NCG550087_Other_20111201

Alo � � rr
C
Weaver, Charles
From: Boone, Ron
Sent. Wednesday, February 16, 2011 12:13 PM
To: Weaver, Charles
Subject: RE: unpaid invoices for Forsyth County SFRs
Well Y 550087 is vacant. Is still listed as Isaac Pitts and Simon Johnson as owners on count website but the house is
empty. Not sure if they were foreclosed on or what. May need to just give it some time to pan out.
550383, probably have to give this one time too. You can try sending to USDA but as you said not sure it'd go anywhere.
I'll keep an eye on both residences when I'm in the areas and let you know if anything changes.
Ron Boone
NC DENR Winston -Salem Regional Office
Division of Water Quality, Surface Water Protection
585 Waughtown Street
Winston - Salem, NC 27107
Voice: (336) 771 -5000
FAX: [phone]
E -mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
From: Weaver, Charles
Sent: Friday, January 28, 2011 10:03 AM
To: Boone, Ron
Subject: unpaid invoices for Forsyth County SFRs
Ron — Fran just gave me some returned invoices from Fors h CQuintv._They_.are:
NCG550087 — 3295 Kittering Ln / W -S .
Owner is Isaac Pitts. He took ownership in 2009, paid fee last year. Invoice returned this year. Billing address was
correct.
NCG550383 — 5006 Woodsboro Ln / W -S
Owner was Norman G. Mabe. He paid every invoice for the past 6 years.
Invoice was returned with the following note:
"Foreclosed on send to USDA -RD / P.O. Box 790170 / St. Louis, MO 63179 - 0170"
We can re -send the invoice to USDA, 1 guess, but without a contact name it would probably go nowhere. Do you want to
check the site out?
Would be grateful for any info you can find.
Thanks,
CHW
Messages to and from this address are subject to the N.C. Public Records Law.

NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue, Governor
Isaac F. Pitts, Jr.
3295 Kittering Lane
Winston - Salem, NC 27105
Dear Permittee:
Division of Water Quality
Coleen H. Sullins, Director
October 8, 2009
Dee Freeman, Secretary
Subject: Renewal of coverage / General Permit NCG550000
3295 Kittering Lane
Certificate of Coverage NCG550087
Forsyth County
In accordance with your renewal application [received on October 8, 2009], the Division is renewing
Certificate of Coverage (CoC) NCG550087 to discharge under NCG550000. This CoC 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] .
If any parts, measurement frequencies or sampling requirements contained in this General 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, the certificate of coverage shall be final and binding.
Please take notice that this Certificate of Coverage is not transferable except after notice to the
Division. The Division may require modification or revocation and reissuance of the certificate of coverage.
Contact the Winston -Salem Regional Office prior to any sale or transfer of the permitted facility.
Regional Office staff will assist you in documenting the transfer of this CoC.
This permit does not affect the legal requirements to obtain other permits which may be required by
the Division of Water Quality or permits required by 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 the requirements of the General Permit, please contact Charles
Weaver of the NPDES staff [919 807 -6391 or [e-mail]].
Si cerely,
f LIVG
, oleen H. Sullins
cc: Central Files
Winston -Salem Regional Office / Surface Water Protection
NPDES file
1617 Mail Service Center, Raleigh, North Carolina 27699 -1617 One 1,,
512 North Salisbury Street, Raleigh, North Carolina 27604 * NorthCarollna
Phone: [phone] /FAX [phone] / Internet: www.ncwaterquality.org ;VatU4911b,
An Equal Opportunity /Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper,

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG550087
DISCHARGE OF DOMESTIC WASTEWATER FROM SINGLE FAMILY RESIDENCES AND
OTHER 100% DOMESTIC 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,
Isaac F. Pitts, Jr.
is hereby authorized to discharge domestic wastewater [450 GPD] from a facility located at
3295 Kittering Lane
Winston -Salem
Forsyth County
to receiving waters designated as Frazier Creek, a class C stream in subbasin 03 -07 -04 of 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 hereof.
This certificate of coverage shall become effective October 8, 2009.
This Certificate of Coverage shall expire on July 31, 2012.
Signed this day October 8, 2009
tit
fo Col n H. Sullins, Director
ivision of Water Quality
By Authority of the Environmental Management Commission

i RECEIVED
N.C. Deot of ENI�
Michael F. Easley, �iovemor
OCT 0 12009 William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
} -y Winston -Sale.
D Regional Off.ce Alan W. Klimek, P.E. Director
Division of Water Quality
SURFACE WATER PROTECTION SECTION,:
PERMIT NAME /OWNERS.HIP CHANGE FORM
I. Please enter the permit number for which the change is requested.
NPDES Permit (or) Certificate of Coverage
N I C I I I I I I T7 I N I C I G 157 15 1 0 10 16 f7 I
II. Permit status LILiff to status change.
a. Permit issued to (company name):
b. Person legally responsible for permit: pr S • ry l % L1.E
First / MI / Last
T itic
Permit Holder Mailing Address
City State Zip
( ) ( )
Phone Fax
c. Facility name (discharge):
d. Facility address: 3 s 1 'i'T E2 1 N G)
Address
W �JV S"TC)m S4 .M M C -
City State Zip
e. Facility contact person: ( )
First / MI / Last Phone
III. Please provide the following for the requested change (revised permit).
a. Request for change is a result of- Change in ownership of the facility
Name change of the facility or owner
If other please explain:
b. Permit issued to (company name):
c. Person legally responsible for permit: A A C F S JY2F
First / MI / Last
RECEIVED
d. Facility name (discharge):
eODTility -Ad�
DENR f A%,T&taWAgTy
POINT SOURCE BRANCH
Revised 7/2005
Title
Permit Holder Mailing Address
ti'so� SSA- I>o�n /V e- g 7/os"
City State Zip
a esaevls, or -
Phone E -mail Address
'
1S
i'ff elej� 1-4tie
Address
City State // Zip
-rsn'l G f �tT _5 Tr,-
First / MI / Last
(33 ) <Z )' &._ yW )- ,` ; As p. q es C' � eg
Phone E -m tl Address jP

PERMIT NAME /OWNERSHIP CHANGE FORM
Page 2 of 2
IV. Permit contact information: (if different from the person legally responsible for the permit)
Permit contact:
First / MI / Last
Title
Mailing Address
City State Zip
Phone E -mail Address
V. Will the permitted facility continue to conduct the same industrial activities conducted prior to
this ownership or name change?
Yes
❑ No (please explain)
VI. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS ARE
INCOMPLETE OR MISSING:
❑ This completed application is required for both name change and/or ownership change requests.
❑ Legal documentation of the transfer of ownership (such as relevant pages of a contract deed, or a bill
of sale) is required for an ownership change request. Articles of incorporation are not sufficient for
an ownership change.
The certifications below must be completed and signed by both the permit holder prior to the change, and the new
applicant in the case of an ownership change request. For a name change request, the signed Applicanis Certification
is sufficient.
PERMITTEE CERTIFICATIO (Permit h d prior to ownership change):
I, L l iT VIY,,, ,,'attest that this application for a name /ownership
change has been reviewed and is accurate iffid co plete to the best of my knowledge. I understand that if all required
parts of this application are not completed and that if all required supporting information is not included, this
application package will be returned-as incomplete.
1"1 �ng ure - Date
APPLICANT CERTIFICATION: �
Ak��1; fattest that this application for aname /ownership
change has been reviewed and is accurate and complete to the best of my knowledge. I understand that if all required
parts of this application are not completed and that if all required supporting information is not included, this
applic tion package w' be returned as incomplete.
°' �D
/Sign atur Date
.. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 .. 0
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Water Quality
Surface Water Protection Section
1617 Mail Service Center
Raleigh, North Carolina 27699 -1617
Revised 7/2005

{� 0
e� k
NCDENR
North Carolina Department of Environment and Natural
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
August 10, 2009
CERTIFIED MAIL 7008 0500 0002 0609 3598
RETURN RECEIPT REQUESTED
Nationstar Mortgage LLC
350 Highland Dr
Lewisville TX 75067
Resources
Dee Freeman
Secretary
SUBJECT: Notice of Violation and Recommendation to Enforce
NCG550087 - NOV- 2009 -PC -0709
Discharge of Wastewater Without a Permit
3295 Kittering Lane, Winston Salem
Forsyth County, NC
Dear Nationstar Mortgage,
A compliance inspection was conducted at 3295 Kittering Lane on August 6, 2009 by Rose Pruitt of the Winston -Salem
Regional Office of the Division of Water Quality (DWQ). This inspection consisted of a file review and site inspection of
3295 Kittering Lane. During the file review it was determined that the Division of Water Quality has no record of your
having a valid permit for the discharge of wastewater at the location noted above. This site discharges to Frazier Creek, a
Class C Water in the Yadkin River Basin.
The Division notes that Forsyth County tax records show you to be the owner of this property since 2008. A permit
issued to Brenda Millet- for this facility expired on July 31, 2007.
There are serious compliance issues and violations noted as follows.
Dischar,c,inV, Without a Permit
You are hereby advised that the discharge of wastewater without benefit of a permit from DWQ constitutes a violation of
North Carolina General Statute (NCGS) § 143 - 215.1. Control of sources of water pollution; permits required
(a) Activities for Which Permits Required. — No person shall do any of the following things or carry out any of
the following activities unless that person has received a permit from the Commission and has complied with all
conditions set forth in the permit:
(1) Make any outlets into the waters of the State.
(2) Construct or operate any sewer system, treatment works, or disposal system within the State.
(6) Cause or permit any waste, directly or indirectly, to be discharged to or in any manner intermixed
with the waters of the State in violation of the water quality standards applicable to the assigned
classifications or in violation of any effluent standards or limitations established for any point source,
unless allowed as a condition of any permit, special order or other appropriate instrument issued or
entered into by the Commission under the provisions of this Article.
North Carolina Division of Water Quality, Winston -Salem Regional Office
Location: 585 Waughtown St. Winston - Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service: 1- 877- 623 -6748
Internet: www.ncwaterquality.org
An Equal Opportunity 1 Affirmative Action Employer
Qne
NorthCarohna
Aaturally

The enforcement options available to DWQ for violations of the previously referenced statutes are found at NCGS 143-
215.6 A, B, and C, and include civil penalties, criminal penalties, and or injunctive relief. The civil penalties for
violations such as these may be as hip_h as $25,000.00 per day per violation. The Certificate of Coverage for this
facility expired July 31, 2007.
You must immediately take whatever steps are necessary to stop the unpermitted discharge of wastewater at the
site.
• As a first step, you should complete the enclosed Renewal Form for Existing Permitted Facilities and return it to
Mr. Charles Weaver at the address indicated on the Renewal form within 10 days of receipt of this notice.
This Office requests that you respond to this letter, in writing, within 10 days of receipt of this Notice. Your
response should include the following items:
• Please clearly discuss your efforts to abate /stem impacts to surface waters and stop the illegal discharge of process
waste water from your facility.
• Explain your status as it pertains to the permit application process.
• A duplicate copy of the completed Renewal Form for Existing Permitted Facilities form should be enclosed with
your response to this Notice to the Winston Salem Regional Office within 10 days of receipt of this Notice.
Our office is considering a recommendation in favor of the pursuit of punitive sanctions against you. Prior to making any
such recommendation, we need to insure that we have all relevant information. If you wish to present any additional
explanation for the violations cited, or if you believe there are other factors which should be considered, please send such
information to me in writing within (10) days following receipt of this letter. Any additional information will be
reviewed, and, if an enforcement action is still deemed appropriate, this information, along with other relevant
information, will be forwarded to the Director of DWQ with the enforcement package for his consideration.
Should you have any questions on this matter, contact Rose Pruitt at (336) 771 -5000.
Sincerely,
Steve W. Tedder
Water Quality Supervisor
Winston -Salem Region
Division of Water Quality
Attachments; NOI
Cc WSRO
Central Files
Charles Weaver, DWQ -NPDES

Print Preview
f
Forsyth County, NC
Page 1 of 1
4.55CA
AS
} * ~" .�i _• `'r }- \ +f� � . .� '.. _4 ;t+�. ,�. { . sr �i~�fy ,'i .: • . r� `Yy1_ ' ,.
y . s s ti
`` _ /'��. t r f d k"' rt � "ti .J . 7,• �: .�„ �,7 �;
ti `hP 'x .•!� t. } �j•a
I i �1 7 • '}. s •. `?•'`. t, f3.. _-
0.12CA .n _
Wit- *iL•+jV`3j•' ` V4 * -T ti -.. y \ r4� l� `.` ! `- "".ti . } • �7 _ ( li t ! .� -'_
Y 4a
,ti' WINSTON-SALEM �k,i ; y �,Y� �7� s?
0.9ACA� -
Air 41
_ i ten: .� - _ �� �' ��. t '� � , r . �• r. , ,: �, +_.A�.
g • a ` + UJ � � ; WI T � Y~ R`i ` • i L yh 1 rt,. C
it .i , `,. A ,i - ���� . i� . :!� ?� t } .•�. ..
- 1.56 A ' 4 .
PIN
6846 -86- 3467.00
Current Deed Stamps
$252
Property Address
3295 Kittering Ln
SELKIRK DR
648866
Block Lot
3221 408
Assessment Method
Additional Lots
W1P
No
Tax Jurisdiction
Winston -Salem
Land Value
$43,000
Anx
N
Dwelling Value
$134,190
Taxable Owner Name
Nationstar Mortgage Llc
Commercial Value
Taxable Owner Name2
Industrial Value
Taxable Owner Address
350 Highland Dr
Misc Imp Value
$300
Taxable Owner City St Zip
Lewisville, TX 75067
Total Value
$177,500
Taxable Deed Bk -Pg
2862 -2267
Acreage
2.77
Taxable Deed Date
11/17/2008
PIN
6846 -86- 3467.00
Current Deed Stamps
$252
Property Address
3295 Kittering Ln
Map Number
648866
Block Lot
3221 408
Assessment Method
Cost
Additional Lots
W1P
No
Tax Jurisdiction
Winston -Salem
Land Value
$43,000
Anx
N
Dwelling Value
$134,190
Taxable Owner Name
Nationstar Mortgage Llc
Commercial Value
Taxable Owner Name2
Industrial Value
Taxable Owner Address
350 Highland Dr
Misc Imp Value
$300
Taxable Owner City St Zip
Lewisville, TX 75067
Total Value
$177,500
Taxable Deed Bk -Pg
2862 -2267
Acreage
2.77
Taxable Deed Date
11/17/2008
Sq Ft Living Area (Res)
1296
Taxable Deed Stamps
$252
Gross Sq Ft (Com)
Current Owner Name
Nationstar Mortgage Llc
Year Built (Res)
1978
Current Owner Name2
Year Built (Com)
Current Owner Address
350 Highland Dr
Census Tract
17
Current Owner City St Zip
Lewisville, TX 75067
Zoning
RS12
Current Deed Bk -Pg
2862 -2267
Last Qualified Sale Price
Current Deed Date
11/17/2008
Disclaimer." Forsyth County cannot guarantee the accuracy of this information, and the
County hereby disclaims all warranties, including warranties as to the accuracy of this Maw Scale
1 inch =165 feet
information.
http:/ /maps2.co.forsyth.nc.us /geodata 08 /pnntPreview.aspx ?PrintOptData= Forsyth County, NC 0... 7/31/2009

State of 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
July 26, 2002
BRENDA S MILLER
MILLER BRENDA - RESIDENCE
3295 KITTERING LN
WINSTON SALEM, NC 27105
1 �•
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: Reissue - NPDES Wastewater Discharge Permit
Miller Brenda- Residence
COC Number NCG550087
Forsyth 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 919 - 733 -5083 FAX 919 - 733 -0719
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post- consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG550000
CERTIFICATE OF COVERAGE No. NCG550087
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 and adopted by the North Carolina Environmental Management Commission, and the.
Federal Water Pollution Control Act, as amended,
BRENDA MILLER
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
MILLER BRENDA - RESIDENCE
3295 KITTERING LN
WINSTON SALEM
FORSYTH COUNTY
to receiving waters designated as the Big East Fork Pigeon River, a class C Tr water, in the French Broad 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
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
Brenda S. Miller
3295 Kittering Lane
Winston - Salem, NC 27105
Dear Permittee:
r
F10
July 21, 1997
Subject: Certificate of Coverage No. NCG550087
Renewal of General Permit
Miller, Brenda - Residence
Forsyth County
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 (910) 771 -4600. 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,
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 (919) 733 -5083 FAX [phone] p &e @dem.ehnr.state.nc.us
An Equal Opportunity Affirmative Action Employer 50% recycled / 10% post- consumer paper

i
STATE OF NORTH CAROLINA
DEPARTMENT, OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
: DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG550000
CERTIFICATE OF COVERAGE NO. NCG550087
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,
Brenda S. Miller
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
Miller, Brenda - Residence
3295 Kittering Lane
Winston -Salem
Forsyth County
to receiving waters designated as subbasin 30704 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.
(V,-%�A Preston Howard, Jr., P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

f
Letter to BRENDA S. MILLER April 15, 1997
NCG550087
INVOICE FOR RENEWAL OF
NPDES PERMIT
F] Check h if d NOT h h
ecere you o O wish to renew this permit. 2 710 ��
p
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
Post Office Box 29535
Raleigh, North Carolina 27626 -0535
Check here if you wish to renew this permit.
Please verify that the following information is documented accurately:
Mailing Address
BRENDA S. MILLER Ef No revision required.
MILLER, BRENDA - RESIDENCE
3295 KITTERING LANE Revision required. (Please specify below.)
WINSTON SALEM, NC 27105
Phone number: (919) 727 -1193
Fax number:
e -mail address:
Facility Location
BRENDA S. MILLER
MILLER, BRENDA - RESIDENCE
WINSTON SALEM, NC 27105
0 No revision required.
❑ Revision required. (Please specify below.)
Please return this page with your letter requesting renewal, and $240 fee (payable to NCDEHNR) to:
r
Mr. Charles H. Weaver, Jr.
Division of Water Quality /WQ Section
NPDES Group
Post Office Box 29535
Raleigh, North Carolina 27626 -0535 d
Signature of applicant or authorized representati 'V-%--�
'2
Date ';5—

ai
a)
a)
d
C
O
d
a
E
0
v
W
C1
CC
z
W
��� S -3o • q
SENDER:
• Complete items 1 and/or 2 for additional services.
s�Complete items 3, 4a, and 4b.
•Print your name and address on the reverse of this form so that we can return this
:ard to you.
• Attach this form to the front of the mailpiece, or on the back if space does not
aermit.
WVrite'Retum Receipt Requested' on the mailpiece below the article number.
• The Return Receipt will show to whom the article was delivered and the date
delivered.
I also wish to receive the
following services (for an
extra fee):
1. ❑ Addressee's Address
2. ❑ Restricted Delivery
Consult postmaster for fee.
3. Article Addressed to:
&LIN CP E. fl LU --
5Nf-
5,)o 6H-tenri LN
1&)\r5 iCmMC ,9-110S
•
sir
sr •twaTirsi
4a. S%-'151—() J
4b. Service Type
❑ Registered
❑ Express Mail
❑ Return Receipt for Merchandise ❑ COD
1:1 ❑ Certified
rtified
Insured
7. Date pf,D9l'very
` d
5. Received By: (Print Name)
g 6 Signatur.: •4dresseq or
�• x IWO
8. Addresse e's dress ( Onl y if re q ue sted
and fee is paid)
/V(G Sso6i?
PS Form 3811, December 1994
Domestic Return Receipt
Thank you for using Return Receipt Service.

J
I �
W
a ro
4-) Q
r
�'
O
Co
r I
. S.
3
c
::1 4-4
u
.y
E
I�
Z
- r-I
a
Q
3
0
Q
v
O
X14
..
o
—�
Vi
E
4-4
o
�
U)
r
W
v
o
U
Q
�
o
ri
r (U
cn
Z
v
4.,
ro
U
• r-I
v
Q
-P
E
`
d;
)
140
U
.r-i
P
P,
..
U
�+
z
00�
(I
a'
�
-P
0)
•�
41 �
M
a
8
x
w
U
(U
u
.r-i
4-1
ro
c;
0
I \'
O
U)
N
I
ro
v
U)
ro
a
a
v
a
C
I—
O
U
a-j
O
Q�
r-.
O
-1--j
a.�
ca
ca
U
a
co
0
co
"-4
C
CD
( H,La9dWOD QL aDI,3,30 rIVNOID aLL )
u
3 j
0 I
4EEH
ro �E
v a,
�44 4-I
� U
O
rS M .n
N
E
ro
ro
L
4-1
u
0
a
r
v
41
3
E U)
4-I
[ U
rn
ro
4-a
O
0
v
E
E
O
Q
4-4
0
0
ro
11
ro
ck,
v
C
Lo
m
,9
N
�4.
ro
b
v�
R..
v
ro
A
x
'_
.H
�n
v
E
v
ri
r (U
U
• r-I
v v
Q
n
U
.r-i
41 �
U
v
:� ro
ro
LH
�C
w
W VV
v
LAW
�r
m
r@
3
v
a
U)
J)
c
v
000
0 0
u ro
O U
..
o 0 fA
ro
ro
r
H
v
( alarldNOD OZ SJDIAUaS ` VDINHOSS, )
v
E
tg
ri
r (U
U
• r-I
v v
Q
v
LAW
�r
m
r@
3
v
a
U)
J)
c
v
000
0 0
u ro
O U
..
o 0 fA
ro
ro
r
H
v
( alarldNOD OZ SJDIAUaS ` VDINHOSS, )

For Appropriate Dischargers, List Complete Guideline Limitations Below
Effluent
Characteristics
Monthly
Average
Maximum Daily
Average
Comments
Type of Product Produced
Lbs /Day Produced
Effluent Guideline Reference

'k ' « °
~ m~ REQUEST NO ° | 1 ?36
^
'
********K************ WASTELOAD ALLOCATTON APPROVAi FORM *********************
FACILITY NAME I L L E R RESIDFNCE
TYPE OF WASTE DOMESTIC
COUNTY FORSYTH
RE0IONAL OFFICE � WS
RECEIVING STREAM FRnTIFR CRK
7Q1O � CFS W7Q1O �
DRAINAGE AREA + 2 SQ,MI^
RFQUESTOR HFLFN FOWiER
13UlyBA53 TN 30 70 4
CFS 30 Q2 C F S
STREAM CLASS C
************************ RECOMMENDED FFFLUFNT iJMITS ************************
WASTEFLOW(S>
BOD-5
�M3-N
D,O^
(MGD) ~00045
(MG/L 3O
(MG/L) + NR
(MG/L) � NR
(SU) + NR
--
FECAL COLIFORM (/10OML NR �c� ~r7
TSS (MG/L 30
, .
O9EI '^ '
***************AK **A*******IK*********************************************
FACILITY IS PROPOSED ( ) EXISTING ( "~) NEW ( )
LIMlTS ARE | REVISION ( ) CONFIRMATION ( ) OF THOSE PREVTOUSLY ISSUED
REVIEWFD AND RECOMMENDED BY�
MODELER
SUPERVISOR,MODELlNG GROUP
RESIONAL S R,
PERMITS MANAGER
4---��' ' ' 'DATE
DATF

�•• .V ',\ • I1�(�V� `f( ••�• ��� ;�Jx'� }�� 111/• `J�'', <' \',O // �' 'I! ' \� �'s� ��J � ' V��{ \��/ � �,/W
lw
e pie
.• w �.,a. ni 10
'' / q '� 1, � , �� i (�� `� - 961` � �«��''\ !I / � i • f J � _. �
Lot f 3 yob emOlo s4io Im"
G /pew 40
ABM M� t : f�M tisl. LM&ss,�G o
yAdAl4o Co3004j
rj
� J
iii[ tl- -.. :� C � I � - .�.. 6 I! � ° 1 l` ` --.�`� i('1 � `•• f'/'�'����' • i -' 'Ir
�l � — _� ^_ _`� �- . � , ;i•..-� ' � � : � � . �� �' � , • ;r=te.. _ -, i '.''
•
' J JAI ,\ ^,71•�:� (� 4v1 .1'1 �' • ar9 `�` 1 :J a ���,� f .;► •�� ' j / il- , j;: \, �,1�� -� r-
Nj
(0
IN
�J � �y �' - � ' • • < - "'• � � 1 /: �, ?�= elf: . Q ..�,LR \7�'�. • r�� �� � bi� ��
r •� -r ` , ri �t11 ! _fir : _
1 `` r e ���• . - ' .. i ` iii '6" 1`