WQ0030055_Sewer Extension Permit Status Update_20191125

Request for Engineering Certification Date of Letter: October 22,2019
Sewer Extension Permit Status Update
Please complete the applicable portion of this form for each permit and return this form and supporting documents to the attention
of Nyle Hothem at the Division's PERCS Unit by the delivery method below and within 30 days of the date of this letter:
NCDEQ/DWR
WQPS—PERCS UNIT
By U.S.Postal Service: By Courier/Special Delivery: By Email:
1617 Mail Service Center 512 N.Salisbury St.Suite 925 Nyle Hothem
Raleigh,NC 27699-1617 Raleigh, NC 27604 [e-mail]
Permit No.: W CO 3 C>©ems Permittee: Kavanaghn Associates Inc
Project Name: U`e 6-love✓ c6 6 - { J
Project Status (Check appropriate box to indicate Permittee's response and complete&sign below)
❑ Permit to Remain Open: The Permittee certifies that the permitted project has not been constructed but shall be constructed in
the future in conformity with the approved Permit,project plans,specifications,and supporting documents.The Permittee
understands that the appropriate certification documents will need to be forwarded to the Division prior to operation. Subject
permit shall be maintained in Active status.
❑ The Permitted project has been constructed and the required Engineer's Certification and supporting documents will be
submitted to the Division with this form. Permittee understands that failure to submit required certification documents for an
active,in-service system may result in enforcement action.
❑ Request Extension: Permittee requests extension to reply to this letter not to exceed 60 days of the date of this letter.
❑ Ownership/Name Change: The Permittee requests information to apply for ownership or name change. Please provide email
and phone number below for follow-up.
Name&Title(print):
Signature: Date:
Comments:
Permit Rescission Request
The Permittee requests that the subject permit be rescinded and certifies that the permitted sewer system has not been and shall
not be constructed nor made operational.We understand that,in the future,should we wish to operate a non-discharge sewer
system,we shall apply for and receive a new Wastewater Collection System Permit.
Name&Title(Print): ( /� l oK i't i iN 193-d
Signature: Date: Cf L C
Comments: r in( I (l^ C_Lrf 4 -e n1 °ems
Contact Information Updates for Current Owner
Updated Contact Person&Title(Print):
Updated Mailing Address:
Updated Email: Updated Phone:

ROY COOPER ";i%'4',;• .
Governor
MICHAEL S, REGAN i� t •
Secretary i'
LINDA CULPEPPER NORTH CAROLINA Director `, . ,
Environmental Quality
October 22,2019
B John Kavanagh
Kavanagh Associates Inc
324 West Wendover Ave,Suite 120
Greensboro, NC 27408
Subject: Engineering Certification Requested
Kavanagh Associates Inc
Dear Permittee:
Based on a review of our records for permits issued during the period of 2002 through 2006, it appears
that the Division of Water Resources (Division) has not yet received a final engineering certification in
accordance with 15A NCAC 02T.0116, as well as the standard conditions of the permit, for the
Wastewater Collection System Extension Permit(s) listed below.
Permit No. Issue Date Facility County
WQ0021591 08/16/02 Hedgecock Place Condominiums Davidson
WQ0021925 12/06/02 Timberbrooke Phase I Guilford
WQ0029571 12/28/05 Whitestone Phase 1-Private Guilford
WQ0030055 04/24/06 Westover Ridge Phase 1- Private Davidson
If the permitted facility, or any portion of the facility, has been constructed and is in operation, a
complete and final engineering certification must be submitted at this time. It should be noted that
failure to certify a non-discharge sewer extension permit appropriately in accordance with the provisions
of 15A NCAC 02T.0116 may result in enforcement action that could include a civil penalty of up to
$10,000 per day.
The Division requests a response from the Permittee within 30 days of the date of this letter. If the
permitted facility has not been constructed and will not be constructed,the Permittee may request to
have the permit rescinded by returning the attached Status Update form.Also, please note that Permits
are not automatically transferable in the event the project site is now owned by others. If the Permittee
no longer owns the facility or the Permittee's name has changed, please return the attached Status
Update requesting information for ownership/name change.
This notification for the period of 2002 through 2006 addresses the earliest period in the Division's
outreach program to update records for those outstanding permits issued from 2002 through 2015. If
you have previously received a letter from the Division requesting an engineering certification for

North Carolina Department of Environmental Quality I Division of Water Resources
DE � 512 North Salisbury Street 11617 Mail Service Center Raleigh,North Carolina 2716699-
17
'" """ 919,707 9000
permits issued during the period of 2007 through 2015, and have not
yet responded, please submit the required information at this time to avoid future notices regarding the
2002-2015 timeframe.
If you have any questions regarding this outreach program, please contact Nyle Hothem via e-mail at
[e-mail],voice mail messages can be left at [phone].
Sincerely,
Christyn L. Fertenbaugh, P.E.
Environmental Engineer
Pretreatment, Emergency Response, and Collection Systems Unit
Division of Water Resources
cc: Winston-Salem Regional Office,Water Quality Section Regional Operations [electronic]
PERCS [electronic copy]/111