WQ0004809_Final Permit_20190523

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Director
JOYE B. STRUCHEN
116 WOODY ROAD
LEASBURG, NORTH CAROUNA 27291
Dear Ms. Struchen:
NORTH CAROLINA
Environmental Quality
May 23, 2019
Subject: Permit No. WQ0004809
116 Woody Rd. SFR
Single -Family Residence
Wastewater Irrigation System
Caswell County
In accordance with your permit renewal request received April 30, 2019, we are forwarding
herewith Permit No. WQ0004809 dated May 23, 2019, to Joye B. Struchen for the continued operation of
the subject single-family residence wastewater treatment and irrigation facilities. Please note that this
renewed permit shall become effective on August 1, 2020 (i.e., the day after the expiration date of the
existing permit).
This permit shall be effective from August 1, 2020 through November 30, 2024, shall void Permit
No. WQ0004809 issued February 13, 2015, and shall be subject to the conditions and limitations therein.
The Permittee shall submit a renewal application no later than June 3, 2024.
Please pay attention to the operation and maintenance requirements listed in Section III for they
may differ from the previous permit issuance. Failure to establish an adequate system for collecting and
maintaining the required operational information shall result in future compliance problems.
The Division has removed the following permit conditions since the last permit issuance dated
February 13, 2015:
➢ Old Condition III.8. —The required fencing is no longer required to meet the 2-wire minimum
standard.
➢ Old Condition VI.2. — This condition has been removed because the permit is not voidable.
The following permit conditions are new since the last permit issuance dated February 13,
2015:
➢ Condition 111.9. —All setbacks applicable to 15A NCAC 02H .02190)(5) have been added.
➢ Condition I11.12. — Metering equipment shall be tested and calibrated annually.
➢ Condition VI.10. —This permit shall not be renewed if the Permittee or any affiliation has not
paid the required annual fee.
: ��DQF
r
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919.707.9000

Ms. Joye B. Struchen
May 23, 2019
Page 2 of 2
If any parts, requirements, or limitations contained in this permit are unacceptable, the Permittee
has the right to request an adjudicatory hearing upon written request within 30 days following receipt of
this permit. This request shall be in the form of a written petition, conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings at 6714 Mail Service
Center, Raleigh, NC 27699-6714. Otherwise, this permit shall be final and binding.
If you need additional information concerning this permit, please contact Poonam Giri at (919)
707-3656 or poonam.girigricdenngov.
Sincerely,
Linda Culpepper, Director
Division of Water Resources
cc: Caswell County Health Department (Electronic Copy)
Winston-Salem Regional Office, Water Quality Regional Operations Section (Electronic Copy)
Laserfiche File (Electronic Copy)
Digital Permit Archive (Electronic Copy)
Central Files

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
RALEIGH
SINGLE-FAMILY RESIDENCE WASTEWATER IRRIGATION SYSTEM PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Joye B. Struchen
Caswell County
FOR THE
continued operation of a 360 gallon per day (GPD) single-family residence wastewater treatment and
irrigation facility consisting of:
a 1,200 gallon baffled septic tank; a 204 square foot (ft2) pressure dosed sand filter with an 18 gallon per
minute (GPM) submersible pump in a 1,000 gallon filter dosing tank; a tablet chlorinator; a 2,000 gallon
storage/pump tank with a 7.6 GPM submersible pump; a 0.25 acre spray irrigation area with four 30-foot
diameter sprinkler heads; and all associated piping, valves, controls, and appurtenances
to serve the single-family residence at 116 Woody Rd., Leasburg, NC 27291 with no discharge of wastes
to surface waters, pursuant to the application received April 30, 2019, and in conformity with the Division -
approved plans and specifications considered a part of this permit.
This permit shall be effective from August 1, 2020 through November 30, 2024, shall void Permit No.
WQ0004809 issued February 13, 2015 and shall be subject to the following conditions and limitations:
I. SCHEDULES
1. The Permittee shall request renewal of this permit on Division -approved forms no later than June 3,
2024. [15A NCAC 02T .0105(b), 02T .0109]
2. If a public or community sewage system is or becomes available, the Permittee shall connect to this
system, and shall request rescission of the single-family residence wastewater treatment and irrigation
facilities permitted herein. [15A NCAC 02T .0607]
WQ0004809 Version 4.0 Shell Version 181105 Page 1 of 7

II. PERFORMANCE STANDARDS
The Permittee shall maintain and operate the subject non -discharge facilities so there is no discharge to
surface waters, nor any contravention of groundwater or surface water standards. In the event the
facilities fail to perform satisfactorily, including the creation of nuisance conditions due to improper
operation and maintenance, or failure of the irrigation areas to assimilate the effluent, the Permittee
shall take immediate corrective actions, including Division required actions, such as the construction
of additional or replacement wastewater treatment or disposal facilities. [15A NCAC 02T
.0108(b)(1)(A)]
2. This permit shall not relieve the Permittee of their responsibility for damages to groundwater or surface
water resulting from the operation of this facility. [15A NCAC 02T .0108(b)(1)(A)]
The Permittee shall apply treated wastewater effluent at or below the following rates:
Field
1 01284
TABLE I — APPLICATION LIMITATIONS
Parameter
Hourly Rate
Yearly Max
Units
— Non -Discharge Application Rate
--
20.8
inches
[15A NCAC 02T .06050)]
4. The Permittee shall only apply treated wastewater effluent to the following:
TABLE 2 — IRRIGATION AREA INFORMATION
Field Owner County Latitude Longitude Net Dominant
Acres a Soil Series
1 7oye B. Struchen Caswell 36.4094990-79.1995570 0.25 --
[15A NCAC 02T .0108(b)(1)(A)]
5. The attached Operation and Maintenance Agreement shall be a condition of this permit.
Noncompliance with the terms of the Operation and Maintenance Agreement shall subject the Permittee
to all sanctions under G. S. 143-215.6A, G.S. 143-215.613, and G.S. 143-215.6C for violation of or
failure to act in accordance with the terms and conditions of this permit. [ 15A NCAC 02T .0604(h)]
6. The compliance boundary is the property boundary. Any exceedance of groundwater standards at or
beyond the compliance boundary shall require corrective action. Division -approved relocation of the
compliance boundary shall be noted in Condition II.4. Multiple contiguous properties under common
ownership and permitted for use as a disposal system shall be treated as a single property with regard
to determination of a compliance boundary. [ 15A NCAC 02L .0106(d)(2), 02L .0107(i), 02T .0105(h),
G.S. 143-215.1(i), G.S. 143-215.1(k)]
7. The review boundary is midway between the compliance boundary and the effluent disposal area. Any
exceedance of groundwater standards at or beyond the review boundary shall require preventative
action. [15A NCAC 02L.0106(d)(1), 02L .0108]
The Permittee shall apply for a permit modification to establish a new compliance boundary prior to
any sale or transfer of property affecting a compliance boundary (i.e., parcel subdivision). [ 15A NCAC
02L .0107(c)]
WQ0004809 Version 4.0 Shell Version 181105 Page 2 of 7

9. The facilities herein were permitted per the following setbacks:
a. The irrigation sites were originally permitted April 25, 1991. The setbacks for spray irrigation sites
originally permitted or modified from October 1, 1987 to January 31, 1993 are as follows (all
distances in feet):
i. Each habitable residence or place of assembly under separate ownership:
400'
ii. Each private or public water supply source:
100
iii. Surface waters:
100
iv. Groundwater lowering ditches:
100
v. Surface water diversions (upslope):
100
vi. Surface water diversions (downslope):
100
vii. Each well with exception of monitoring wells:
100
viii. Each property line:
150 2, 3
ix. Top of slope of embankments or cuts of two feet or more in vertical height:
100
x. Each water line:
10
xi. Each swimming pool:
100
xii. Public right of way:
50
xiii. Nitrification field:
20
xiv. Each building foundation or basement:
100
' Habitable residences or places of assembly under separate ownership constructed after the
facilities herein were originally permitted or subsequently modified are exempt from this
setback.
2 Setbacks to property lines are not applicable when the Permittee, or the entity from which the
Permittee is leasing, owns both parcels separated by the property line.
3 Per a setback waiver recorded in the Caswell County Register of Deeds, reduced setbacks from
the wetted area to any property line are as follows:
Parcel No.
Deed Book / Pages
Setback
Easement
128/11
613 / 594-595
1 foot
149 feet
[15A NCAC 02H .02190)(5)]
b. The storage and treatment units were originally permitted April 25, 1991. The setbacks for storage
and treatment units originally permitted or modified from October 1, 1987 to January 31, 1993 are
as follows (all distances in feet):
i. Each habitable residence or place of assembly under separate ownership (only 100'
applicable to surface sand filters):
ii. Each private or public water supply source: 100
iii. Each well with exception of monitoring wells: 100
iv. Each property line: 50 2,3
v. Nitrification field: 20
' Habitable residences or places of assembly under separate ownership constructed after the
facilities herein were originally permitted or subsequently modified are exempt from this
setback.
2 Setbacks to property lines are not applicable when the Permittee, or the entity from which the
Permittee is leasing, owns both parcels separated by the property line.
WQ0004809 Version 4.0 Shell Version 181105 Page 3 of 7

3 Per a setback waiver recorded in the Caswell County Register of Deeds, reduced setbacks from
the storage and treatment units to any property line are as follows:
Parcel No.
Deed Book / Pages
Setback
Easement
128/11
613 / 594-595
10 feet
40 feet
[15A NCAC 02H .02190)(5)]
III. OPERATION AND MAINTENANCE REQUIREMENTS
1. The Permittee shall operate and maintain the subject facilities as a non -discharge system. [ 15A NCAC
02T .0600]
2. Upon the Water Pollution Control System Operators Certification Commission's (WPCSOCC)
classification of the subject non -discharge facilities, the Permittee shall designate and employ a certified
operator in responsible charge (ORC), and one or more certified operators as back-up ORCs. The ORC
or their back-up shall operate and visit the facilities as required by the WPCSOCC. [15A NCAC 02T
.0117]
3. The Permittee shall maintain vegetative cover on the irrigation sites, such that crop health is optimal,
allows even effluent distribution, and allows inspection of the irrigation system. [15A NCAC 02T
.0608(a)]
4. The Permittee shall take measures to prevent effluent ponding in or runoff from the irrigation sites
listed in Condition HA. [15A NCAC 02T .0608(b)]
5. The Permittee shall not irrigate treated effluent during inclement weather, or when the soil is in a
condition that will cause ponding or runoff. [ 15A NCAC 02T .0605(o)]
6. The Permittee shall only irrigate treated effluent from the single-family residence at 116 Woody Rd.,
Leasburg, NC 27291 on the sites listed in Condition II.4. [15A NCAC 02T .0601]
7. The Permittee shall not allow vehicles or heavy machinery on the irrigation area, except during
equipment installation or maintenance activities. [ 15A NCAC 02T .0608(d)]
The Permittee shall prohibit public access to the wastewater treatment and irrigation facilities through
lockable treatment units, and fencing around the irrigation sites. [15A NCAC 02T .0605(i)]
9. The Permittee shall dispose or utilize generated residuals in a Division -approved manner. [15A NCAC
02T .1100].
10. The Permittee shall not divert or bypass untreated or partially treated wastewater from the subject
facilities. [15A NCAC 02T .0605(f)]
11. Pump tanks shall have audible and visual alarms external to any structure. [15A NCAC 02T .0605(n)]
12. Metering equipment shall be tested and calibrated annually. [I 5A NCAC 02T .0608(c)]
WQ0004809 Version 4.0 Shell Version 181105 Page 4 of 7

13. The Permittee is responsible for the operation and maintenance of the wastewater treatment and
irrigation system including the following:
a. Inspect the septic tank annually, and pump out solids as needed. Inspect and clean the septic tank
effluent filter annually.
b. Inspect the tablet chlorinator weekly. Add wastewater grade chlorine tablets (e.g., calcium
hypochlorite) as needed. Swimming pool grade chlorine tablets are not acceptable.
c. 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.
d. 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.
[15A NCAC 02T .0608]
IV. MONITORING AND REPORTING REQUIREMENTS
1. The Permittee shall conduct and report any Division required monitoring necessary to evaluate this
facility's impact on groundwater and surface water. [15A NCAC 02T .0108(c)]
2. Noncompliance Notification:
The Permittee shall report to the Winston-Salem Regional Office, telephone number [phone],
within 24 hours of first knowledge of the following:
a. Any process unit failure (e.g., mechanical, electrical, etc.) rendering the facility incapable of
adequate wastewater treatment.
b. Any facility failure resulting in a discharge to surface waters.
c. Any time self -monitoring indicates the facility has gone out of compliance with its permit
limitations.
d. Ponding in or runoff from the irrigation sites.
Emergencies requiring reporting outside normal business hours shall call the Division's Emergency
Response personnel at telephone number [phone], [phone], or [phone]. All
noncompliance notifications shall file a written report to the Winston-Salem Regional Office within
five days of first knowledge of the occurrence, and this report shall outline the actions proposed or
taken to ensure the problem does not recur. [15A NCAC 02T .0108(b)(1)(A)]
WQ0004809 Version 4.0 Shell Version 181105 Page 5 of 7

V. INSPECTIONS
1. The Permittee shall perform inspections and maintenance to ensure proper operation of the wastewater
treatment and irrigation facilities. [15A NCAC 02T .0608(f)]
2. The Permittee shall inspect the wastewater treatment and irrigation facilities to prevent malfunctions,
facility deterioration, and operator errors that may result in discharges of wastes to the environment,
threats to human health, or public nuisances. The Permittee shall maintain an inspection log that
includes the date and time of inspection, observations made, and maintenance, repairs, or corrective
actions taken. The Permittee shall maintain this inspection log for a period of five years from the date
of the inspection, and this log shall be made available to the Division upon request. [15A NCAC 02T
.0608(e), 02T .0608(f)]
Division authorized representatives may, upon presentation of credentials, enter and inspect any
property, premises, or place related to the wastewater treatment and irrigation facilities permitted herein
at any reasonable time for determining compliance with this permit. Division authorized
representatives may inspect or copy records maintained under the terms and conditions of this permit,
and may collect groundwater, surface water, or leachate samples. [G.S. 143-215.3(a)(2)]
VI. GENERAL CONDITIONS
1. Failure to comply with the conditions and limitations contained herein may subject the Permittee to a
Division enforcement action. [G.S. 143-215.6A, 143-215.613, 143-215.6C]
2. This permit is effective only with respect to the nature and volume of wastes described in the permit
application, and Division -approved plans and specifications. [G.S. 143-215.1(d)]
3. Unless specifically requested and approved in this permit, there are no variances to administrative codes
or general statutes governing the construction or operation of the facilities permitted herein. [15A
NCAC 02T .0105(n)]
4. The issuance of this permit does not exempt the Permittee from complying with all statutes, rules,
regulations, or ordinances that other jurisdictional government agencies (e.g., local, state, and federal)
may require. [15A NCAC 02T .0105(c)(6)]
5. If the permitted facilities change ownership, or the Permittee changes their name, the Permittee shall
submit a permit modification request on Division -approved forms. The Permittee shall comply with
all terms and conditions of this permit until the permit is transferred to the successor -owner. [G.S. 143-
215.1(d3)]
6. The Permittee shall retain a set of Division -approved plans and specifications for the life of the facilities
permitted herein. [15A NCAC 02T .0105(o)]
7. The Permittee shall maintain this permit until the proper closure of all facilities permitted herein, or
until the facilities permitted herein are permitted by another authority. [15A NCAC 02T .01050)]
WQ0004809 Version 4.0 Shell Version 181105 Page 6 of 7

8. This permit is subject to revocation or modification upon 60-day notice from the Division Director, in
whole or part for:
a. violation of any terms or conditions of this permit or Administrative Code Title 15A Subchapter
02T;
b. obtaining a permit by misrepresentation or failure to disclose all relevant facts;
c. the Permittee's refusal to allow authorized Department employees upon presentation of credentials:
i. to enter the Permittee's premises where a system is located or where any records are required
to be kept;
ii. to have access to any permit required documents and records;
iii. to inspect any monitoring equipment or method as required in this permit; or
iv. to sample any pollutants;
d. the Permittee's failure to pay the annual fee for administering and compliance monitoring; or
e. a Division determination that the conditions of this permit are in conflict with North Carolina
Administrative Code or General Statutes.
[15A NCAC 02T .0110]
9. Unless the Division Director grants a variance, expansion of the facilities permitted herein shall not
occur if any of the following apply:
a. The Permittee or any parent, subsidiary, or other affiliate of the Permittee has been convicted of
environmental crimes under G.S. 143-215.6B, or under Federal law that would otherwise be
prosecuted under G.S. 143-215.6B, and all appeals of this conviction have been abandoned or
exhausted.
b. The Permittee or any parent, subsidiary, or other affiliate of the Permittee has previously abandoned
a wastewater treatment facility without properly closing the facility.
c. The Permittee or any parent, subsidiary, or other affiliate of the Permittee has not paid a civil
penalty, and all appeals of this penalty have been abandoned or exhausted.
d. The Permittee or any parent, subsidiary, or other affiliate of the Permittee is currently not compliant
with any compliance schedule in a permit, settlement agreement, or order.
e. The Permittee or any parent, subsidiary, or other affiliate of the Permittee has not paid an annual
fee.
[ 15A NCAC 02T .0120(b), 02T .0120(d)]
10. This permit shall not be renewed if the Permittee or any affiliation has not paid the required annual fee.
[15A NCAC 02T .0120(c)]
Permit issued this the 23rd day of May 2019
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
�mda Culpepper, Director
U Division of Water Resources
By Authority of the Environmental Manag ment Commission
Permit Number WQ0004809
WQ0004809 Version 4.0 Shell Version 181105 Page 7 of 7

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Unofficial Document
Filed: 04/122019 09:55:11 AM
Ginny S. Mitchell, Register of Deeds
Caswell County, NC
Unofficial Document
BOOK 613 PAG�i34239J
N
State of North Carolina
Department of Environmental Quality
Division of Water Resources
NON -DISCHARGE WASTEWATER SYSTEM WAIVER
AGREEMENT TO WAIVE SETBACKS AS REQUIRED BY
15A NCAC 02T .0506(a), .0506(b), .0606(a), .0706(a) AND .1006(a)
r.
I, certify that I am a deeded owner of the property located at:
Address: _ Parcel No.: 128 f
City: State: GZip Code: 22"q County:
Furthermore, I certify that I am authorized to make decisions regarding this property, and that I do hereby
agree that the setback distances cited below be granted to the Applicant/Permittee listed on the following
page.
[0/, understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from _LAM_ feet to 1_ feet, thereby allowing the
application of wastewater effluent as near as I feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
application of wastewater effluent as near as feet from my residence.
U4 uunderstand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from !&L feet to JJ2_ feet, thereby allowing the
construction of wastewater treatment and storage units as near as M feet from my property line.
❑ I understand the setback requirements set forth in 15A NCAC 02T. For the parcel identified
above, I consent to a reduced setback from feet to feet, thereby allowing the
construction of w stewater treatment and storage units as near as feet from my residence.
`-' Signature: 1 / Date: 1 (G f 9
FORM: NDWS 03-17 Page 1 of 2

Unofficial Document
Applicant/Permittee:
Address:
City:
G� Parcel No.:
State: zip Coder County: gd
NORTH CAROLINA, e-K S D Y� _ COUNTY
I, a � i Q �( .1�.t�� a Notary Public for- c-y �j, qy-\ County, North Carolina,
do hereby certify that t 4 , SA ,< v,C�ka._y\ personally appeared before me this day
and acknowledged the due execution of the foregoing instrument. n
Witness my hand and official seal, this theyA day of �► h.c , as
SEW
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0 z=
=y 7-
v
Cj
PEAs,``,��.
Signature of Notary Public
My commission expires A �
Once notarized, this form shall be recorded at the Register of Deeds in the county or
counties in which the described properties are located. A copy of the recorded
waiver shall be sent to the following address:
Division of Water Resources
Water Quality Permitting Section
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
FORM: NDWSW 03-17 Page 2 of 2

RECEIVEDINCDFQIDWR
APR 3 0 2019 State of North Carolina
Department of Environment and Natural Resources
Non-Discharg
nne
tt Division of Water Resources
DWR15A NCAC 02T .0600 — SIN( *WAV ASIDENCE WASTEWATER IRRIGATION SYSTEMS
OPERATION AND MAINTENANCE AGREEMENT
Division of Water Resources FORM: SFRWWIS O&M 08-13
County: (�'- a 5 W P/ 1/
Property owner(s) as appearing on the recorded deed:
Mailing address: _ �! �O W 0D 6— U L Yg
Facility address: _ � O-
Irrigation Method SPRAY ❑ DRIP
I / We agree to operate and maintain the single-family residence wastewater treatment and irrigation system as follows:
1. The Permittee is responsible for the operation and maintenance of the entire wastewater treatment and irrigation
system including, but not limited to, the following items:
a. The septic tank shall be checked annually and pumped out as needed.
b. The septic tank effluent filter shall be checked and cleaned annually.
c. Accessible sand filter surfaces shall be raked and leveled every six months and any vegetative growth shall be
removed manually.
d. XThe tablet chlorinator shall be checked weekly. Wastewater grade tablets (calcium hypochlorite) shall be
added as needed to provide proper chlorination (pool chlorine tablets shall not be used), OR
❑ The ultraviolet disinfection unit shall be checked weekly. The lamp(s) and quartz sleeve(s) shall be
cleaned or replaced as needed to ensure proper disinfection.
e. All pump and alarm systems shall be inspected monthly.
f. The irrigation system shall be inspected monthly to ensure that the system is free of leaks, that all irrigation
equipment is operating as designed, that vegetative growth does not interfere with the system inspection or
operation, that the soil is assimilating the disposed treated wastewater with no visible runoff or ponding, and
that no objectionable odors are being generated.
2. Failure to pay the annual fee shall be cause for the Division to revoke the permit pursuant to 15A NCAC 02T
.0105(e)(3).
3. The Permittee's failure to properly operate this system is subject to a penalty up to $25,000 per day.
4. Failure to meet the permit conditions or violation of the State's surface water or groundwater regulations may void
the permit.
All owners appea6up, on the legalh recorded proper[ ► deed shall sign this Operation & Maintenance Agreement
I / We understand the above requirements and agree to these terms as part of the issued permit.
Owner Signature: Date:
f J
Owner Signature: Date:
FORM: SFRWWIS O&M 08-13 Page i of 1