WQ0013808_Permit Renewal_20180320

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ROY COOPER
Governor
MICHAEL S.REGAN
Secretary
Water Resources LINDA CULPEPPER
ENVIRONMENTAL QUALITY Interim Director
March 20,2018
BILL KOTIS—PRESIDENT
KOTIS PROPERTIES,INC.
POST OFFICE Box 9296
GREENSBORO,NORTH CAROLINA 27429-9296
Subject: Application No.WQ0013 808
Additional Information Request
Summerfield Shopping Center
Wastewater Irrigation System
Guilford County
Dear Mr. Kotis:
Division of Water Resources' Central and Regional staff has reviewed the application package received
January 2,2018. However,additional information is required before the review may be completed. Please
address the items on the attached pages no later than the close of business on April 20,2018.
Please be aware that you are responsible for meeting all requirements set forth in North Carolina rules and
regulations. Any oversights that occurred in the review of the subject application package are still the
Applicant's responsibility. In addition, any omissions made in responding to the outstanding items in
Sections A through D,or failure to provide the additional information on or before the above requested date
may result in your application being returned as incomplete.
Please reference the subject application number when providing the requested information. All revised
and/or additional documentation shall be signed, sealed and dated (where needed), with three copies
submitted to my attention at the address below.
If you have any questions regarding this request,please do not hesitate to contact me at(919)807-6348 or
[e-mail]. Thank you for your cooperation.
Sincerely,
)//
Ashley Kabat,Environmental Engineer
Division of Water Resources
cc: Winston-Salem Regional Office,Water Quality Regional Operations Section(Electronic Copy)
Permit Application File WQ0013808
<' Nothing Compares':-
State of North Carolina I Environmental Quality l Water Resources I Water Quality Permitting I Non-Discharge Permitting
1617 Mail Service Center I Raleigh,North Carolina 27699-1617
919-807-6332

Mr.Bill Kotis
March 20,2018
Page 2 of 2
A. Schedules From Previous Permit Issuance:
1. A certification (see attached form)must be received from a professional engineer certifying that
the permitted facility's modifications have been installed in accordance with this permit, the
approved plans and specifications, and other supporting materials including the location of all
monitoring wells as applicable. [15A NCAC 02T.0116(a)]
2. Waste-level gauges,to monitor waste levels in the wetland treatment cells and lined wet weather
storage pond,shall be installed within 60 days of issuance of this permit for the wetland treatment
cells and prior to operation of the lined wet weather storage pond. [15A NCAC 02T.0108(bX2),
02T 0505(d)]
B. Property Ownership Documentation:
1. Septic tanks and grease traps that feed into this system are located on two parcels north of the parcel
containing the ponds and irrigation fields. The Permittee is Kotis Properties, Inc. which is the
owner of the southernmost parcel containing the ponds and irrigation fields. The other two parcels
are owned by Kotis Summerfield, LLC and Kotis Summerfield Outparcel, LLC (see attached
Figure). Because these three parcels are not under the same company name,an agreement between
Kotis Properties, Inc. and each of the two other property owners must be signed allowing the
treatment of wastewaster on their property. [15A NCAC 02T.0604(e)]
C. Site Man;
1. As requested in the Non-Discharge System Renewal Form, submit two copies of an updated site
map in accordance with 15A NCAC 02T.0105(d).
D. Insuection:
1. In the most recent permit issued on September 12, 2008, it states the facility should have soil
moisture sensors in each irrigation field. There were not soil moisture sensors present at the time
of inspection by the Division on January 30, 2018. Install soil moisture sensors on each field or
request the requirement for soil moisture sensors be removed by submitting a minor modification
request and providing supporting documentation verifying the presence of soil moisture sensors is
not warranted.
2. Portions of the facility do not match the proposed plans and facility description in the permit issued
September 12,2008. Provide as-built plans and a facility description.
3. The Permittee shall designate and employ a certified operator to be in responsible change(ORC)
and one or more certified operator(s)to be back-up ORC(s)of the facilities in accordance with 15A
NCAC 08G.0200. The primary ORC for this facility did not renew his certification and the back-
up ORC does not possess an irrigation certification. Designate appropriately certified operators for
this facility using the attached Water Pollution Control System Operator Designation Form
(WPCSOCC).
4. There was not an operation and maintenance plan or a residuals management plan at the time of
inspection by the Division on January 30,2018. Provide a copy of each of these required items.

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Permit No.WQ0013808 Wastewater Irrigation System
Kotis Properties,Inc. September 12,2008
Summerfield Shopping Center Guilford County
ENGINEERING CERTIFICATION
❑Partial ❑Final
In accordance with 15A NCAC 02T.0116,I, >as
a duly registered Professional Engineer in the State of North Carolina,having the Permittee's authorization
to 0 periodically❑weekly❑fully observe the construction of the permitted facility,hereby state to the
best of my abilities that due care and diligence was used in the observation of the construction,such that
the facility was built within substantial compliance and intent of this permit,the Division-approved plans
and specifications,and other supporting documentation.
❑ Any variation to this permit, the Division-approved plans and specifications, and other supporting
documentation has been documented in the attached as-built drawings, and shall serve as the
Permittee's minor modification request to amend the permit accordingly.
Provide a brief narrative description of any variations:
Professional Engineer's Name
Engineering Firm
Mailing Address
City i State I Zip
Telephone E-mail ; NC PE Seal, Signature&Date
THE COMPLETED ENGINEERING CERTIFICATION,INCLUDING ALL SUPPORTING
INFORMATION AND MATERIALS,SHALL BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
NON-DISCHARGE PERMITTING UNIT
By U.S.Postal Service: By Courier/Special Delivery:
1617 MAIL SERVICE CENTER 512 N. SALISBURY ST.
RALEIGH,NORTH CAROLINA 27699-1617 RALEIGH,NORTH CAROLINA 27604
WQ0013808 Version 3.0 Attachment A
Page 1 of 1

WATER POLLUTION CONTROL SYSTEM OPERATOR DESIGNATION FORM (WPCSOCC)
NCAC 15A 8G .0201
Press TAB to enter information
Permittee Owner/Officer Name:
Mailing Address: Phone:
City: State: Zip:
Email Address:
Signature: Date:
Facility Name: Permit#
County:
YOU MUST SUBMIT A SEPARATE FORM FOR EACH TYPE AND CLASSIFICATION OF SYSTEM:
Facility Type: Select
Facility Grade: Select
OPERATOR IN RESPONSIBLE CHARGE (ORC)
Print Full Name: Work Phone:
Certificate Type: Select Certificate Grade: Select Certificate#:
Email Address:
Signature: Date:
"I certify that I agree to my designation as the Operator in Responsible Charge for the facility noted. I understand and will abide by the
rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G.0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
BACKUP ORC
Print Full Name: Work Phone:
Certificate Type: Select Certificate Grade: Select Certificate#:
Email Address:
Signature: Date:
"I certify that I agree to my designation as a Back-up Operator in Responsible Charge for the facility noted. I understand and will abide by
the rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G.0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
Mail,fax or email WPCSOCC, 1618 Mail Service Center, Fax:[phone] Email:[e-mail]
ORIGINAL to: Raleigh, NC 27699-1618
Mail or Fax Asheville Fayetteville Mooresville Raleigh
a COPY to: 2090 US Hwy 70 225 Green St.,Suite 714 610 E.Center Ave.,Suite 301 3800 Barrett Dr.
Swannanoa, NC 28778 Fayetteville, NC 28301-5043 Mooresville, NC 28115 Raleigh, NC 27609
Fax:[phone] Fax:[phone] Fax:[phone] Fax:[phone]
Phone:[phone] Phone:[phone] Phone:[phone] Phone:[phone]
Washington Wilmington Winston-Salem
943 Washington Sq. Mall 127 Cardinal Dr. 45 W. Hanes Mall Rd.
Washington, NC 27889 Wilmington,NC 28405-2845 Winston-Salem, NC 27105
Fax:[phone] Fax:[phone] Fax:[phone]
Phone:[phone] Phone:[phone] Phone:[phone] Revised 4/2016

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WPCSOCC Operator Designation Form(continued) Page 2
Facility Name: Permit#:
BACKUP ORC
Print Full Name: Work Phone:
Certificate Type: Select Certificate Grade: Select Certificate#:
Email Address:
Signature: Date:
"I certify that I agree to my designation as a Back-up Operator in Responsible Charge for the facility noted. I understand and will abide by
the rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G.0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
BACKUP ORC
Print Full Name: Work Phone:
Certificate Type: Select Certificate Grade: Select Certificate#:
Email Address:
Signature: Date:
"I certify that I agree to my designation as a Back-up Operator in Responsible Charge for the facility noted. I understand and will abide by
the rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G.0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
BACKUP ORC
Print Full Name: Work Phone:
Certificate Type: Select Certificate Grade: Select Certificate#:
Email Address:
Signature: Date:
"I certify that I agree to my designation as a Back-up Operator in Responsible Charge for the facility noted. I understand and will abide by
the rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G.0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
BACKUP ORC
Print Full Name: Work Phone:
Certificate Type: Select Certificate Grade: Select Certificate#:
Email Address:
Signature: Date:
"/certify that I agree to my designation as a Back-up Operator in Responsible Charge for the facility noted. I understand and will abide by
the rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G.0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
Revised 4/2016

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Disclaimer: While every effort is made to keep information provided over the internet accurate and up-to- Map Scale
date, Guilford County does not certify the authenticity or accuracy of such information. No warranties, 1 inch = 261 feet
express or implied,are provided for the records and/or mapping data herein, or for their use or 1/24/2018
Interpretation by the User.