTEM
CHANGE OF EXISTING PERMIT ( Well / Septic) ( Limited / Comprehensive )
NMI
(CI 19\ (Home) LI 9 I - 56 1/3 (Cell)
Email: dpriC�yQ. 0O GOIY�
(Home) (Cell)
Mailing Address: fS0.�e
BEmail:
Agent: e,6(j Pt2 MO AS 1 I'll( A*L'(e W0.terwo ckS
�▪ ** see page 3
Mailing Address: ? 0 . Box S'( I , C3(0 RocK , ti`( C, 9.8 60 5 Email: bo66y Oet41.o A 0
/1
INFORMATION ON THE PROPERTY
TO BE EVALUATED 9Ma;(. [oM
DETAILED Directions to Propcny: RA:01'125S IS I{ 1 1 t{ w.( 411 tit. VW(a s tikieS+
- l.eS oew•- I05 6'c€. Go esas V— cS* Chcistat+l C.kt; rand) iacus Y f k
&u -4x. Ret9 61,t`c.k. kauSQ 6A. CtS k t.
Phone: (828\(Home) L(0(p- 0000 (Cell)
▪ Property Size:. 6vS oCCQS Parcel ID/ PIN: 1.9Q - a S- OSa3 -OC) 0 County of Property: W0.tug0.
^
Subdivision Name: Lot #: Section: Date Platted**
**Date property recorded with the county as it currently exists.
YES I ✓NO Is any part of the property in the 100 flood plain?
YES NO Are there any drinking water supplies within 100 feet of this property? (If yes show them on the site plan.)
YES V.1 NO Is this property subject to watershed restrictions?
SECTION 3
STRUCTURE INFORMATION
DES 1BE THE EXISTING OR PROPOSED STRUCTURE:
HOUSE I MOBILE HOME
GARAGE APARTMENT
BUSINESS / OTHER
]
APARTMENTS /TOWNHOMES
i CONSTRUCTION DESCRIBED BELOW
Iv
YES 1 INO Basement
YES NO Water Fixtures in Basement
Number of Bedrooms: 3
^ Special Fixtures: Circle all that apply: Garbage Disposal, Oversized Tubs, Multi -head showers, Multiple Master Bathrooms or Kitchens
Special Fixture Description: NA
Business / Other Description: N
Number of Employees: NA
Square footage of Commercial Building: Hours of Operation:
Compliance Inspection (for proposed construction only):
Describe the proposed construction and show the location of any existing structures, proposed additions, excavation or other
- improvements ton the property on the site plan. a Describe: IV
- If you have an existing septic system, what year was it installed and under whose name was it permitted?
SECTION 4
SECTION TO REOUEST AN ON -SITE WASTEWATER SYSTEM 'TYPE:
Please Indicate Desired System Type(s) (Systems can be ranked in order ofyour preference):
' Any System Type 0 Accepted 0 Alternative 0 Conventional 0 Innovative ❑Other

n
SECTION 5
WATER SUPPLY INFORMATION
(SHOW LOCATION ON SITE PLAN)
NO Is water provided by a public water supply? Name of water supply system: (ryes then please skip to Section 8.
ram
Well will be used for:
min
Pal
The following information applies to a: LIProposed Well
Private Well
Existing Spring (skip to section 8)
x
Shared Well
Other Includes: Business, Restaurant, Daycare, Migrant housing, etc. Description:
Existing Well Year the well was drilled:
=Proposed Spring (skip to section 8)
=Other (Describe below)
CeSj eltee
If different than the property described above, property the drinking water supply is located on. LOT #: Parcel ID #:
Directions to the Water Supply: W tU. nett ( to base...m ir* door
SHARED WELL INFORMATION
What is number of the existing and/or possible future connections to this well? ( If more than one (1) connection, list the
connections by Lot # and / or Parcel ID #:
SECTION b
WELL SITING INFORMATION N R
ES NO Is there or are you proposing to place a fuel tank(s) on the property? (Not including propane or natural gas tanks)
YES NO Is there a fuel tank(s) on the adjacent properties?
YES NO Are there any easements, or right of ways recorded on this property? If yes describe and attach a copy of the
easement and / or right of way documentation to this application:
If you have an existing septic system, what year was it installed and under whose name was it permitted?
SECTION 7
WELL ABANDONMENT or WELL CAMERA INSPECTION iv A
Year the well was drilled: Depth of the existing well: Casing depth of the existing well:
Describe why the well is being abandoned:
Is there any contamination of the water in the well?
ES
L ✓ .EYES
ES
YES
ES
NO Property corners clearly and correctly identified
NO Plat attached
NO Proposed structures staked onsite
NO Proposed well site staked
1 I NO Holes dug
Permit
Expiration
Improvement (IP)
5years
Construction Authorization (CA)
(not to exceed the IP)
5 years
Well Construction
5 years
Compliance Inspections
1 year
TO COMPLETE THE APPLICATION DRAW A DIAGRAM OF THE PROPOSED CONSTRUCTION ON THE SITE PLAN PAGE PROVIDED.
Applicant must notify this department if this site is subject to approval by other public agencies
(other than the planning and inspection department) or wastewater other than sewage will be generated.
THIS APPLICATION AND FEES PAID WILL BE VALID FOR A PERIOD OF TWELVE MONTHS FROM DATE OF RECEIPT. AFTER
12 MONTHS THE APPLICATION IS VOID AND THE APPLICATION FEE IS NON-REFUNDABLE.
ALL HEALTH DEPARTMENT PERMITS ARE SUBJECT TO SUSPENSION OR REVOCATION
IF THE SITE PLAN OR THE INTENDED USE CHANGES.
�!
I CERTIFY THAT THE INFORMATION ON THIS APPLICATION IS TRUE AND CORRECT AND WILL NOT BE ALTERED WITHOUT
PRIOR HEALTH DEPARTMENT APPR AL.
�uxn cQ a, lela !caste it (a3I� a_SIGNATURE OF APPLICANT OR AUTHORIZED AGENT DATE
2

rmi
MEI
Mgt
ASHE COUNTY
P.O. BOX 208
JEFFERSON, NC 28640
[phone] (fax)
[phone]
APPALACHIAN DISTRICT HEALTH DEPARTMENT
ALLEGHANY COUNTY WATAUGA COUNTY
P.O. BOX 309
SPARTA, NC 28675
[phone](fax)
(336) 372- 8813
126 POPLAR GROVE CONNECTOR
BOONE, NC 28607
[phone] (fax)
[phone]
PROPERTY TO BE EVALUATED
MUST FILL OUT COMPLETELY
Owner of Property: J0.1 t CC a(e Gh, 1 ('CU. tee Parcel ID / PIN #: 199 (` a s-- 0 8 a 3 - 000
Fa'' Subdivision Name:
Pal
Lot #: Section #:
PROPERTY OWNER'S AUTHORIZATION FOR APPLICANT (Potential Buyer)
1, (name of property owner), being the owner or the legal
pir' representative of the business which owns the property specifically described above, do hereby authorize
(name of applicant) or their legal representative to pursue
permits issued by the Appalachian District Health Department. 1 understand that this authorization
''o" includes but is not limited to: (1) Applying for Health Department permits, (2) Preparing the site for on -site
soil evaluations, (3) Accomplishing other necessary actions as required by the Appalachian District Health
Department (i.e backhoe pits, surveying, clearing the lot of underbrush), (4) Locating or gaining knowledge
A'' of all pertinent fuel storage tanks, wells, springs, septic systems, etc...
F,
MR
This authorization will be in effect until a written notice of revocation is received by this office from the owner,
or until one year from date of signature by owner.
(Owner's signature) (Date)
m APPLICANT'S A UTHORIZA TION FOR AN AGENT TO ACT AS THEIR LEGAL REPRESENTA TI VE
,(-N j
I, I ‘i ice1 rat et(. < \4 Q. (name), beingthe applicant for an Improvement Permit /
( ) PP P
,�, Author{{'z�ation for Wastewater System Construction and/or a Well permit do hereby authorize
'Boob QeewAoLkS (name)to act as an agent on my' g behalf to do the following: (1) Apply for
Health D!partment permits, (2) Prepare the site for on -site soil evaluations,(3)Accomplish other necessary
P
m, actions as required by the Appalachian District Health Department (i.e. backhoe pits, surveying, clearing
the lot of underbrush), (4) Locate or gain knowledge of all pertinent fuel storage, wells, springs, septic
systems, etc...
MI
I understand that I or my legal representative must sign for all permits issued by the Health Department.
This authorization will be in effect until a written notice of revocation
is received by this office from the applicant.
O. t1� cv tjakltA. TC-Ltstee.
143Ice.
(Applicant's signature) (Date)
(Authorized agent's signature) (Date)
3

MIN
MIN
MIR
ASHE COUNTY
P.O. BOX 208
JEFFERSON, NC 28640
[phone] (fax)
[phone]
APPALACHIAN DISTRICT HEALTH
ALLEGHANY COUNTY
P.O. BOX 309
SPARTA, NC 28675
[phone](fax)
(336) 372- 8813
DEPARTMENT
WATAUGA COUNTY
126 POPLAR GROVE CONNECTOR
BOONE, NC 28607
[phone] (fax)
[phone]
SITE PLAN
I (MEASUREMENTS MUST BE ACCURATE.
NAME: �Jo�vi� ?4Ie fa Tustee
SEE EXAMPLE)
DATE: !(-3-ta
`118 RWy L(21 rt. \i (as, Nc
Arc 1/ JO' Roo' 29 09'
N 620/:52- .3/. 92'
A/ 2/ 2/ 75
9.3
4,c_cs yd
S 7777:510
/06.0/"
shy
��c
4

•
Stamps: -0-
STATE OF NORTH CAROLINA
COUNTY OF WATAUGA
This Deed, made this
FILED JaRnn Townsend
Register of Deeds, Watauga Co,NC
Recording Fee: $22.00
NC Real Estate TX: $.00
20101229000113170 NWD
Bk:BR1550 Pg:803
12/29/2010 01:45:01 Pf1 112
It=
II
11111111111111
NON -WARRANTY DEED
day of December, 2010, by and between
Andrew David Paletta (unmarried),
554 Dogwood Road, Boone, NC 28607
(hereinafter called "Grantor")
and
David R. Paletta, as Trustee for
The David R. Paletta Living Trust dated December 5, 2000,
213 Landsbury Drive, Durham, NC 27707
(hereinafter called "Grantee")
The designation Grantor and Grantee as used herein shall include said parties, their heirs,
successors, and assigns, and shall include singular, plural, masculine, feminine, or neuter as required by
context.
WITNESSETH:
The Grantor, for and in consideration of the sum of Ten Dollars and other good and valuable
consideration paid by Grantee, the receipt of which is hereby acknowledged, has and by these presents
does grant, bargain, sell, and convey unto the Grantee, all right, title and interest in that certain lot or tract
of land situated in Watauga County, North Carolina, and more particularly described as follows:
Prepared by: David R. Paletta, Attorney, 213 Landsbury Drive, Durham, NC 27707
Return to: GRANTEE

PE anglign
8R1550 804 212
Being a .605 acre tract of land on the North side of Hwy 421 North, bounded by Wallace Cook on the
West, North and East, and said road on the South, North being relative to NC Grid, and being more
particularly described as follows: BEGINNING on a point in Hwy 421 North, the point located N 52-13 E
32.80' from NCGS Monument "Lovill" N-915675.41 E-1192028.24, thence from the BEGINNING and
,,,p, with said road N 70-30-19 W 151.01' to a point; thence leaving said road and with the center of 20' right
of way N 14-43-05 E 18.20' to a point at the edge of pavement; thence continuing with the center of said
right of way N 21-21-15 E 135.93' to a point; thence with a curve to the right having a radius of 29.09', an
irn arc of 41.30 and a chord of N 62-01-45 E 37.92' to a point; thence S 77-17-40 E 106.01' to a point; thence
leaving said road and with a new line S 14-26-10 W passing a 5/8" rebar at 10.00' and then another 5/8"
rebar at 135.03' and then 50.02' for a total of 195.23' to the point and place of beginning, as shown on plat
# 05002 dated January 7, 2005 by Hencle J. Matheson PLSL-2561.
The property conveyed herein does not include the primary residence of the Grantor.
TO HAVE AND TO HOLD the aforesaid lot or tract of land and all privileges and appurtenances
thereunto belonging to the Grantee in fee simple. The Grantor makes no warranty, express or
implied, as to title to the property herein above described.
IN WITNESS WHEREOF, the Grantor has hereunto set her hand and seal, the day and year first above
written.
OJceIc(Seal)
Andrew David Paletta
(Seal)
STATE OF NORTH CAROLINA COUNTY OF WATAUGA
I, a Notary Public of said County and State, do hereby certify that Andrew David Paletta, Grantor,
personally appeared before me this day and acknowledged the execution of the foregoing instrument.
WITNESS my hand and official stamp or seal, this the day of December, 2010.
1.M4CLL3C (Notary Seal)
otaryblic
My commission expires: 1,),7ja01
*** Notary Seal must be placed within Margins ***

**NOTE -SQUARE
ACCESS FOR
CONCRETE RISER OR
OPTIONAL PLASTIC
20' ROUND RISER
CAST -IN
107'
102'
55' 50'
•
ti
VENT
L 15•J
�1-- 4'
TOP VIEW
r
17'
*NOTEI ALL MEASUREMENTS ON TOP
VIEW ARE TO WIDEST DIMENSIONS
NO BOOTS ON-
SIDE INLETS,
USE CONCRETE
KNOCKOUTS
65'
INLET
54'
TO BOTTOM
OF 3' INLET
54'
TO BOTTOM
OF 4 INLET
105'
100'
31'
52' TO BOTTOM OF 4' OUTLET
52 1/2' TO BOTTOM OF 3' OUTLET
2i'
3' OR 4'
OUTLET BOOTS
ON OUTLET END
ONLY
OUTLET
SHOAF PRECAST SEPTIC INC.
MODEL: MS 1000 STB
NON p p C
NON TRAFFIC
1000 Gallon Septic Tank
4130 WEST US HWY 64
LEXINGTON, NC 27295
PHONE [phone]
FAX [phone]
W W W.SHOAFPRECAST.COM
SHOAF-1000 NON TRAFFIC RATED
STB-760 NON TRAFFIC
LIQUID CAPACITY-1039 US GALLONS/9 i' AIRSPACE
TANK HEIGHT-66'
BOTTOM OF TANK TO CENTER OF INLET-56'
BOTTOM OF TANK TO CENTER OF OUTLET-54'
LENGTH TO WIDTH RATIO-2 TO 1
SIZE OF INLET & OUTLET-3' OR 4' PIPE
TYPE OF INLET & OUTLET-POLYLOCK OR EQUAL <MEETS ASTM C-923)
CONCRETE PSI-4000J TANK WEIGHT-8,500 LBS.
REINFORCING PER STATE CODE
*NOTE - TEE
NOT SUPPLIED
SCALE - N.T.S.
STATE
APPROVAL #
SHOAF-1000
STB-760
1' BUTYL RUBBER
MASTIC SEALANT
CONTINUOUS IN
JOINT
[ [ f 1 [ [ [ [ [ f 1 1 f 1 1 1 1 1 1

0
0
0
'.
M
2
0
O
O
.-1
1.0
M
TOPO! map printed on 05/23/13 from "Untitled.tpo"
81°45.000' W 81°44.000' W
�►
e. Lwifti ii1JBv Laphic; 020d5 ele-Att0 Rel. 8/200
81°46.000' W
81°45.000' W 81°44.000' W
0 S 1
WGS84 81°43.000' W
36°15.000' N
36°14.000' N
WGS84 81°43.000' W
MN* TN
NATIONAL
GEOGRAPHIC
MILES
100000 -. 0 1000 2000 2000 4000 5120
FEET
.5 0
1000
KIOMETEE1S
0 Mf!FOS
05/23/13