NCG550354_Lakeside_Drive_Lot_13_Edgar_Brown_CEI_Letter_20231204

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
Edgar C. Brown
P.O. Box 395
Stoneville, NC 27048
NORTH CAROLINA
Environmental Quality
December 4, 2023
SUBJECT: Compliance Evaluation Inspection for
Lakeside Drive/Lot 13, Deep Springs Country Club, Mayodan, NC, 27027
Single -Family Residence Wastewater Discharge Permit NCG550354
Rockingham County
Dear Mr. Brown:
Ron Boone, of the NC Division of Water Resources (DWR) Winston-Salem Regional Office (WSRO), spoke
with you by phone on November 30, 2023, concerning the subject property and single-family residence
wastewater discharge permit. You informed Mr. Boone at that time that there is no home or wastewater
treatment system built on the property, but that you intend to maintain the permit and may sell the
property in the future.
Given that there is no home or treatment system built on the property, no onsite inspection is required
at this time. However, please be advised that you should contact us immediately when you do build a
home on the property so an onsite inspection can be conducted. Please also be aware that if you sell the
property, this permit should also transfer to the new owner. To make that transfer please use the attached
Name/Ownership Change Form.
A review of the permit in our database shows that all but the last annual permit fee have been paid,
thereby keeping the permit current. Please locate the invoice that was sent to you by the Division with
the payment due 9/1/2023 and remit the required payment to keep the permit current.
If you have any questions or need assistance, please contact Mr. Boone by phone at 336.776.9690, or by
email at [e-mail].
Sincerely
DocuSigned by:
E�O=3C 7456
Jenraznak, Assistant Regional Supervisor
Water Quality Regional Operations Section
Winston-Salem Regional Office
Division of Water Resources, NCDEQ
Attachments:
1. NCG550000 General Permit
2. Name/Ownership Change Form
DffNorth Carolina Department of Environmental Quality I Division of Water Resources
oan caaouNn
Winston-Salem Regional Office 1 450 W. Hanes Mill Rd, Suite 300 I Winston-Salem, North Carolina 27105
M336.776.9800
oep.m.m or em�nmen� Qualm,

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 IN 2 u 3 I NCG550354 111 121 23/11/30 I17 18 [C] I 19 I s I 20L]
21111I I I I I I I II I I I I I I I I I I I I I I I I I I I I I I I II I I I I I r6
Inspection
Work Days Facility Self -Monitoring Evaluation Rating B1 QA ---------------------- Reserved -------------------
67
I 72 I ni I 73 � I 74 79 I I I I I I I80
70 I I 71 I LL -1 I I
LJ
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES Dermit Number)
11:15AM 23/11/30
20/11/20
Lakeside Drive / Lot #13
Deep Springs Country Club
Exit Time/Date
Permit Expiration Date
Mayodan NC 27027
11:30AM 23/11/30
25/10/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Edgar C Brown,PO Box 395 Stoneville NC 27048///
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
cusigned by: DWR/WSRO WQ/336-776-9690/
Ron Boone DE'-,-
cl Boo.ue' 12/4/2023
0F8DD5F2A3460...
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
by:
jDocuSigned
if, '-4 -'!� DWR/WSRo 336-776-9695 12/4/2023
1-0=3CE3F167456...
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

NPDES yr/mo/day Inspection Type
NCG550354 I11 12I 23/11/30 117 18 i c i
(Cont.)
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Ron Boone, of the NC Division of Water Resources (DWR) Winston-Salem Regional Office (WSRO),
spoke with you by phone on November 30, 2023, concerning the subject property and single-family
residence wastewater discharge permit. You informed Mr. Boone at that time that there is no home or
wastewater treatment system built on the property, but that you intend to maintain the permit and may
sell the property in the future.
Given that there is no home or treatment system built on the property, no onsite inspection is
required at this time. However, please be advised that you should contact us immediately when you
do build a home on the property so an onsite inspection can be conducted. Please also be aware
that if you sell the property, this permit should also transfer to the new owner. To make that transfer
please use the attached Name/Ownership Change Form.
A review of the permit in our database shows that all but the last annual permit fee have been paid,
thereby keeping the permit current. Please locate the invoice that was sent to you by the Division with
the payment due 9/1/2023 and remit the required payment to keep the permit current.
If you have any questions or need assistance, please contact Mr. Boone by phone at 336.776.9690,
or by email at [e-mail].
Page#

Permit: NCG550354
Inspection Date: 11/30/2023
Owner -Facility: Lakeside Drive / Lot #13
Inspection Type: Compliance Evaluation
Permit
Yes
No
NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new
❑
❑
❑
application?
Is the facility as described in the permit?
0
❑
❑
❑
# Are there any special conditions for the permit?
❑
0
❑
❑
Is access to the plant site restricted to the general public?
❑
❑
0
❑
Is the inspector granted access to all areas for inspection?
0
❑
❑
❑
Comment: Neither a home nor a wastewater treatment system have been constructed at this site.
Page# 3