HomeMy WebLinkAboutWQ0019143_Application_20190321DWR
Division of Water Resources
RECEIVED
�a C;DEQIYiWR
21 MAR 2019
LE-FAiiW AP%ftydg1WASTEW
State of North Carolina
nt of Environmental Quality
Division of Water Resources
ER IRRIGATION 5Y S I'EM RENEWAL
FORM: SFRWW IS-R 09-18
This form is for renewal without modification for single-family residence wastewater irrigation system permits.
For more Information, visit the Water Quality Permitting Section's Non -Discharge Branch.
PERMIT INFORMATION:
Permit No.: WQ0019143
_. Permittee: Michael J. Barone (i.e.. deeded propem, owners)
Signature authority's name: Michael J- Barone (i.e., deeded property owner or legal representative) [15A NC:AC 02T .0105[
4. Phvsica? address of re idence with treatment`irrigation system: 754 01de Thompson Creek Rd.
Cit} State: NC, Zip: 27523-� County: Chatham
5. Permittec's mailing address tifdifferent from above): _
City: State:
b. Permittee's contact information:
Priman° Contact: °1�16 Phone number: bGc $ Z Primary email address:
td
Seccondary Contact:((ttr. Phone number: )3 Secondary email address:t GreCl"`i l
7. Has the treatmenVirrigation system been installed? ® Yes or ❑ No �cw�
Applicant's Certification per 15A NCAC 02T .0104(b):
4JaEI _L-,Vf attest that this renewal application has been reviewed by me, and is
accurate and complete to the best of my knowledge. 1 understand that any unauthorized discharge of wastewater from this non -discharge
system to surface waters or the land may result in an enforcement action that may include civil penalties, injunctive relief, and/or criminal
prosecution. I will make no claim against the Division of Water Resources should a condition of this permit be violated. I also
understand that if all required parts of this application are not completed, this application may be returned to me as incomplete. I further
certify that the Applicant or any parent, subsidiary, or other affiliate of the Applicant has not been convicted of an environmental crime,
has not ab:uuioned a asteu-ter facili ithout proper closure, does not have an outstanding civil penalty where all appeals have been
exhausted or.a ndon�i, ar co with any active compliance schedule, and does not have any overdue annual fees.
Signature: Date: 1
ourf
p-Discharge Brdg,Branch -
(I617 Mail Service Center ON. Salisbury
Raleigh, NC 27699-161' Wileigh. NC 27604
TELEPHONE NUMBER: (919) 707-3654
FORM: SFIIWWIS-R 09-I8 Page I of 1
State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
SINt 1.,F:-F'AM1'lll.1' RF:.SII)1'..tiCE NA'A.STE:WATF."R IRRIGATION SYSTECm
Division of Water Resources OPERATION AND M AINTE IN"ANCEr AGREEMENT
FORM: SFRWWIS-O&M 09-18
Permit No. WQ0019143
Permittee: Michael J. Barone (Le.. all deeded property owners)
County: Chatham
The Pennittee agrees to operate and maintain the single-family residence wastewater treatment and irrigation system as
follows:
1. Inspect the septic tank annually, and pump out solids as needed.
?. Inspect and clean the septic tank effluent filter annually. (if applicable)
3. Inspect the tablet chlorinator weekly. Add wastewater grade chlorine tablets (e.g.. calcium hypochloritc) as needed.
Swimming pool grade chlorine tablets are not acceptable. (if applicable)
4. Inspect the ultraviolet disinfection unit weekly. Clean or replace the lamps and quartz sleeves as needed. (if
applicable)
5. Inspect all storage tanks, pumps, and alarms monthly. Remove the floating scum layer in all pump/storage tanks
when pumping the septic tank solids out.
6. Inspect the spray irrigation system monthly to verify: proper operation of the spray heads; that there are no leaks:
that vegetative growth does not obstruct the spray heads; that the irrigated wastewater is not ponding in or running
off the designated irrigation area. and that there are no objectionable odors. (if applicable)
7. Inspect the drip irrigation system monthly to verify: proper operation of the drip lines; that there are no leaks; that
vegetative growth does not obstruct the drip emitters; that the irrigated wastewater is not ponding in or running off
the designated irrigation area; and that there are no objectionable, odors. (if applicable)
8. Maintain a set of Division -approved engineering plans and specifications.
9. Pay the required annual fee.
10. Request renewal of this permit on Division -approved forms no later than 180 days prior to expiration.
11. Sign and provide a Change of Ownership application to any future owner of the single-family residence wastewater
treatment and irrigation system for their completion and submission to the Division of Water Resources.
We understand t Sabo n Vgree to these terms as part of the issued permit.
Signature: Date:
Signature:
Signature:
Signature:
Date:
Date:
Date:
All deeded ttrogeM owners shall sign this Operation and Maintenance Agreement
FORM: SFRWWIS-O&M 09-18 Paoe t of t