NCG550071_Permit (Issuance)_20020726

State of North Carolina w A
Department of Environment Al
•
and Natural Resources y
Division of Water Quality
Michael F. Easley, Governor NCDENR
William G. Ross Jr., Secretary
Alan W. Klimek, P.E., Director NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
July 26,2002
ELIZABETH WARNER
WARNER ELIZABETH-RESIDENCE
179 CREEKWOOD DR
ADVANCE, NC 27006
Subject: Reissue-NPDES Wastewater Discharge Permit
Warner Elizabeth-Residence
COC Number NCG550071
Davie County
Dear Permittee:
In response to your renewal application for continued coverage under general permit NCG550000,the Division of
Water Quality(DWQ)is forwarding herewith the reissued wastewater general permit Certificate of Coverage
(COC). This COC is reissued pursuant to the requirements of North Carolina General Statute 143-215.1 and the
Memorandum of Agreement between the state of North Carolina and the U.S.Environmental Protection Agency,
dated May 9, 1994(or as subsquently amended).
The following information is included with your permit package:
* A copy of the Certificate of Coverage for your treatment facility
* A copy of General Wastewater Discharge Permit NCG550000
* A copy of a Technical Bulletin for General Wastewater Discharge Permit NCG550000
Your coverage under this general permit is not transferable except after notice to DWQ. The Division may require
modification or revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal
requirements to obtain other permits which may be required by DENR or relieve the permittee from responsibility
for compliance with any other applicable federal,state,or local law rule,standard,ordinance,order,judgment,or
decree.
Please note that effective January 1, 1999 the fees for all permits issued by DWQ were changed. This changed the
fee for your wastewater general permit coverage from a$240 fee paid once every five years to a yearly fee of$50.
If you have not already been billed this year for the yearly fee,you will receive a bill later this year.
If you have any questions regarding this permit package please contact Mack Wiggins of the Central Office
Stormwater and General Permits Unit at(919)733-5083,ext.542
Sincerely,
for Alan W. Klimek,P.E.
cc: Central Files
Stormwater&General Permits Unit Files
Winston-Salem Regional Office
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] FAX [phone]
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y
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO.NCG550000
CERTIFICATE OF COVERAGE No.NCG550071
TO DISCHARGE DOMESTIC WASTEWATERS FROM SINGLE FAMILY RESIDENCES
AND OTHER DISCHARGES WITH SIMILAR CHARACTERISTICS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1,other lawful standards and
regulations promulgated adopted ated and ado ted by the North Carolina Environmental Management Commission,and the
Federal Water Pollution Control Act,as amended,
ELIZABETH WARNER
is hereby authorized to operate a domestic wastewater treatment facility which includes a septic tank,sand filter,
and associated appurtenances with discharge of treated domestic wastewater from the facility located at
WARNER ELIZABETH-RESIDENCE
179 CREEKWOOD DR
ADVANCE
DAVIE COUNTY
to receiving waters designated as a ut to Smith Creek,a class C water,in the Yadkin-Pee Dee 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 No.NCG550000 as attached.
This certificate of coverage shall become effective August 1,2002.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 26,2002.
for Alan W.Klimek,P.E.,Director
Division of Water Quality
By Authority of the Environmental Management Commission

State of North Carolina
Department of Environment,
Health and Natural Resources � • •
Division of Water Quality
James B. Hunt, Jr., Governor p E H N Ri
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director July 21, 1997
Elizabeth Warner
179 Creekwood Drive
Advance,NC 27006
Subject: Certificate of Coverage No. NCG550071
Renewal of General Permit
Warner, Elizabeth - Residence
Davie County
Dear Permittee:
In accordance with your application for renewal of the subject Certificate of Coverage, the Division is forwarding
the enclosed General Permit. This renewal is valid from the effective date on the permit until July 31, 2002. This
permit is issued pursuant to the requirements of North Carolina General Statute 143-215 .1 and the Memorandum of
Agreement between North Carolina and the U.S. Environmental Protection Agency dated December 6, 1983. If any
parts,measurement frequencies or sampling requirements contained in this permit are unacceptable to you,you have
the right to request an individual permit by submitting an individual permit application. Unless such demand is
made, this Certificate of Coverage shall be final and binding.
The Certificate of Coverage for your facility is not transferable except after notice to the Division. Use the enclosed
Permit Name/Ownership Change form to notify the Division if you sell or otherwise transfer ownership of the
subject facility. The Division may require modification or revocation and reissuance of the Certificate of Coverage.
If your facility ceases discharge of wastewater before the expiration date of this permit, contact the Regional
Office listed below at [phone]. Once discharge from your facility has ceased, this permit may be rescinded.
This permit does not affect the legal requirements to obtain other permits which may be required by the Division of
Water Quality, the Division of Land Resources, Coastal Area Management Act or any other Federal or Local
governmental permit that may be required.
If you have any questions concerning this permit,please contact the NPDES Group at the address below.
Sincerely,
•
1),-frE:k gry-k/cii____.-
A. Preston Howard,Jr.,P.E.
cc: Central Files
Winston-Salem Regional Office
NPDES Group
Facility Assessment Unit
P.O. Box 29535, Raleigh, North Carolina 27626-0535 [phone] FAX[phone] p&[e-mail]
An Equal Opportunity Affirmative Action Employer 50% recycled /10%post-consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG550000
CERTIFICATE OF COVERAGE NO. NCG550071
TO DISCHARGE DOMESTIC WASTEWATERFROM SINGLE FAMILY RESIDENCES
AND OTHER DISCHARGES WITH SIMILAR CHARACTERISTICS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision 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,
Elizabeth Warner
is hereby authorized to operate a wastewater treatment facility which includes a septic tank, sand filter
and associated appurtenances with the discharge of treated wastewater from a facility
located at
Warner, Elizabeth - Residence
179 Creekwood Drive
Advance
Davie County
to receiving waters designated as subbasin 30702 in the Yadkin 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 No. NCG550000 as attached.
This certificate of coverage shall become effective August 1, 1997.
This certificate of coverage shall remain in effect for the duration of the General Permit.
Signed this day July 21, 1997.
i)iter.L q774410C11—
festVA. Preston Howard,Jr., P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

Letter to ELIZABETH WARNER February 7,1997
NCG550G71
INVOICE FOR RENEWAL OF g60
NPDES PERMIT VW(-6)0
Check here if you do NOT wish to renew this permit.
Please return this page along with a letter documenting your reasons
for not requesting renewal to:
Mr. Charles H. Weaver, Jr.
Division of Water Quality/WQ Section
NPDES Group .0
Post Office Box 29535
Raleigh, North Carolina 27626-0535 -c
d Check here if you wish to renew this permit. , rrl
'k Please verify the following information and revise any incorrect entries:
C6.40.1(11;10Mailing Address
ELIZABETH WARNER
WARNER, ELIZABETH - RESIDENCE o revision required.
Alp REEKWOOD DRIVE
ADVANCE,NC 27006 ElRevision required. (Please specify below.)
00
Phone number: (919)998-�39.
Fax number:
e-mail address:
Facility Location
ELIZABETH WARNERo revision required.
/r/ CREEKWOOD DRIVE
ADVANCE,NC 27006 Revision required. (Please specify below.)
Please return this page with your letter requesting renewal, and $240 fee (payable to NCDEHNR) to:
Mr. Charles H. Weaver, Jr.
Division of Water Quality/WQ Section
NPDES Group
Post Office Box 29535
Raleigh, North Carolina 27626-0535
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Signature of applicant or authorized representative
Date 5- —q7

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Division of Environmental Management
PO Box 29535
Raleigh, NC 27626-0535
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