NCG550083_Permit (Issuance)_20060612

AVIA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross,Jr., Secretary
Alan W. Klimek, P.E., Director
June 12, 2006
CERTIFIED MAIL — 7006 0100 0001 8758 5804
RETURN RECEIPT REQUESTED
Mr. Alan Eugene and Julie Grab Casey
8800 Buckey Ct.
Clemmons, N.C. 27012
Subject: General Permit NCG550000
Certificate of Coverage NCG550083
8800 Buckey Ct. •
Forsyth County
Dear Ms. Casey:
You are receiving this notice because you currently own a home/property covered under the
subject General Permit for the discharge of domestic wastewater. The Certificate of Coverage
specific to your property expired in 2002.
The Division needs information from you to determine if coverage under NCG550000 is still necessary. -
D. If your property still has a wastewater system like the ones described in the enclosed Technical
Bulletin,you should renew the subject permit. Complete the enclosed form and submit it to the
address on the form.
➢ If you are not sure what type of system your property has, contact Rose Pruitt in the NC DENR
Winston-Salem Regional Office at(336) 771-5000. She can help you determine if you should
renew coverage under the General Permit.
➢ If you know that your property no longer discharges wastewater to a waterbody, contact me at the
address or phone number listed below to request rescission of the Certificate of Coverage.
If you have any questions concerning this matter, please contact me at the telephone number
or e-mail address listed below.
Sincerely,
1.0-2 Charles H. Weaver, Jr.
NPDES Unit
CW/RP
cc: Central Files
Winston-Salem Regional Office
ILCL)raailesiWceavieraNalE frlE
1617 Mail Service Center,Raleigh,North Carolina 27699-1617 One
512 North Salisbury Street,Raleigh,North Carolina 27604 NorthCarolina
Phone: [phone],extension 511/FAX [phone]/[e-mail] ! aturallAn Equal Opportunity/Affirmative Action Employer—50%Recycled/10%Post Consumer Paper

46677A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
GENERAL PERMIT Certificate of Coverage RENEWAL FORM
CURRENT PERMIT INFORMATION:
Certificate of Coverage (CoC) Number: NCG55
•
Owner's name (name to be put on permit): •
Owner's or signing official's name and title: •
(Person legally responsible for permit)
•
(Title) •
Mailing address:
City: State: Zip Code:
•
Phone: ( )
E-mail address:
Applicant's Certification:
l , attest that the property previously
covered by the Certificate of Coverage (CoC) listed above is under my ownership/control. I
hereby request renewal of the CoC listed above and assume responsibility for wastewater
discharge[s] from the site.
Signature: Date:
Send this completed form and a copy of the property deed to:
Mr. Charles H. Weaver, Jr.
NC DENR/ DWQ/ NPDES Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
1617 Mail Service Center,Raleigh,North Carolina 27699-1617 One •
512 North Salisbury Street,Raleigh,North Carolina 27604 NorthCarolina
Phone: [phone]/FAX [phone]/Internet:h2o.enr.state.nc.us Naturally
An Equal Opportunity/Affirmative Action Employer—50%Recycled/10%Post Consumer Paper

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NORTH CAROLINA DIVISION OF WATER QUALITY
•
revised October 2004
Who Is Covered Under This Permit? Operation and Maintenance
This permit covers discharges of treated domestic In order to protect water quality and to ensure proper
wastewater from single family residences at flows not to operation of domestic wastewater systems,the following
exceed 1000 gallons per day. Other types of facilities measures should be taken:
discharging less than 1000 gallons per day of treated
domestic wastewater may be covered under this permit • Check the septic tank every year to see if solids
with the approval of the Division. should be removed.
• Have the septic tank pumped out every three to five
Changes in Reissued General Permit years. Contact a local septic service/repair
company.
The previous General Permit expired July 31, 2002. The • Inspect disinfection and dechlorination equipment
permit has been reissued for an additional five years. The (if applicable) every week to confirm proper
new permit contains no significant changes from the operation.
previous version. There were changes made to the Notice • If a chlorinator is installed, replace chlorine tablets
of Intent (NOI) which must be filed to obtain coverage • whenever necessary. Chlorine tablets must be
under this permit. The changes to the NOI were for maintained in the chlorinator at all times.
clarification and to request additional information.
Tips for Maintaining Your Wastewater System
Key Permit Requirements
The septic tank is usually a watertight concrete box buried
• Annual sampling of the effluent from the system is in the ground outside the house. Wastewaters from the
required. The parameters to be sampled can be found house, including the toilets, shower, bathtub, washing
in Part I, Section A. A North Carolina certified machine and dishwasher flow into the tank. Heavier solid
laboratory should be contacted to perform the materials settle to the bottom and the liquid flows out of
analytical monitoring. A list of certified laboratories the septic tank onto a sandfilter and through a disinfection
can be obtained by calling the Division. unit. Both the septic tank and sandfilter must be properly
• All samples should be collected before the effluent maintained for the system to work correctly. Some tips
joins or is diluted by any other wastestream, body of for maintaining your wastewater system are:
water or substance. (Part II, Section D:1)
• The permittee shall give notice to the Division of any • Do not put too much water into the septic system.
planned physical alterations or additions to the Try to conserve water wherever possible.
system that could significantly increase the quantity • Do not add materials such as chemicals, sanitary
of pollutants discharged or introduce new pollutants napkins,or other foreign objects.
to the discharge. These alterations include any types • Restrict the use of your garbage disposal.
of residence/facility expansions. (Part II, Section • Do not pour grease or cooking oils down the drain.
E:3) • Have the solids pumped out of the septic tank every
• Submission of monitoring reports is not required. All 3-5 years.
monitoring information must be retained on site for a • Keep automobiles and heavy equipment off of the
period of 3 years. (Part II, Section E:1) septic tank,sandfilter and disinfection unit.
• Do not plant trees or bushes near the septic tank or on
Minimum Treatment System Requirements top of the sandfilter or disinfection unit.
System requirements for existing (previously Chlorine Tablets
constructed) systems are a septic tank, sand filter and
disinfection apparatus. System requirements for a new All treatment systems must have a chlorinator. It is
(not yet constructed) system are a septic tank, primary important that there is an adequate supply of chlorine
and secondary(or recirculating) sand filters, disinfection tablets in the chlorinator to ensure proper operation.
and post-aeration apparatus. There will usually be a white PVC pipe sticking up from
the chlorination unit where the tablets should be inserted.
Tablets may sometimes be obtained from plumbing

supply stores. If you cannot find tablets, contact your 4) Does a certified lab need to be used to analyze
local Division of Water Quality regional office. Make samples?
sure that the tablets are certified for wastewater use. Yes, a North Carolina certified lab must be used to
These chlorine tablets are NOT the same type of chlorine perform the sample analysis. The only exception to
used for swimming pools. this rule is when measuring the value of pH. pH
values should be measured in the field because they
Signs of Wastewater System Problems may change considerably between the time a sample
is collected and it is analyzed at the laboratory. A list
Some of the signs that your wastewater system may be of certified labs is available from the Division.
having problems are:
5) What If I Sell My Property?
• Sewage backing up into your toilets,tubs or sinks. The Division views changes of name or ownership as
• Slowly draining fixtures; particularly after it has a minor modification and requires the Director's
rained. approval. Name and ownership changes require you
• The smell of raw sewage accompanied by soggy soil to complete a Name/Ownership Change Form. The
over the sandfilter. forms are available by contacting the NPDES Unit at
• Sewage discharging over the ground or in nearby [phone].
ditches or woods.
6) When does my permit expire and how do I renew
If you see any of these signs, contact a septic it?
service/repair company in your area. You should also The expiration date of the permit is on the first page
contact. the appropriate Division of Water Quality of the General Permit. This General Permit expires
regional office. . on July 31, 2007. Approximately 180 days prior the
expiration of the General Permit, you will receive a
Right-of-Way •
renewal notice in the mail from the Division.
Issuance of this general permit does not relieve the Contact Us
permittee from obtaining all necessary right-of-way or
easement rights to discharge wastewater on or across For additional information,please contact us at:
another property.
N.C.Division of Water Quality
Frequently Asked Questions Water Quality Section
Point Source Branch
1) Do I need to submit the monitoring results 1617 Mail Service Center
annually? Raleigh,N.C.27699-1617
No. The submission of monitoring reports for this Phone: [phone] Fax: [phone]
permit is not required. There are no standardized
Discharge Monitoring Reports (DMRs) associated You may also contact your local Regional Office at:
with this permit. All monitoring results should be
kept on site for three years. The Division may Asheville: [phone]
request these reports for review at any time. (Part II, Mooresville: [phone]
Section E:1) Winston-Salem: [phone]
Raleigh: [phone]
2) Do I need to employ a certified wastewater Fayetteville: [phone]
treatment plant operator to manage and run the Washington: [phone]
system? Wilmington: [phone]
Not at this time. The Division's Technical
Assistance and Certification Unit does not currently The Division can be found on the World Wide Web at
plan to classify these types of facilities for the http://h2o.enr.state.nc.us/. Another source of information
purposes of requiring a certified operator. The is the DENR Customer Service Center. They may be
condition regarding operators remains in the permit at reached at 1-877-NC ENR 4 U (1-877-623-6748). An
this time in the event that these facilities are additional source of information is the North Carolina
classified in the future. (Part II, Section C:1) Office of Waste Reduction. They have lots of specific
information on how to minimize pollutants at various
3) Where do I find my stream classification? types of industries. They may be reached at (919) 571-
The stream classification, i.e. WS-IV, C, Tr, etc. can 4100.
usually be found in the Certificate of Coverage. If
you are unsure of your stream classification, you can
contact the NPDES Unit.

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Block Lot 4405 017P New Deed Date I i
Property Address d 8800 Buckey Ct 1 New Deed Stamps 1
Additional Lots 1 I Map Number '1 576842
PIN 5874-65-9234 1 WIP
,, Tax Jurisdiction Lewisville/Lewisville FD, WR FD 1 Land Value $30,400 I
_
Taxable Owner Namel ;CASEY, ALAN EUGENE 1 Dwelling Value I$136,243
Taxable Owner Name2 CASEY, JULIE GRAB 11
3 Commercial Value
1 Taxable Owner Address 8800 Buckey Ct 1 Industrial Value
Taxable Owner City St Zip 1 Clemmons, NC 27012-0000 ;Misc Imp Value
II Taxable Deed Bk-Pg 2144-1442 i Total Value ' $166,643
Taxable Deed Date 11/29/2000 1 Acreage 0.54
Taxable Deed Stamps $298 1 Sq Ft Living Area (Res) 1803 '
New OwnerNamel �Gross Sq Ft(Com)
j New Owner Name2 Year Built(Res),. 11978�w,
New Owner Address a i Year Built(Com)
New Owner City St Zip •_�.�,�..,.,,.__. _,�,,,,,.�.,.,._, ,_ ,,,.,.,.,. �.._�'•.'•••""--y_._._- -�----�"`��Census Tract 40.07
New Deed Bk-Pg I 1 Zoning RS20
Disclaimer: Forsyth County cannot guarantee the accuracy of this information, and the Map Scale
1 of 2 6/5/2006 1:46 PM

NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
2004PR007227
INVOICE
Annual Permit Fee PC -
This annual fee is required by the North Carolina Administrative Code. It covers the administrative costs associated with your
permit. It is required of any person holding a permit for any time during the annual fee period,regardless of the facility's operating
status. Failure to pay the fee by the due date will subject the permit to revocation. Operating without a valid permit is a violation
and is subject to a$10,000 per day fine. If the permit is revoked and you later decide a permit is needed,you must reapply,with
the understanding the permit request may be denied due to changes in environmental,regulatory,or modeling conditions.
Permit Number: NCG550083 Annual Fee Period: 2004-09-01 to 2005-08-31
Forsyth County Invoice Date: 10/21/04
Kingery Terry-Residence
Terry Kingery Due Date: 11/20/04
8800 Buckey Ct Annual Fee: $50.00
Clemmons, NC 27012
Notes:
1. A$25.00 processing fee will be charged for returned checks in accordance with the North Carolina General Statute 25-3-512.
2. Non-Payment of this fee by the payment due date will initiate the permit revocation process. ke_, -v/ �,
/5(ki7ec4/
3. Remit payment to: p
NCDENR-Division of Water Quality /rI `��
1617 Mail Service Center /
Raleigh,NC 27699-1617
4. Should you have any questions regarding this invoice,please comtact the Annual Administering and Compliance Fee Coordinator at
919-733-5083 extension 210 444e.
--a 6V 61 ei // (Orr /Jer' Wj 10
3 ' , z - ` 5-72 -
ANNUAL PERMIT INVOICE
(Return This Portion With Check)
2004PR007227
Permit Number: NCG550083 Annual Fee Period: 2004-09-01 to 2005-08-31
Forsyth County Invoice Date: 10/21/04
Kingery Terry-Residence
Terry Kingery Due Date: 11/20/04
8800 Buckey Ct Annual Fee: $50.00
Clemmons, NC 27012
Check Number: