NCG550083_Permit (Issuance)_20070130

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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
January 30, 2007
CERTIFIED MAIL-RETURN RECEIPT REQUESTED
Julie G. &Alan E. Casey
8800 Buckey Ct
Clemmons, NC 27012
Subject: Renewal Notice/General Permit NCG550000
Certificate of Coverage NCG550083
Forsyth County
Dear Sir or Madam:
You are receiving this notice because Forsyth County tax records indicate that you own
the property at:
8800 Buckey Ct
Clemmons, NC 27012
The property was previously covered under General Permit NCG550000 for the discharge
of domestic wastewater. That coverage expired on July 31, 2002; the owner who obtained
coverage did not respond to renewal notices from the Division. If this property is still
discharging wastewater, you must renew coverage under NCG550000.
The Certificate of Coverage (CoC) specific to your property [NCG550083] was last issued
on July 21, 1997. The Division needs information from you to determine if coverage under
NCG550000 is still necessary.
➢ If your property still has a wastewater system like the ones described in the
enclosed Technical Bulletin, you must renew the subject CoC. 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 [phone]. That person [or
other staff members] can help you determine if you should renew your CoC.
➢ If you know that your property no longer discharges wastewater, contact me at
the address or phone number listed below to request rescission of the CoC.
➢ If you have already mailed a renewal request, you may disregard this
notice.
1617 Mail Service Center,Raleigh,North Carolina 27699-1617 One
512 North Salisbury Street,Raleigh,North Carolina 27604 No Carolina
Phone: [phone],extension 511/FAX [phone]/[e-mail] atura!!y
An Equal Opportunity/Affirmative Action Employer—50%Recycled/10%Post Consumer Paper

NCG550083 renewal notice
Page 2
The attached application form shows the information the Division has on file for your
property. Please verify that the provided information is correct, or make corrections on the
form. Complete the additional questions, then sign and date the form.
The completed form should be submitted to the address listed below the signature block.
If you have any questions concerning this matter, please contact me at the telephone
number or e-mail address listed below. Please reference CoC number NCG550083 when
you make contact. (If it is difficult to reach me, please be aware that your facility is one of
over 1100 that I am contacting regarding the renewal of NCG550000.)
Thanks for your attention to this matter.
Sincerely,
;7.
Charles H. Weaver, Jr.
NPDES Unit
cc: Central Files
Winston-Salem Regional Office/Rose Pruitt
NPDES file

SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete /I •ignat re .= 1
item 4 if Restricted Delivery is desired. 1!yjfi`"/ 0 Agent
• Print your name and address on the reverse i�d 0 Addressee
so that we can return the card to you. B:,Received by(Printed Name) C. Date of Delivery
• Attach this card to the back of the mailpiece,
or on the front if space permits.
D. Is delivery address different from item 1? 0 Yes
1. Article Addressed to: If YES,enter delivery address below: 0 No
Julie G. & Alan E. Casey l�
8800 Buckey Ct �� l,�O ✓)
Clemmons NC 27012
3. Service Type /
Certified Mail ❑ Express Mail
Cl Registered ❑ Return Receipt for Merchandise
0 Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number (�./�
(Transfer from service labe0 17(0jrl f2`,1,�'1 (--FAQ, 7& >C_,may�D
PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540
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UNITED $#li'fdSP6`t`P�L�$�RVI� � .At•.i\. -•„�,,, ---- ..6irSt=�Ias�Mail w.�
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• Sender: Please print your name, address, and ZIP+4 in this box•
NC DENR/DWQ/NPDES
1617 MAIL SERVICE CENTER
RALEIGH NC 27699-1617
ATTN CHARLES WEAVER
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