NCG550152_HistoricFile_20200505

Buncombe County Tax Lookup -..., operty Card Page 1 of 2
COUNTY OF BUNCOMBE,
NORTH CAROLINA
Web Properly Record Card
9679-00-4731-00000
Date Printed: 8/9/2011
Owner Information Parcel Information Total Property Value: 214,800
Status: Active
Owners: DAVID REBOUSSINAccount: 81794o6
BETH ETAL JTRS Deed Date: 6/16/2003
REBOUSSIN Deed Book/Page: 3253/ 0320
Address: Plat Book/Page: 0041/ 0122
135 STAFFORDSHIRE CT Legal Reference: WARRANTY OR SPL/COMP
WINSTON SALEM NC 27104 TRANSFER
Property Location: 43 DRIFTWOOD CT
Location: 43 DRIFTWOOD CT Class: RESIDENTIAL
Taxing Districts Neighborhood: BOTANY WOODS
Subdivision: BOTANY WOODS
County: Buncombe County Sub Lot: 9&ADJ
City: Zoning:
Fire: RICEVILLE FIRE Conservation/Easement:N
School: Flood:
Ownership History
Transfer Legal Deed Vacant Seller
Date Price Reference Book/Page Qualified When Account Names
Sold
WARRANTY OR GOLDSTON
o6/16/03 $164,500 SPL/COMP 3253/ 0320 Yes No 8138597 DAVID BRAIN
TRANSFER
BENNETT
WARRANTY OR STEPHEN A
o8/30/99 $138,000 SPL/COMP 2158/ 0294 Yes No 8095449 BENNETT
TRANSFER HARRY L
PLUMB
Assessment History
Year Account Acres Land Bldgs IO prr Assessed Desc Exemptions Deferred Taxable
eon 81794o6 1.15 96,500 117,600 700 214,800 0 0 214,800
2010 181794o6 1.15 96,500 117,600 700 214,800 10 0 214,800
2oog 81794o6 1.15 66,9oo 147,000 900 214,800 0 0 214,800
2oo8 81794o6 1.15 66,9oo 147,000 900 214,800 0 0 214,800
2007 81794o6 1.15 66,9oo 147,000 900 214,800 0 0 214,800
2oo6 81794o6 1.15 66,9oo 147,000 900 214,800 0 0 214,800
2005 81794o6 1.15 35,800 98,200 700 134,700 0 0 134,700
2004 81794o6 1.15 35,800 98,200 700 134,700 0 0 134,700
2003 8138597 1.15 35,800 98,200 700 134,700 0 0 1134,700
2002 8138597 1.15 35,800.98,200 700 134,700 0 0 1134,700
I -2001 8138597 1.15 30,3o0 6o,000 300 90,600 0 0 90,600
http://www.buncombetax.org/PropertyCard.aspx 8/9/2011

Buncombe County Tax Lookup - ' perty Card - Page 2 of 2
Land Data Total Acres: 1.15 Land Value: Other Improvements Value: 700
Acres 96,500 Improv# Description Year Units
Segment# Units Description 224 Square
1 1.15 Acres LOT 1 DECK 1983 Feet
Building Structures
Res. Sq Bsmt Bsmt Year
Building ID Style Feet SgFt Finished Bit Grade Condition Value
1 1.o-STY
CONVENTIONAL 936 0 0 198o C N 117600
Refinement Description Built-Ins Units
Foundation PIERS-WD/STL/MSNY Full Bath(s) 1
Roof TY/MT GABLE W/COMP. SHGL. Fireplace/Gas Log 1
Roof Structure WOOD JOIST Bedrooms(s) 2
Floor Finish W/W CARPET
Interior Finish DRYWALL/SHEETROCK
Heating FORCED AIR
Air Condition NONE(NO CENTRAL A/C)
Section SgFt * Stories zoom
BASE AREA 936 1.00
SCREENED PORCH192 1.00 ON
,WOOD DECK 224 1.00
CARPORT 1208 ji.00
Total Building Value: 117,600
http://www.buncombetax.org/PropertyCard.aspx 8/9/2011

(Page l of 3)
9999-00205534
BOOK 3253
PAGES 320 - 322
Buncombe 1:21am
County, NC
Recorded 08/18/2003 10:5
No 9999-00205534 1 of 3 pages
Excise Tax: $329.00
Otto Y. DeBruhl, Register of Deeds
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax: $3 29.00
Parcel Identifier No.9679-17-00-3636 Verified by County on the_ day of 20_
By:
MaiUBox to: Richard J.Maita Law Offices of Richard J.Marta P.A. 35A Montford Avenue Asheville NC 28801
This instrument was prepared by:Law Offices of Richard J.Maita,P.A„35A Montford Avenue,Asheville,NC 28901
Brief description for the Index: —
THIS DEED made this 13th day of June 20 03,by and between
O� GRANTEE
David Brian Goldston,single
RANTOR David Reboussin and wife Beth Reboussin
Q Roland Reboussin and wife,Pat Reboussin
Dan Reboussin and wife,Ann Glowasky
O
G 43 Driftwood Circle
Asheville,NC 28805
Joint Tenants With Right Of Survivorship
Mailing address: 135 Staffordshire Ct.
Winston Salem, NC 27104
The designation Grantor and Grantee as usedherein shall include said parties,their heirs,successors,and assigns,and shall include
singular,plural,masculine,feminine or neuter as required by context.
WITNESSETH,that the Grantor,for a valuable consideration paid by the Grantee,the receipt of whichis hereby acknowledged,has
and by these presents does grant,bargain,sell and convey unto the Grantee in fee simple,all that certain lotor parcel of land situated
in the City of Township, Buncombe County,North Carolina and
more particularly described as follows:
See Attached
The property hereinabove described was acquired by Grantor by instrument recorded in Book page _
A map showing the above described property is recorded in Plat Book 41 page 122
NC Bar Association Form No.Lr3 @ 1976,Revised®1977,2002
Printed by Agreement with the NC Bar Association—1981 SoftPro Corporation,333 E.Six Forks Rd.,Raleigh,NC 27609
Book 3253, Paue 320. File Number

(Page 2 of 3)
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee
in fee simple.
And the Grantor covenants with the Grantee,that Grantor is seized of the premises in fee simple,has the right to convey the same in
fee simple,that title is marketable and free and clear of all encumbrances,and that Grantor will warrant and defend the title against
the lawful claims of all persons whomsoever,other than the following exceptions:Restrictive covenants recorded in Book
1101,Page 185•Buncombe County Registry.
IN WITNESS WHEREOF,the Grantor has duly executed the foregoing as of the day
//and yea
��first above written.
SEAL)
(Entity Name) David Brian Goldston
By. (SEAL)
Title:
By (SEAL)
Title:
By: (SEAL)
Title:
State of North Carolina-County of` wtevarbe OUfVo X^
I,the undersigned Notary Public of the County and State aforesaid,certify that David Brian Goldston,single
personally appeared before me this day and
acknowledged the due execution of the foregoing instrument for the purposes therein expressed. Witness my hand and Notarial
stamp or seal this 13th day of June ,20 03
My Commission Expires: 0'1-
otary lic
State of North Carolina-County of A
I,tluundetsignedNotaryPublicoftheQ- State aforesaid certify that
personally came before me this day and acknowl . that_he is the - 'of
cry Nor*%Uta r
cotporationtlimited liability y/g r.11 artnerahip/limitedpartnerahip( y {nap�ica�l aed
that by authority duly given and as the act of such entity, he signed the foregoing instrument ieittt*=sits istha itg a
deed. Witness my hand and Notarial stamp or seal,this day of cAj, O=, t,
My Commission Expires
Notary Public
State of North Carolina-Courtly of IFti —
I the undersigned Notary Public of the County and State aforesaid,certify that
Witness my hand and Notarial stamp or seal,this day of 120_.
My Commission Expires:
Notary Public
The foregoing Certificates)of t
Ware certified to be correct.This instrument and this certificate are dulyregistered at the date and time and in the Book and Page shown
on the first page f.
C R Register of Deeds for County
By: ILIL _ i? , Deputy/Assistant-Register of Deeds
NC Bar Association Form No.1,3 @ 1976,Revised C 1977,2002
Printed by Agreement with the NC Bar Association-1981 SoftPro Corporation,333 E.Six Forks Rd.,Raleigh,NC 27609
Book 3253, Paae 320. File LQtunber

(Page 3 of 3)
3
ATTACHMENT
TRACT ONE: BEING all of Lot 9,of Section 5,of Botany Woods,as shown on a plat duly recorded in the Office of
the Register of Deeds for Buncombe County,North Carolins,in Plat Book 41,at Page 122,reference to which is
hereby made for a more particular description.
TRACT TWO: BEGINNING at a stake in the Western bank of the Swannanoa River at the Southeastern comer of
Lot 9 as shown on a plat of the Driftwood Section of Botany Woods Subdivision,which said plat is duly recorded in
the Office of the Register of Deeds for Buncombe County,North Carolina,in Plat Book 41,at Page 122,and runs
thence from said Beginning corner thus established and with the Southeastern line of said Lot 9,South 43-22-17
West 180 feet to a stake which stands in the Northeastern line of Lot 6 of Section 3,of Botany Woods Subdivision as
shown on a plat duly recorded in the Office of the Register of Deeds for Buncombe County,North Carolina,in Plat
Book 36,at Page 126,and runs thence withe the Northeastern lines of Lots 6 and 7 as shown on said plat,South
46-37-43 East 150 feet to a stake;runs thence Noah 43-22-17 East 104.12 feet to a stake in said bank of the
Swannanoa River;and runs thence with said bank,North 40-35-02 West 150.84 feet to the BEGINNING.
Being the same property conveyed to David Brian Goldston by Deed recorded in Deed Book 2158 at Page 294,
Buncombe County Registry.
The above property is also described in a survey for the Grantees dated May 28-June 6,2003,prepared by Brian
O'Connor,PLS,identified as file number 3E22 Reboussin,and containing 1.14 acre according to said survey.
Reference to said unrecorded survey being hereby made for a more particular description.
GRANTEES accept title to this property SUBJECT TO a RIGHT OF FIRST REFUSAL amongst each other(and not
with the seller). If one of the Grantees("selling Grantee")receives an offer from a third party to purchase selling
Grantees'1/3 interest,said selling Grantee shall give the other Grantees the right of first refusal. Upon the selling
Grantee receiving a written notice of the other Grantees decision not to exercise their right of first refusal,the selling
Grantee may proceed with the sale to the third party.
Q�
Go
Reboussin43
43 Driftwood Circle,Asheville,NC 28805
Book 3253, Pacre 320, File Number

A 7
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross,Jr., Secretary
Coleen H.Sullins, Director
July 27,2007
David Reboussin
135 Staffordshire Court
Winston-Salem,NC 27104
Subject: Renewal of coverage/General Permit NCG550000
43 Driftwood Court
Certificate of Coverage NCG550152
Buncombe County
Dear Permittee:
In accordance with your renewal application [received on February 13,20071,the Division is renewing
Certificate of Coverage(CoC)NCG550152 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 May 9, 1994 [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 Asheville Regional Office prior to any sale or transfer of the permitted facility.
Reg-ional 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 Toya
Fields [919 733-5083,extension 551 or [e-mail]] or Susan Wilson [919 733-5083,extension 510
or [e-mail].
Sincerely,
for Coleen H. Sullins ' - -- -
cc: Central Files
Asheville Regional Office/Surface Water Protection j
NPDES file ¢ /
J U L 3 1 2007 Go
c_ -
1617 Mail Service Center,Raleigh,North Carolina 27699-1617 ACHE`viL.i E REGIONAL OFFICE
512 North Salisbury Street,Raleigh,North Carolina 27604 e7
Phone: [phone]/FAX [phone]/Internet:www.ncwaterquality.org
� atural�
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 NCG550152
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,
David Reboussin
is hereby authorized to discharge domestic wastewater [300 GPD] from a facility located at
43 Driftwood Court
Asheville
Buncombe County
to receiving waters designated as Swannanoa River in subbasin 04-03-02 of 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 hereof.
This certificate of coverage shall become effective August 1, 2007.
This Certificate of Coverage shall remain in effect for the duration of the General Permit..
Signed this day July 27, 2007.
for Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

1
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A �1
NORTH CAROLINA DIVISION OF WATER QUALITY
Revised August 1,2008
Who Is Covered Under This Permit? disinfection apparatus. All existing facilities adding
chlorination after August 1,2007 will also be required to
This permit covers discharges of treated domestic add dechlorination. System requirements for a new(not
wastewater from single family residences at flows not to yet constructed) system are a septic tank,primary and
exceed 1000 gallons per day. Other types of facilities secondary (or recirculating) sand filters,
discharging less than 1000 gallons per day of treated chlorination/dechlorination (or equivalent means of
domestic wastewater may be covered under this permit disinfection)and post-aeration apparatus.
with the approval of the Division.
Operation and Maintenance
Changes in Reissued General Permit
In order to protect water quality and to ensure proper
The previous General Permit expired July 31,2007. The operation of domestic wastewater systems,the following
permit has been reissued for an additional five years. The measures should be taken:
new permit contains the following significant changes Check the septic tank every year to see if solids
from the previous version: should be removed.
• Dechlorination is now required for all facilities • Have the septic tank pumped out every three to five
installing chlorination after the effective date of the years. Contact a local septic service/repair company
final permit. from the yellow pages:
• Risers will be required on all new septic tanks. • Inspect disinfection and dechlorination equipment
making them easier to locate. (if applicable)weekly to confirm proper operation.
• If a chlorinator and/or dechlorinator is installed,
There were also changes made to the.Notice of Intent replace tablets whenever necessary.
(NOI) which is filed to gain coverage under this permit.
The NOI requires updated buffer requirements aligning Tips for Maintainine Your Septic Tank
with 1SA NCAC 02T .0506, and the sign-off of a
professional engineer for all new systems. The septic tank is usually a watertight concrete box buried
in the ground outside the house. Wastewaters from the
Key Permit Requirements house, including the toilets, shower, bathtub, washing
machine and dishwasher flow into the tank. Heavier solid
• Annual sampling of the effluent from the system is materials settle to the bottom and the liquid flows out of
required. The parameters to be sampled can be found the tank into a soil drainfield. Both the septic tank and
in Part 1, Section A. A North Carolina certified drainfield must be properly maintained for the system to
laboratory should be contacted to perform the work correctly for many years. Some tips for maintaining
analytical monitoring. A list of certified laboratories your septic system are:
can be obtained by calling the Division.
• All samples should be collected before the effluent • Do not put too much water into the septic system.
joins or is diluted by any other wastestream,water.or Try to conserve water wherever possible.
substance. (Part II,Section DA) • Do not add materials such as chemicals, sanitary
• The permittee shall give notice to the Division of any napkins,or other foreign objects.
planned physical alterations or additions to the • Restrict the use of your garbage disposal.
system that could significantly increase the quantity • Do not pour grease or cooking oils down the drain.
of pollutants discharged or introduce new pollutants • Have the solids pumped out of the septic tank every
to the discharge. These alterations include any types 3-5 years.
of residence/facility expansions (Part 11, Section • Keep automobiles and heavy equipment off of the
E:3) septic tank and drain field.
• Submission of monitoring reports is not required. All
monitoring information must be retained on site for a Chlorination and Dechlorination Tablets
period of 3 years. (Part It,Section E:1)
If the treatment system has a chlorinator or dechlorinator,
Minimum Treatment System Requirements it is important that there is an adequate supply of tablets
to ensure proper operation. There will usually be a white
System requirements for existing (previously PVC pipe sticking up from the chlorinator/dechlorinator
constructed) systems are a septic tank, sand filter and where the tablets should be inserted. Tablets can be

obtained from most plumbing supply stores. Make sure 4) Does a certified lab need to be used to analyze
that the tablets are certified for wastewater use. Chlorine samples?
tablets are NOT the same•type of chlorine used for Yes, a North Carolina certified lab,must be used to
swimming pools. perform analytical monitoring. The only exception to
this rule is when measuring the value of pH. pH
Siens of Septic System Problems values should be measured in the field because they
may change considerably between when the sample
Some of the signs that your septic system may be having is pulled and it is analyzed at the laboratory. A list of
problems are: certified labs is available from the Division.
• Sewage backing up into your toilets,tubs or sinks. 5) What If I Sell My Property?
• Slowly draining fixtures; particularly after it has
rained. The Division views changes of name or ownership as
• The smell of raw sewage accompanied by soggy soil a minor modification and requires the Director's
over the drainfield. approval. Name and ownership changes require you
Sewage discharging over the ground or in nearby to complete a Name/Ownership Change Form. The
ditches or woods. forms are available by contacting the NPDES
Permitting Program at(919)807-6300.
If you see any of these signs, contact a septic repair
company from the yellow pages in your area. 6) When does my permit expire and.how do I renew
it?
Rieht-of--Way The expiration date of the permit is on the first page
of the General Permit. This General Permit expires
Issuance of this general permit_does not relieve the on July 31, 2012. Approximately 180 days prior the
permittee from obtaining all necessary right-of-way or expiration of the General Permit, you will receive a
easement rights to discharge wastewater on or across renewal notice in the mail from the Division:'"
another property.
Contact Us
Frequently Asked Questions
For additional information,please contact us at:
1) Do I need to submit the monitoring results
annually? N.C.Division of Water Quality
No. The submission of monitoring reports for this Surface Water Protection Section
permit is not required. There are no standardized NPDES Program
Discharge Monitoring Reports (DMRs) associated 1617 Mail Service Center
with this permit. All monitoring results should be Raleigh,N.C.27699-1617
kept on site for three years. The Division may Phone: [phone].
request these reports for review at any time. (Part II, Fax: . [phone]
Section E:1)
You may.also contact your local Regional Office at:
2) Do I need to employ a certified wastewater
treatment plant operator to manage and run the Asheville: [phone] .
system? Fayetteville: [phone]
Not at this time. The Division's Operator Training Mooresville: [phone]
and Certification Unit does not currently plan to Raleigh: [phone]
classify these types of facilities for the purposes of Washington: [phone]
needing a certified operator. The requirement was Wilmington: [phone]
left in the permit at this time with clarification,in the Winston-Salem: [phone]
event that classification was assigned in the future.
(Part 11,Section C:1) The NPDES Permitting Program can be found online at
http•//www.ncwaterquality.orz/NPDES Another source of
3) Where do I find my stream classification? information is the DENR Customer Service Center.They
The stream classification, i.e. WS-IV, C,Tr, etc. can may be reached at 1-877 NC ENR 4 U(1-877-623-6748).
usually be found in the Certificate of Coverage. If An additional source of information is the North Carolina
you are unsure of your stream classification,you can Division of Pollution Prevention and Environmental
contact the NPDES Permitting Program. Assistance. They have information on how to minimize
pollutants at various types of industries. They may be
reached at(919)715-6500.

General Permit NCG550000
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG550000
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, this permit is hereby issued to all owners or operators, hereafter
permittees, which are covered by this permit as evidenced by receipt of a Certificate
of Coverage by the Environmental Management Commission to allow the discharge of
treated domestic wastewater in accordance with the effluent limitations, monitoring
requirements, and other conditions set forth in Parts 1, II, III and IV hereof.
This permit shall become effective August 1, 2007.
This permit shall expire at midnight on July 31, 2012.
ORIGINAL SIGNED BY SUSAN A. WILSON
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Page 1 of 11 Pages

AWL
General Permit NCG550000
PART I
MONITORING, CONTROLS, AND LIMITATIONS FOR PERMITTED DISCHARGES
A. EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
During the period beginning on August 1, 2007 and lasting until expiration, the Permittee is
authorized to discharge domestic wastewater from outfall 001. Such discharges shall be limited and
monitored by the Permittee as specified below:
Flow 2 Annually Estimate Effluent
BOD, S-Day, 20°C3 30.0 mg/1 45.0 mg/l Annually Grab Effluent
Total Suspended Solids3 30.0 mg/1 45.0 mg/l Annually Grab Effluent
Fecal Coliform3 400 / 100
(Geometric mean) 200 / 100 ml ml Annually Grab Effluent
Total Residual Chlorine3,4 Annually Grab Effluent
1. Effluent is defined as wastewater leaving the treatment system, prior to discharge into a creek
or other waterbody.
2. The wastewater discharge flow from this facility may not in any case exceed 1000 gallons per
day.
3. A North Carolina certified laboratory must perform the wastewater analysis.
4. Instream chlorine levels are not to exceed 17 jig/L. The sample shall be taken from the effluent
pipe, prior to discharge into a creek or other waterbody.
Treatment system requirements for existing (previously constructed) systems:
Septic tank, sand filter, and disinfection. All facilities adding chlorination after the August 1, 2007
effective date of this permit will also be required to add dechlorination.
Treatment system requirements for new (not yet constructed) systems:
Septic tank (with riser), primary& secondary (or recirculating) sand filters, chlorination/dechlorination
(or equivalent means of disinfection), and post-aeration apparatus.
The tablet chlorinator and dechlorinator [if applicable] shall be inspected weekly to ensure there is an
adequate supply of tablets for continuous &proper operation. The dechlorinator unit shall be labeled
"dechlorination only".
The permittee must conduct and document the following maintenance activities:
• Septic tanks shall be maintained at all times to prevent seepage of sewage to the surface of the
ground.
• Septic tanks will be checked at least yearly to determine if solids must be removed or if other
maintenance is necessary.
• Septic tanks shall be pumped out within three to five years of the issuance date on the Certificate
of Coverage.
• Contents removed from septic tanks shall be disposed at a location and in a manner compliant
with all local and state regulations.
• Surface sand filters, disinfection apparatus and (if applicable) dechlorination apparatus shall be
inspected weekly to confirm proper operation.
• Annual sampling data shall be retained onsite for a minimum of three years.
There shall be no discharge of floating solids or foam visible in other than trace amounts.
Page 2 of 11 Pages

- General Permit NCG550000
PART II
STANDARD CONDITIONS FOR NPDES PERMITS
SECTION A. DEFINITIONS
1. Permit Issuing Authority The Director of the Division of Water Quality.
2. Division: The Division of Water Quality in the North Carolina Department of Environment and
Natural Resources.
3. EMC: North Carolina Environmental Management Commission.
4. Permittee: The entity who obtains coverage under this General Permit by subsequent issuance
of a"Certificate of Coverage" by the Division.
5. Act or "the Act The Federal Water Pollution Control Act, also known as the Clean Water Act,
as amended,33 USC 1251, et. seq.
6. Concentration Measurements
a. Monthly Average Concentration: The sum of the concentrations of all daily discharges
sampled and/or measured during a calendar month on which daily discharges are
sampled and measured, divided by the number of daily discharges sampled and/or
measured during such month (arithmetic mean of the daily concentration values). The
daily concentration value in the case of grab samples is the arithmetic mean (weighted
by flow value) of all the samples collected during that calendar day.
b. Monthly Average Concentration for Fecal Coliform: The geometric mean of the counts
for samples collected during a calendar month. This limitation is identified as "Monthly
Average" in Part I of the permit.
c. Daily Maximum Concentration: The concentration of a pollutant discharge during a
calendar day. If only one sample is taken during any calendar day the concentration of
pollutant calculated from it is the "Maximum Daily Concentration". It is identified as
"Daily Maximum" in Part I of the permit.
7. Grab Samples: Individual samples of at least 100 ml collected over a period of time not
exceeding 15 minutes. Grab samples can be collected manually.
8. Calculations
a. Geometric Mean:The Nth root of the product of the individual values where N is equal to the
number of individual values. The geometric mean is equivalent to the antilog of the arithmetic
mean of the logarithms of the individual values. For purposes of calculating the geometric mean,
values of zero (0)shall be considered to be one(1).
9. Hazardous Substance: Any substance designated under 40 CFR Part 116 pursuant to Section
311 of the Clean Water Act.
10.Toxic Pollutant: Any pollutant listed as toxic under Section 307(a)(1) of the Clean Water Act.
11. Bypass: The intentional diversion of waste streams from any portion of a treatment facility
(including the collection system). The permittee may allow any bypass to occur which does not
cause effluent limitations to be exceeded, but only if it also is for essential maintenance to
assure efficient operation.
Page 3 of 11 Pages

General Permit NCG550000
12. Severe property damage: Substantial physical damage to property, damage to the treatment
facilities which causes them to become inoperable, or substantial and permanent loss of
natural resources which can reasonably be expected to occur in the absence of a bypass.
Severe property damage does not mean economic loss caused by delays in production.
13. Upset: An exceptional incident in which there is unintentional and temporary noncompliance
with technology-based permit effluent limitations because of factors beyond the reasonable
control of the permittee. An upset does not include noncompliance to the extent caused by
operational error, improperly designed treatment facilities, inadequate treatment facilities, lack
of preventive maintenance, or careless or improper operation.
SECTION B. GENERAL CONDITIONS
1. Duty to Comply
The permittee must comply with all conditions of this General Permit. Any permit noncompliance
constitutes a violation of the Clean Water Act and is grounds for enforcement action; for permit
termination, revocation and reissuance, or modification; or denial of a permit upon renewal
application.
a. The permittee shall comply with standards or prohibitions established under section 307(a) of
the Clean Water Act for toxic pollutants within the time provided in the regulations that
establish these standards or prohibitions, even if the permit has not yet been modified to
incorporate the requirement.
b. The Clean Water Act provides that any person who violates a permit condition is subject to a
civil penalty not to exceed $25,000 per day for each violation. Any person who negligently
violates any permit condition is subject to criminal penalties of $2,500 to $25,000 per day of
violation, or imprisonment for not more than 1 year, or both. Any person who knowingly
violates any permit conditions is subject to criminal penalties of$5,000 to $50,000 per day of
violation, or imprisonment for not more than 3 years, or both. Also, any person who violates a
permit condition may be assessed an administrative penalty not to exceed $10,000 per violation
with the maximum amount not to exceed $125,000. [Ref: Section 309 of the Federal Act 33
USC 1319 and 40 CFR 122.41(a).]
c. Under state law, a daily civil penalty of not more than twenty-five thousand dollars($25,000)
per violation may be assessed against any person who violates or fails to act in accordance with
the terms, conditions, or requirements of a permit. [Ref: North Carolina General Statutes 143-
215.6A]
d. Any person may be assessed an administrative penalty by the Director for violating section 301,
302, 306, 307, 308, 318, or 405 of the Act, or any permit condition or limitation implementing
any of such sections in a permit issued under section 402 of the Act. Administrative penalties
for Class I violations are not to exceed $11,000 per violation, with the maximum amount of any
Class I penalty assessed not to exceed $27,500. Penalties for Class II violations are not to
exceed $11,000 per day for each day during which the violation continues, with the maximum
amount of any Class II penalty not to exceed $137,500.
2. Duty to Mitigate
The permittee shall take all reasonable steps to minimize or prevent any discharge in violation of
this permit.
3. Civil and Criminal Liability
Except as provided in permit conditions on "Bypassing" (Part II, C.4.) and "Power Failures" (Part II,
C.7.), nothing in this permit shall be construed to relieve the permittee from any responsibilities,
liabilities, or penalties for noncompliance pursuant to NCGS 143-215.3, 143-215.6 or Section 309 of
the Federal Act, 33 USC 1319. Furthermore, the permittee is responsible for consequential
damages, such as fish kills, even though the responsibility for effective compliance may be
temporarily suspended.
4. Oil and Hazardous Substance Liability
Page 4 of 11 Pages

General Permit NCG550000
Nothing in this permit shall be construed to preclude the institution of any legal action or relieve
the permittee from any responsibilities, liabilities, or penalties to which the permittee is or may be
subject to under NCGS 143-215.75 et seq. or Section 311 of the Federal Act, 33 USG 1321.
Furthermore, the permittee is responsible for consequential damages, such as fish kills, even
though the responsibility for effective compliance may be temporarily suspended.
5. Property Rights
The issuance of this permit does not convey any property rights in either real or personal property,
or any exclusive privileges, nor does it authorize any injury to private property or any invasion of
personal rights, nor any infringement of Federal, State or local laws or regulations.
6. Onshore or Offshore Construction
This permit does not authorize or approve the construction of any onshore or offshore physical
structures or facilities or the undertaking of any work in any navigable waters.
7. Severability
The provisions of this permit are severable, and if any provision of this permit, or the application of
any provision of this permit to any circumstances, is held invalid, the application of such provision
to other circumstances, and the remainder of this permit, shall not be affected thereby.
8. Duty to Provide Information
The permittee shall furnish to the Permit Issuing Authority, within a reasonable time, any
information which the Permit Issuing Authority may request to determine whether cause exists for
modifying, revoking and reissuing,or terminating this permit or to determine compliance with this
permit. The permittee shall also furnish to the Permit Issuing Authority upon request, copies of
records required to be kept by this permit.
9. Duty to Reapply
If the permittee wishes to continue an activity regulated by this permit after the expiration date of
this permit, the permittee must apply for and obtain a new permit.
10. Permit Termination
After public notice and opportunity for a hearing, the General Permit and Certificates of Coverage
issued under this General Permit may be terminated for cause.
11.When an Individual Permit may be Required
The Division may require any owner authorized to discharge under this permit to apply for and
obtain an individual permit. Cases where an individual permit may be required include, but are
not limited to,the following:
a. The discharger is a significant contributor of pollution.
b. Conditions at the operating facility change altering the constituents and/or characteristics of
the discharge such that the discharge no longer qualifies for a General Permit.
c. The discharge violates the terms or conditions of this permit.
d. A change has occurred in the availability of demonstrated technology or practices for the
control or abatement of pollutants applicable to the point source.
e. Effluent limitation guidelines are promulgated for the point sources covered by this permit.
f. A water quality management plan containing requirements applicable to such point sources is
approved after the issuance of this permit.
This permit may be terminated as to an individual owner for any of the reasons set forth above
after appropriate notice in accordance with N.C.G.S. 143-215.1.
12.When an Individual Permit may be Requested
Any permittee operating under this permit may request to be excluded from coverage by applying
for an individual permit. When an individual permit is issued, the applicability of this General
Permit is automatically terminated on the effective date of the individual permit.
13. Signatory Requirements
All applications, reports, or information submitted to the Permit Issuing Authority shall be signed
and certified.
Page 5 of 11 Pages

General Permit NCG550000
a. All permit applications shall be signed as follows:
(1) In the case of a corporation, by a principal executive officer of at least the level of vice
president, or his duly authorized representative, if such representative is responsible for the
overall operation of the facility from which the discharge described in the permit application
form originates;(2)In the case of a partnership or sole proprietorship: by a general partner
or the proprietor, respectively; or;
(3) In the case of a municipality, State, Fedral, or other public entity by either a principal
executive officer, ranking elected official, or other duly authorized employee.
b. All reports required by the permit and other information requested by the Permit Issuing
Authority shall be signed by a person described above or by a duly authorized representative of
that person. A person is a duly authorized representative only if:
(1) The authorization is made in writing by a person described above;
(2) The authorization specified either an individual or a position having responsibility for the
overall operation of the regulated facility or activity, such as the position of plant manager,
operator of a well or well field, superintendent, a position of equivalent responsibility, or an
individual or position having overall responsibility for environmental matters for the
company. (A duly authorized representative may thus be either a named individual or any
individual occupying a named position.); and
(3) The written authorization is submitted to the Permit Issuing Authority.
c. Certification: Any person signing a document under paragraphs a. or b. of this section shall
make the following certification:
"I certify, under penalty of law, that this document and all attachments were prepared
under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gather and evaluate the information submitted. Based on
my inquiry of the person or persons who manage the system, or those persons directly
responsible for gathering the information, the information submitted is, to the best of
my knowledge and belief, true, accurate, and complete. I am aware that there are
significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations."
14. Permit Actions
This permit may be modified, revoked and reissued, or terminated for cause. The filing of a request
by the permittee for a permit modification, revocation and reissuance, or termination, or a
notification of planned changes or anticipated noncompliance does not stay any permit condition.
15. Permit Modification Revocation and Reissuance, or Termination
The issuance of this permit does not prohibit the permit issuing authority from reopening and
modifying the permit, revoking and reissuing the permit, or terminating the permit as allowed by
the laws, rules, and regulations contained in Title 40, Code of Federal Regulations, Parts 122 and
123; Title 15A of the North Carolina Administrative Code, Subchapter 2H .0100; and North Carolina
General Statute 143-215.1 et. al.
SECTION C. OPERATION AND MAINTENANCE OF POLLUTION CONTROLS
1. Certified Operator
Pursuant to Chapter 90A-44 of North Carolina General Statutes, the permittee shall employ a
certified wastewater treatment plant operator in responsible charge (ORC) of the wastewater
treatment facilities. Such operator must hold a certification of the grade equivalent to or greater
than the classification assigned to the wastewater treatment facilities. The permittee shall notify
the Division's Operator Training and Certification Unit within one hundred and twenty days of any
change in the ORC status. NOTE: This requirement does not apply until the permittee
receives a letter notifying them of classification of the facility. Currently,facilities are not
being classified for this purpose, but may at some time in the future.
Page 6 of 11 Pages

General Permit NCG550000
2. Proper Operation and Maintenance
The permittee shall at all times properly operate and maintain all facilities and systems of
treatment and control (and related appurtenances) which are installed or used by the permittee to
achieve compliance with the conditions of this permit. Proper operation and maintenance also
includes adequate laboratory controls and appropriate quality assurance procedures. This
provision requires the operation of back-up or auxiliary facilities [or similar systems] installed by a
permittee only when the operation is necessary to achieve compliance with the conditions of the
permit.
3. Need to Halt or Reduce not a Defense
It shall not be a defense for a permittee in an enforcement action that it would have been necessary
to halt or reduce the permitted activity in order to maintain compliance with the conditions of this
permit.
4. Bypassing of Treatment Facilities
a. Bypass not exceeding limitations.
The permittee may allow any bypass to occur which does not cause effluent limitations to be
exceeded, but only if it also is for essential maintenance to assure efficient operation. These
bypasses are not subject to the provisions of Paragraphs b. and c. of this section.
b. Notice
(1) Anticipated bypass. If the permittee knows in advance of the need for a bypass, it shall
submit prior notice, if possible at least ten days before the date of the bypass; including an
evaluation of the anticipated quality and affect of the bypass.
(2) Unanticipated bypass. The permittee shall submit notice of an unanticipated bypass as
required in Part II.E.6 of this permit. (24-hour notice).
c. Prohibition of Bypass
(1) Bypass is prohibited and the Permit Issuing Authority may take enforcement action against
a permittee for bypass, unless:
(a) Bypass was unavoidable to prevent loss of life, personal injury or severe property
damage;
(b) There were no feasible alternatives to the bypass, such as the use of auxiliary treatment
facilities, retention of untreated wastes or maintenance during normal periods of
equipment downtime. This condition is not satisfied if adequate backup equipment
should have been installed in the exercise of reasonable engineering judgment to
prevent a bypass which occurred during normal periods of equipment downtime or
preventive maintenance; and
(c) The permittee submitted notices as required under Paragraph b. of this section.
(2) The Permit Issuing Authority may approve an anticipated bypass, after considering its
adverse affects, if the Permit Issuing Authority determines that it will meet the three
conditions listed above in Paragraph c. (1) of this section.
5. Upsets
a. Effect of an upset.
An upset constitutes an affirmative defense to an action brought for noncompliance with such
technology based permit effluent limitations if the requirements of paragraph b. of this
condition are met. No determination made during administrative review of claims that
noncompliance was caused by upset, and before an action for noncompliance, is final
administrative action subject to judicial review.
b. Conditions necessary for a demonstration of upset.
A permittee who wishes to establish the affirmative defense of upset shall demonstrate, through
properly signed, contemporaneous operating logs, or other relevant evidence that:
Page 7 of 11 Pages

General Permit NCG550000
(1) An upset occurred and that the permittee can identify the cause(s) of the upset;
(2) The permitted facility was at the time being properly operated; and
(3) The permittee submitted notice of the upset as required in Part II.E.6.b.2 of this permit.
(3) The permittee complied with any remedial measures required under Part II.B.2 of this
permit.
c. Burden of proof.
In any enforcement proceeding the permittee seeking to establish the occurrence of an upset
has the burden of proof.
6. Removed Substances
Solids, sludges, filter backwash, or other pollutants removed in the course of treatment or control
of wastewaters shall be disposed of in accordance with NCGS 143-215.1 and in a manner such as to
prevent any pollutant from such materials from entering waters of the State or navigable waters of
the United States. The permittee shall comply with all existing federal regulations governing the
disposal of sewage sludge. Upon promulgation of 40 CFR Part 503, any permit issued by the Permit
Issuing Authority for the disposal of sludge may be reopened and modified, or revoked and
reissued, to incorporate applicable requirements at 40 CFR Part 503. The permittee shall comply
with applicable 40 CFR Part 503 Standards for the Use and Disposal of Sewage Sludge (when
promulgated) within the time provided in the regulation, even if the permit is not modified to
incorporate the requirement. The permittee shall notify the Permit Issuing Authority of any
significant change in its sludge use or disposal practices.
7. Power Failures
The permittee is responsible for maintaining adequate safeguards as required by DWQ Regulation,
Title 15A, North Carolina Administrative Code, Subchapter 2H, .0124 Reliability, to prevent the
discharge of untreated or inadequately treated wastes during electrical power failures either by
means of alternate power sources, standby generators or retention of inadequately treated effluent.
SECTION D. MONITORING AND RECORDS
1. Representative Sampling
Samples collected and measurements taken, as required herein, shall be characteristic of the
volume and nature of the permitted discharge. Samples collected at a frequency less than daily
shall be collected on a day and time that is characteristic of the discharge over the period the
sample represents. All samples shall be taken at the monitoring points specified in this permit
and, unless otherwise specified, before the effluent joins or is diluted by any other wastestream,
body of water, or substance. Monitoring points shall not be changed without notification to and
the approval of the Permit Issuing Authority.
2. Test Procedures
Test procedures for the analysis of pollutants shall conform to the EMC regulations published
pursuant to NCGS 143-215.63 et. seq., the Water and Air Quality Reporting Acts, and to regulations
published pursuant to Section 304(g), 33 USC 1314, of the Federal Water Pollution Control Act, as
Amended, and Regulation 40 CFR 136. To meet the intent of the monitoring required by this
permit, all test procedures must produce minimum detection and reporting levels that are below
the permit discharge requirements and all data generated must be reported down to the minimum
detection or lower reporting level of the procedure. If no approved methods are determined capable
of achieving minimum detection and reporting levels below permit discharge requirements, then
the most sensitive (method with the lowest possible detection and reporting level) approved method
must be used.
3. Penalties for Tampering
The Clean Water Act provides that any person who falsifies, tampers with, or knowingly renders
inaccurate, any monitoring device or method required to be maintained under this permit shall,
upon conviction, be punished by a fine of not more than $10,000 per violation, or by imprisonment
for not more than two years per violation, or by both. In the case of a second or subsequent
conviction, punishment is a fine of not more than $20,000 per day of violation, or by imprisonment
of not more than 4 years, or both.
Page 8 of 11 Pages

General Permit NCG550000
4. Records Retention
The permittee shall retain records of all monitoring information, including all calibration and
maintenance records and all original strip chart recordings for continuous monitoring
instrumentation, copies of all reports required by this permit, for a period of at least 3 years from
the date of the sample, measurement, report or application. This period may be extended by
request of the Director at any time.
5. Recording Results
For each measurement or sample taken pursuant to the requirements of this permit, the permittee
shall record the following information:
a. The date, exact place, and time of sampling or measurements;
b. The individual(s) who performed the sampling or measurements;
c. The date(s) analyses were performed;
d. The individual(s) who performed the analyses;
e. The analytical techniques or methods used; and
f. The results of such analyses.
6. Inspection and Entry
The permittee shall allow the Director or his authorized representative[s], upon the presentation of
credentials and other documents as may be required by law, to;
a. Enter upon the permittee's premises where a regulated facility or activity is located or
conducted, or where records must be kept under the conditions of this permit;
b. Have access to and copy any records that must be kept under the conditions of this permit;
c. Inspect any facilities, equipment (including monitoring and control equipment), practices, or
operations regulated or required under this permit; and
d. Sample or monitor, for the purposes of assuring permit compliance or as otherwise authorized by the
Clean Water Act,any substances or parameters at any location.
SECTION E. REPORTING REQUIREMENTS
1. Submission of Reports
Submission of standardized monitoring forms or other monitoring reports to the Division is not
required. All monitoring information and copies of any reports required by this permit, must be
retained on site for a period of at least 3 years from the date of the sample, measurement,report or
application. This period may be extended by request of the Director at any time. The permittee
shall furnish to the Permit Issuing Authority upon request; copies of records required to be kept by
this permit.
2. Change in Discharge
All discharges authorized herein shall be consistent with the terms and conditions of this permit.
The discharge of any pollutant identified in this permit more frequently than or at a level in excess
of that authorized shall constitute a violation of the permit.
3. Planned Changes
The permittee shall give notice to the Director as soon as possible of any planned physical
alterations or additions to the permitted facility. Notice is required only when:
a. The alteration or addition to a permitted facility may meet one of the criteria for determining
whether a facility is a new source in 40 CFR Part 122.29 (b); or
b. The alteration or addition could significantly change the nature or increase the quantity of
pollutants discharged. This notification applies to pollutants that are not subject to effluent
limitations in the permit or to notification requirements under 40 CFR Part 122.42 (a) (1).
4. Anticipated Noncompliance
The permittee shall give advance notice to the Director of any planned changes in the permitted
facility or activity that may result in noncompliance with permit requirements.
5. Transfers
Page 9 of 11 Pages

General Permit NCG550000
This permit is not transferable to any person except after notice to and approval by the Director.
The Director may require modification or revocation and reissuance of the permit and incorporating
such other requirements as may be necessary under the Clean Water Act.
6. DutV to Report Noncompliance
a. The permittee shall report to the central office or the appropriate regional office any
noncompliance that may endanger health or the environment. Any information shall be
provided orally within 24 hours from the time the permittee became aware of the
circumstances. A written submission shall also be provided within 5 days of the time the
permittee becomes aware of the circumstances.
(1) The written submission shall contain a description of the noncompliance, and its cause; the
period of noncompliance, including exact dates and times, and if the noncompliance has
not been corrected, the anticipated time it is expected to continue; and steps taken or
planned to reduce, eliminate, and prevent reoccurrence of the noncompliance.
b. The following shall be included as information that must be reported within 24 hours under
this paragraph.
(1) Any unanticipated bypass that exceeds any effluent limitation in the permit.
(2) Any upset which exceeds any effluent limitation in the permit.
(3) Violation of a maximum daily or monthly average discharge limitation for any of the
pollutants listed by the Director in the permit to be reported within 24 hours.
c. The Director may waive the written report on a case-by-case basis for reports under paragraph
b. above of this condition if the oral report has been received within 24 hours.
7. Other Information
Where the permittee becomes aware that it failed to submit any relevant facts in a permit
application, or submitted incorrect information in a permit application or in any report to the
Director, it shall promptly submit the correct facts or information.
8. Noncompliance Notification Procedure
The permittee shall report by telephone to either the central office or the appropriate regional office
of the Division as soon as possible, but in no case more than 24 hours or on the next working day
following the occurrence or first knowledge of the occurrence of any of the following:
a. Any occurrence at the water pollution control facility which results in the discharge of
significant amounts of wastes which are abnormal in quantity or characteristic, such as the
dumping of the contents of a sludge digester; the known passage of a slug of hazardous
substance through the facility; or any other unusual circumstances.
b. Any process unit failure, due to known or unknown reasons, that render the facility incapable
of adequate wastewater treatment such as mechanical or electrical failures of pumps, aerators,
compressors, etc.
c. Any failure of a pumping station, sewer line, or treatment facility resulting in a by-pass directly
to receiving waters without treatment of all or any portion of the influent to such station or
facility.
Persons reporting such occurrences by telephone shall also file a written report [in letter form] within 5
days following first knowledge of the occurrence.
9. Availability of Reports
Except for data determined to be confidential under NCGS 143-215.3(a)(2) or Section 308 of the
Federal Act, 33 USC 1318, all reports prepared in accordance with the terms shall be made
available for public inspection at the offices of DWQ or at the site of the discharge within a
reasonable time period, not to exceed five (5) days. As required by the Act, effluent data shall not
be considered confidential. Knowingly making any false statement on any such report may result
in the imposition of criminal penalties as provided for in NCGS 143-215.1(b)(2) or in Section 309 of
the Federal Act.
10. Penalties for Falsification of Reports
Page 10 of 11 Pages

General Permit NCG550000
The Clean Water Act provides that any person who knowingly makes any false statement,
representation, or certification in any record or other document submitted or required to be
maintained under this permit, including monitoring reports or reports of compliance or
noncompliance shall, upon conviction, be punished by a fine of not more than $10,000 per
violation, or by imprisonment for not more than two years per violation, or by both.
PART III
OTHER REQUIREMENTS
1. Previous Permits
All previous State water quality permits issued to this facility for this particular discharge, whether
for construction or operation or discharge, are hereby revoked by issuance of this permit and
subsequent issuance of a Certificate of Coverage. The conditions, requirements, terms, and
provisions of this permit authorizing discharge under the National Pollutant Discharge Elimination
System govern discharges from this facility.
2. Construction
No construction of wastewater treatment facilities or additions thereto shall be begun until Final
Plans and Specifications have been submitted to and approved by the Division. Design and
operation of facilities and/or treatment works shall be in accordance with the application and
supporting information. If facility deficiencies, design and/or operational, are identified in the
future which could affect the facility performance or reliability, it is the responsibility of the
permittee to correct such deficiencies.
3. Limitations Reopener
This permit shall be modified or alternatively, revoked and reissued, to comply with any applicable
effluent guideline or water quality standard issued or approved under Sections 302(b) (2) (c), and
(d), 304(b) (2), and 307(a) (2) of the Clean Water Act, if the effluent guideline or water quality
standard so issued or approved:
a. contains different conditions or is otherwise more stringent than any effluent limitation in the
permit; or
b. controls any pollutant not limited in the permit.
The permit as modified or reissued under this paragraph shall also contain any other requirements
in the Act then applicable.
PART IV
ANNUAL ADMINISTERING& COMPLIANCE MONITORING FEE
The permittee must pay the annual administering and compliance monitoring fee (if any such fee is
assessed) within 30 days after being billed by the Division. Failure to pay such fees in a timely
manner in accordance with 15 NCAC 21-1.0105(b)(4) may cause the Division to initiate action to revoke
the Certificate of Coverage.
Page 11 of 11 Pages

�,k�
___

4
NCDENR
North Carolina Department of Environment a turf Ae & l
Division of Water Quality
Michael F. Easley, Governor "TER Jr.,S cretary�.E. irector
January 9, 2007x ;. �,F,..a r a a
David Reboussin
135 Staffordshire Ct
Winston Salem, NC 27104
Subject: Renewal Notice/General Permit NCG550000
Certificate of Coverage NCG550152
Buncombe County
Dear Permittee:
You are receiving this notice because you currently own a property covered under the subject
General Permit for the discharge of domestic wastewater. NCG550000 will expire on July 31, 2007.
Federal (40 CFR 122.41) and North Carolina (15A NCAC 2H.0105(e)) regulations require
that permit renewal applications be filed at least 180 days prior to expiration of the current permit.
To satisfy this requirement, the Division must receive a renewal request postmarked no later than
February 1, 2007.
The Certificate of Coverage (CoC) specific to your property was last issued on March 2, 2005.
The Division needs information from you to determine if coverage under NCG550000 is still
necessary.
➢ If your property still has a wastewater system like the ones described in the enclosed
Technical Bulletin, you must renew the subject CoC. Complete the enclosed form and
submit it to the address on the form.
➢ If you are not sure what type of system your property has, contact Larry Frost in the NC
DENR Asheville Regional Office at. That person [or other staff members] can help you
determine if you should renew your CoC.
➢ If you know that your property no longer discharges wastewater, contact me at the
address or phone number listed below to request rescission of the CoC.
➢ This information request does not pertain to the Annual Fee of$50 00 billed
separately by the Division's Budget Office. No money is required for this
procedure. The Annual Fee is like the fee you annually pay the DMV for the sticker on
your vehicle's license plate. Renewal of your CoC is like the renewal of your Driver's
License [ca. every five years].
➢ If you have already mailed a renewal request, you may disregard this notice.
1617 Mail Service Center,Raleigh,North Carolina 27699-1617 One
512 North Salisbury Street,Raleigh,North Carolina 27604 1y orthCarOlilla.
Phone: [phone],extension 511/FAX [phone]/[e-mail]
An Equal Opportunity/Affirmative Action Employer-50%Recycled/10%Post Consumer Paper
aturallr�

NCG550152 renewal notice
January 9,2007
The attached application form shows the information the Division has on file for your
property. Please verify that the provided information is correct, or make corrections on the form.
Complete the additional questions, then sign and date the form.
The completed form should be submitted to the address listed below the signature block.
If you have,any questions concerning this matter, please contact me at the telephone number
or e-mail address listed below. (If it is difficult to reach me, please be aware that your facility is one
of over 1100 that I am contacting regarding the renewal of NCG550000.)
Thanks for your attention to this matter.
Sincerely,
Charles H. Weaver, Jr.
NPDES Unit
cc: Central Files
Asheville Regional Office/Larry Frost
NPDES file

.wrs
NCDENR
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
March 2,2005
Mr.David Reboussin
135 Staffordshire Court
Winston-Salem,North Carolina 27104
Subject: Renewal of coverage/General Permit NCG550000
Reboussin property
Certificate of Coverage NCG550152
Buncombe County
Dear Mr.Reboussin:
In accordance with your application for a Certificate of Coverage[received on February 25,2005],the Division is
forwarding herewith Certificate of Coverage NCG550152 to discharge under NCG550000. Your property was previously
assigned this CoC number in 1993. The previous owner allowed the CoC to expire. Thus your application is being treated
as a renewal of an existing CoC,rather than a new discharge application. This permit 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 May 9, 1994 [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.
This pernut 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 this permit,please contact Charles H.Weaver,Jr.at telephone number 919
733-5083,extension 511.
Sincerely,
A;164-Alan W.�-- P.E.
1 0
E c E � y E D
cc: Central Files MAR — 4 2005
Ahevilte Regional Office!Larry Frost f
NPDES file
WATER QUALITY SECTION
ASHEVILLE REGIONAL OFFICE
1617 Mail Service Center,Raleigh,North Carolina 27699-1617 one
512 North Salisbury Street,Raleigh,North Carolina 27604 NorthCarolina
Phone: [phone]/FAX [phone]/Internet:h2o.enr.state.nc.us ;Vaturally
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 NCG550152
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,
David Reboussin
is hereby authorized to operate a wastewater treatment facility that consists of a septic tank, subsurface sandfilter,
chlorine disinfection,and associated appurtenances with the discharge of treated wastewater from
43 Driftwood Court
Asheville
Buncombe County
to receiving waters designated as the Swannanoa River in the French Broad River Basin in accordance with the
effluent limitations,monitoring requirements,and other conditions set forth in Parts I, H,III and IV hereof.
This certificate of coverage shall become effective March 2, 2005.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day March 2, 2005.
ZACS,-i 77--)
Man W.Klimek,P.E.,Director
Division of Water Quality
By Authority of the Environmental Management Commission

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Latitude:35°36'18" NCG550152 Facility
Longitude:82'28'18" Location
Quad:CReen,N.0 David Reboussin
Stream Gass:C
in:Receiving Stream:Swannanoa River OVO ttl NOT TO ICALE

State of North Carolina
Department of Environment,
Health end Natural Resources 01i
A4t
Division of Environmental. Management
James B. Hunt, Jr., Governor
Jonathan B. Hawes, Secretary ID C
A. Preston Howard, Jr., P.E., Director
September 30,1993
LUCYLEE W.COLFORD
COLFORD RESIDENCE (LUCYLEE W.)
43 DRIFTWOOD COURT
ASHEVILLE NC 28805 Subject: COLFORD RESIDENCE (LUCYLEE W.)
Certificate of Coverage NCG550152
General Permit NCG550000
Formerly NPDES Permit NCO048020
Buncombe County
Dear Permittee:
The Division of Environmental Management has recently evaluated all existing individual permits for potential
coverage under general permits currently issued by the Division. 15A N.C.A.C.2H.0127 allows the Division to
evaluate groups of permits having similar discharge activities for coverage under general permits and issue coverage
where the Division finds control of the discharges more appropriate in this manner.The Division has determined
that the subject discharge qualifies for such coverage. Therefore,the Division is hereby issuing the subject
Certificate of Coverage under the state-NPDES general permit no. NCG550000 which shall void NPDES Permit
NC0048020. This Certificate of Coverage is issued pursuant to the requirements of North Carolina and the US
Environmental Protection Agency Memorandum of Agreement dated December 6,1983 and 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 submit an individual permit application,associated processing fee and letter requesting
coverage under an individual permit. Unless such demand is made,this decision shall be final and binding. Please
take notice this Certificate of Coverage is not transferable. Part 11,EA. addresses the requirements to be followed in
case of change of ownership or control of this discharge.
In the event that the facilities fail to perform satisfactorily, including the creation of nuisance conditions,the
Permittee shall take immediate corrective action,including those as may be required by this Division, such as the
construction of additional or replacement wastewater treatment or disposal facilities. Construction of any
wastewater treatment facilities will require issuance of an Authorization to Construct from this Division.
Failure to abide by the requirements contained in this Certificate of Coverage and respective general permit may
subject the Permittee to an enforcement action by the Division of Environmental Management in accordance with
North Carolina General Statute 143-215.6A to 143-215.6C. Please note that the general permit does require
monitoring in accordance with federal law. The monitoring data is not required to be submitted to the Division
unless specifically requested,however,the permittee is required to maintain all records for a period of at least three
(3) years.
Post Office Box 29535,Raleigh,North Carolina 27626-0535 Telephone[phone] FAX[phone]
An Equal Opportunity Affirmative Action Employer 50%recycled-10%post-consumer paper

a
Paget.
LUCYLEE;W.COLFORD
COLFORD RESIDENCE(LUCYLEE W.)
Certificate of Coverage No.NCG550152
The issuance of this Certificate of Coverage is an administrative action initiated by the Division of
Environmental Management and therefore,no fees are due at this time. In accordance with current rules,there
are no annual administrative and compliance monitoring fees for coverage under general permits. The only fee
you will be responsible for is a renewal fee at the time of renewal. The current permit expires July 31,1997.
This coverage will remain valid through the duration of the attached general permit. The Division will be
responsible for the reissuance of the general permit and at such time,you will be notified of the procedures to
follow to continue coverage under the reissued permit. Unless you fail to follow the procedures for continued
coverage,you will continue to be permitted to discharge in accordance with the attached general permit.
The issuance of this Certificate of Coverage does not preclude the Permittee from complying with any and all
statutes,rules,regulations,or ordinances which may be required by the Division of Environmental Management
or permits required by the Division of Land Resources,the Coastal Area Management Act or any Federal or Local
other governmental permit that may be required.
If you have any questions or need additional information regarding this matter,please contact either the
Asheville Regional Office,Water Quality Section at telephone number 704/ 251-6208,or a review engineer in
the NPDES Group in the Central Office at telephone number 919/733-5083.
S. erely,
A.Preston Howar ,P.E.
cc: Asheville Regional Office
Central Files

State of North Carolina
Department of Environment,Health and Natural Resources
Division of Environmental Management
512 North Salisbury Street•Raleigh,North Carolina 27611
James G.Martin,Governor
William W.Cobey,Jr.,Secretary George T.Everett,Director
January 9, 1992
Lucylee W. Colford
43 Driftwood Ct.
Asheville,NC 28805
Subject: NPDES Permit No. NCO048020
Lucylee W. Colford Residence
Dear Ms. Colford: Buncombe County
In accordance with your application for discharge permit received on September 5, 1991, we
are forwarding herewith the subject state - NPDES permit. 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 US 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 town adjudicatory hearing upon written request within
thirty (30) days following.receipt of this letter. This request must 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, Post Office Drawer 27447, Raleigh, North Carolina 27611
-7447. Unless such demand is made, this decision shall be final and binding.
Please take notice this permit is not transferable. Part II, B.2. addresses the requirements to
be followed in case of change in ownership or control of this discharge.
This permit does not affect the legal requirements to obtain other permits which may be
required by the Division of Environmental Management 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 this permit, please contact Mr. Mack Wig ins at
telephone number 919/733-5083. g
Sincerely,
Ori&al signed by
bale:Oarcash for
cc: Mr. Jim Patrick,EPA George T.Everett
[ tal
WF,
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Pollution Prevention Pays
P.O.Box 29535,Raleigh,North Carolina 27626-0535 Telephone [phone]
An Equal Opportunity Affirmative Action Employer
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Permit No. NCO048020
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH,AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT pIS HARrF Fi iMINATION SY TEM
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,
Lucylee W. Colford
is hereby authorized to discharge wastewater from a facility located at
Lucylee W. Colford
43 Driftwood Court
northeast of Asheville
Buncombe County
to receiving waters designated as Swannanoa River in the French Broad River Basin
in accordance with effluent limitations,monitoring requirements,and other conditions set forth in
Parts I, II, and III hereof.
This permit shall become effective March 1, 1992
This permit and the authorization to discharge shall expire at midnight on September 30, 1995
Signed this day January 9, 1992
jonaj sagged by
+ xi for
George T.Everett,Director
Division of Environmental Management
By Authority of the Environmental Management Commission

Permit No. NC0048020
SUPPLEMENT TO PERMIT COVER SHEET
Lucylee W. Colford
is hereby authorized to:
1. Continue to operate an existing wastewater treatment system consisting of a 1200 gallon septic
tank,300 square foot subsurface sand filter trench located at Lucylee W. Colford, 43 Driftwood
Court, northeast of Asheville,Buncombe County (See Part III of this Permit), and
2. Discharge from said treatment works at the location specified on the attached map into
Swannanoa River which is classified Class C waters in the French Broad River Basin.

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TO: PERMITS AND ENCI ERING UNIT
® WATER QUALITY SCT I ON
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DATE: October 16, 1991
NPDES STAFF REPORT AND RECOMMENDATION
COUNTY Buncombe
PERMIT NUMBER NCO048020
PART I - GENERAL INFORMATION
1. Facility and Address: Lucy Lee Colford Residence
43 Driftwood Court
Asheville, North Carolina 28801
2 . Date of Investigation: August 14, 1991
3 . Report Prepared By: Kerry S. Becker
4. Persons Contacted and Telephone Number:
5. Directions to Site: From the intersection of NCSR 2402 and 2403 ,
travel east on NCSR 2402 0. 55 mile to Driftwood Ct. Turn
left onto Driftwood Ct. and travel to intersection. Turn
right and proceed 0. 1 mile to end of cul-de-sac. Residence
located on the right.
6. Discharge Point(s) , List for all discharge points:
Latitude: 350 36' 18" Longitude. 820 28' 18"
Attach a USGS map extract and indicate treatment facility site and
discharge point on map.
U. S.G. S. Quad No. E95 W U. S.G. S. Quad Name Oteen, NC
7. Size (land available for expansion and upgrading) : n/a
8. Topography (relationship to flood plain included) : Sloping,
within flood plain of the Swannanoa River.
9. Location of nearest dwelling: n/a
i
_ham.

10y Receiving strealo,ri affected surface water So
)Swannanoa River
a. Classification: C
b. River Basin and Subbasin No. : FBR 04-03-02
C. Describe receiving stream features and pertinent downstream
uses: Swift moving stream with rocky substrate. Avg. flow
is 160 cfs. The river serves as habitat for the propagation
and maintenance of wildlife .
PART II - DESCRIPTION OF DISCHARGE AND TREATMENT WORKS
1 . Type of wastewater: 100 % Domestic
Industrial
a. Volume of Wastewater: 0. 00030 MGD (Design Capacity)
b. Types and quantities of industrial wastewater:
C. Prevalent toxic constituents in wastewater:
d. Pretreatment Program (POTWs only) :
in development approved
should be required not needed
2 . Production rates (industrial discharges only) in pounds per day:
a. Highest month in the past 12 months: lbs/day
b. Highest year in the past 5 years: lbs/day
3 . Description of industrial process ( for industries only) and
applicable CFR Part and Subpart:
4. Type of treatment (specify whether proposed or existing) : The
existing facility consists of a 1200 gallon septic tank followed
by a 300 sq ft subsurface sand filter trench.
5. Sludge handling and disposal scheme: Licensed commercial septic
tank cleaning firm.
6. Treatment plant classification (attach completed rating sheet) :
7. SIC Codes(s) : 4952
Wastewater Code( s) : Primary 04 Secondary
Main Treatment Unit Code: 440-7

PART III - OTHER I �-ANENT INFORMATION J
1 . Is this facility being constructed with Construction Grant funds
(municipals only)? n/a
2 . Special monitoring requests:
3 . Additional effluent limits requests:
4. Other
PART IV EVALUATION AND RECOMMENDATIONS
The Asheville Regional Office recommends renewal of NPDES Permit
#NCO048020.
CIL
Signatur of Report Preparer
W ter Quali y Regional Supervisor
Date

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State of North Carolina
Department of Environment, Health, and Natural Resources
Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27611
James G.Martin,Governor George T. Everett,Ph.D.
WiWam W.Cobey,Jr.,Secretary Director
October 4, 1991
Lucylee W. Colford Subject : NPDES Permit Application
43 Driftwood Court NPDES Permit No.NC0048020
Asheville, NC 28805 Lucylee W. Colford
Dear Ms. Colford : Buncombe County
This is to acknowledge receipt of the following documents on October 4, 1991:
Application Form
Engineering Proposal (for proposed control facilities) ,
Request for permit renewal,
Application Processing Fee of $120.00,
Engineering Economics Alternatives Analysis,
Local Government Signoff,
Source Reduction and Recycling,
Interbasin Transfer,
Other ,
The items checked below are needed before review can begin:
Application Form I ,
Engineering proposal (see attachment) ,
Application Processing Fee of
Delegation of Authority (see attached)
Biocide Sheet (see attached) „
Engineering Economics Alternatives Analysis,
Local Government Signoff,
Source Reduction and Recycling,
Interbasin Transfer,
Other
Pollution Prevention Pays
P.O.Box 27687,Raleigh,North Carolina 27611-7687 Telephone [phone]
i

If the application is not made complete within thirty (30) days, it will be
returned to you and may be resubmitted when complete .
This application has been assigned to Mack Wiggins
(919/733-5083) of our Permits Unit for review. ou wi e advised of any
comments recommendations, questions or other information necessary for the
review of the application.
I am, by copy of this letter, requesting that our Regional Office
Supervisor prepare a staff report and recommendations regarding this
discharge. If you have any questions regarding this applications,
please contact the review person listed above.
Sincerely,
M. Dale Overc P .E.
`3
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--ARECEIVED
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31j Water Qushty Sgcti061
.� SEP 2 7 1991
State of North Carolina Asheville R€ginn-Z! G
Department of Environment, Health and Natural ResoX #lei North Catolin
Division of Environmental Management
512 North Salisbury Street.Raleigh,North Carolina 27604
James G. Martin,Governor George T. Everett,Ph.D.
William W. Cobey,Jr., Secretary Director
September 24, 1991
Ms.LUCYLEE W. COLFORD
43 DRIFTWOOD COURT
ASHEVILLE,NORTH CAROLINA 28805
Subject: Application No. NCO048020
COLFORD RESIDENCE(LUCYLEE W)
Buncombe County
Dear Ms. COLFORD:
The Division's Permits and Engineering Unit acknowledges receipt of your permit application and
supporting materials received on September 5, 1991. This application has been assigned the number
shown above. Please refer to this number when making inquiries on this project.
Your project has been assigned to Mack Wiggins for a detailed engineering review. A technical
acknowledgement will be forthcoming. If this acknowledgement is not received within thirty (30)
days,please contact the engineer listed above.
Be aware that the Division's regional office,copied below, must provide recommendations from the
Regional Supervisor for this project prior to final action by the Division.
If you have any questions,please contact Mack Wiggins at(919) 733-5083.
Sincerely, j
&Vr&—§ I DJ*""
Q7 M. Dale Overcash, P.E.
Supervisor, NPDES Permits Group
cc: Asheville Regional Office
Pollution Prevention Pays
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

NORTH CAROLINA DEPT. OF NATURAL RESOURCES AND COMMUNITY DEVELOPMENT
ENVIRONMENTAL MANAGEMENT COMMISSION
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM APPLICATION RUMbFR
APPLICATION FOR PERMIT TO DISCHARGE - SHORT FORM D FOENCYAOR o 0 o a
USE DATE RECEIVI.n
to be filed oaily by services. wholesale and retail trade.and other commercial establishments including vessels
YEAR MO. DAY
*16.2v
Do not attempt to complete this form without reading the accompanying instructions
Please print or type
1. Name, address, and telephone number of facility producing discharge
A. Name
B. Street address
C. City 4 &9 .k - D. State A!L'
E. County --Rimeawsbe F. 2IP 288aS•'
G. Telephone No. ,794 add- 11-147
Area ,
code
esy -
2. SIC
(Leave blank)
3. Number of employees
JY c n
4. Nature ofbusiness
5. (a) Check here if discharge occurs all yeare or
(b),Check the month(s) discharge occurs:
1.0 January 2.0 February 3.O March 4.O Apri1 5.0 May
6.0June 7.OJuly B.aAugust 9.csepteeber 10.00ctober
11.0 November 12.0 December ¢
(c) How many days per week:
1.01 2.0 2-3 3.0 4.6. 4.0 6-1
J"
6.' Types of waste water discharged to surface waters only (check as applicable)
Flow, gallons per operating day ' , Volume t at .rrfore
discharging percent)
Dischargeoperating per 0.1-999 =-4999 1600b=9989 a 10.000-.� -S- O QWI , None 0.1- 30- 6S- 95-
operating day 49,g49 or fort 29.9 64.9 94.9 100
(1) (2) {3) (4) (5) (6) (7) (8) (9) (10)
A. Sanitary. daily
average
B. Cooling water, etc.,
daily average
C. Other discharge(%),
deity average;
Specify
D. Maximum per operat-
ing day for combined
discharge (all types)

7. if any of the types of waste identified in item 6, either treated or
treated, are discharged to places other than surface waters, check below
as applicable.
Masts water is discharged to: 0.1-999 1000-49" S000-9999 10.00049,91g SO.000 or more
(1) (2) (j) (4) M
A. Mun.1.01ml %mw r System
II. IIniM•rgi•aind rn•.11
C. Septic tank
U. Evaporation lagoon or pondtp
s ._
E. Other, specify:
A,
S. Number of separate discharge points:
A.41 B.a2-3 C.a 4-6 D.O 6 or more
9. Name of receiving water or waters
.10. Does your discharge contain or is it possible for your discharge to contain
one or were of the following substances.4�as a result of your operaki'Ans.
activities, or processes: go omia, al
cyanldo,— uminum, beryllium, cadmium.
chromium, Copper, lead, mercury, nickel, selenium, !Inc. phenols, Oil .ate`
grease. and chlorine (residual).
A.O yas B.�no
1 certify that 1 am tamillsr with ,the information contained In the application and
that to the best of my knowledge and belief such information is true, complete, and
accurate.
3r
Printed N of Person Signing
Title
Date A licstion Signe
Signature f licant
North Carolina General Statute 143-215.6(b) (2) provides that: Any person who knowingly, ma'wss
any false statement representations or certification in any applicatton,'record, report, plan,
or other document files or required to be maintained under Article 21 or regulations of the
Enviranae:ntal 'Management Com il!13icop implemouttng that Article, or who falsifies, tampers v_th,
ur knowly renders inaccurate any recording or nonitotilj ¢vice or vethod required to be
operated or maintained under Ar;;Cale 21;oir regulations -of the Environmental Management Cornissi
implementing that Article, sha1-1''be=%uUtv---'of itmisdomeanor punishable by a -fine not to exceed
S10,non, or by imprisonment- not to exceed six months, or by both. (18 U.S.C. Section 1001 pro -
a punishment by a fine of'aot more than $10,000 or i.aprisornseent not tore than 5 years, or both,
A.ur a similar offense.)
...__ ._,. .._. ...- . . � � s:.>vz..'::��r:, a,,Awx.+n.:,,<x.. +,,,.+,_,:.�-:ate: �r.�.,:. ,�., .;-sa�. ,ten,�..w,�: .••;:*�,..� �-�-:,.,T.. -

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August 19, 1991
LUCYLEE W. COLFORD
COLFORD RESIDENCE (LUCYLEE W.
43 DRIFTWOOD COURT
ASHEVILLE, NC 28805
Subject: NPDES PERMIT NO. NCO048020
BUNCOMBE COUNTY
Dear Permittee:
The subject permit issued on 6/15/87 expires on 5/31/92. North Carolina
General Statute (NCGS) 143-215. 1(c) requires that an application for permit renewal
be filed at least 180 days prior to the expiration date. As of the date of this
letter, the Division of Environmental Management had not received an application for
renewal.
If operation of a discharge or waste treatment facility is to occur after the
permit's expiration date, or if continuation of the permit is desired, it must not be
allowed to expire. A renewal request must be submitted no later than 180 days prior
to the permit's expiration date. Operation of the waste treatment works or
continuation of a discharge after the expiration date would constitute a violation of
NCGS 143-215. 1 and could result in assessment of civil penalties of up to $10,000 per
day. If continuation of the permit is desired, failure to request renewal at least
180 days prior to expiration will result in a civil assessment of at least $300.00;
larger penalties may be assessed depending upon the delinquency of the request.
A renewal application shall consist of a letter requesting permit renewal along
with the appropriate completed and signed application form (copy attached), submitted
in triplicate, referenced in Title 15 of the North Carolina Administrative Code (15
NCAC) Subchapter 2H .0105(a) . Primary industries listed in Appendix A of Title 40 of
the Code of Federal Regulations, Part 122 shall also submit a priority pollutant
analysis in accordance with Part 122.21. A processing fee must be submitted with the
application. In addition to penalties referenced above, a permit renewal request
received after the expiration date will be considered as a new application and will
require the higher application fee.
RECEtt
AS CV

Attached is a copy of the fee schedule from 15 NCAC 2B.0105(b). The application
processing fee is based on the design or permitted flow, whichever is appropriate,
listed in the first five categories of facilities. Presently, no facility is allowed
to submit a fee for the general permits listed in the schedule since the Environmental
Protection Agency has not approved the State of North Carolina's general permit. If
the facility covered by this permit contains some type of treatment works, a narrative
description of the sludge management plan must be submitted with the application for
renewal.
The Environmental Management Commission adopted revised rules on October 1, 1990
(attached), requiring the payment of an annual fee for most permitted facilities. You
will be billed separately for that fee (if applicable), after your permit is approved.
The letter requesting renewal, the completed Permit application, and appropriate
fee should be sent to:
Permits and Engineering Unit
Division of Environmental Management
Post Office Box 29535
Raleigh, North Carolina 27626-0535
The check should be made payable to the North Carolina Department of Environment,
Health, and Natural Resources which may be abbreviated as DEHNR.
If there are questions or a need for additional information regarding the permit
renewal procedure, please contact me at telephone number (919) 733-5083.
Sincerely,
M. Dale Overcash, P.E.
Supervisor, NPDES Permits Group
cc: sh€vill :.ltegnna3fi
Permits and Engineering Unit
Central Files

w.n
State of North Carolina
Department of Natural Resources and Community Development
Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27611
James G. Martin, Governor R. Paul Wilms
S. Thomas Rhodes, Secretary Director
June 15, 1987
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Ms. Lucylee W. Colford
43 Driftwood Court
Asheville, North Carolina 28805
SUBJECT : Permit No. NC0048020
Lucylee W. Colford - Residence
Buncombe County
Dear Ms. Colford :
In accordance with your application for discharge permit received on September
5, 1986, we are forwarding herewith the subject State NPDES Permit. 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 may request a waiver or modification
pursuant to Regulation 15 NCAC 2B .0508(b) by written request to the Director
identifying the specific issues to be contended. Unless such request is made
within 30 days following receipt of this permit, this permit shall be final and
binding. Should your request be denied, you will have the right to request
an adjudicatory hearing.
Please take notice that this permit is not transferable. Part 11, B.2.
addresses the requirements to be followed in case of change in ownership or
control of this discharge.
This permit does not affect the legal requirement to obtain other permits
which may be required by the Division of Environmental Management 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.
ContinLl-rl V
f
Pollution Prevention Pays -,
0 i
P.O. Box 27697, Raleigh, North Carolina 27611-76137 Telephone [phone]
F
An Equal Opportunity Affirmative Action Employer

-......_..-_._.-.
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43 -'-bzi f twood doutt
c#Azui Lz, Aortfi daaohw 28505
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Date ( �,
NPDES STAFF REPORT AND RECOMMENDATIONS
County Buncombe
NPDES Permit No. NCO048020
PART I - GENERAL INFORMATION
1 . Facility and Address : Lucy Lee Colford Residence
43 Driftwood Court
Asheville, North Carolina 28803
2. Date of Investigation : August 25, 1986
1�.
3. Report Prepared By : Kerry S. Becker
4 . Persons Contacted and Telephone Number : Lucy Lee Colford
(704) 252-5252 (Home)
(704) 298-9747 ([cork)
5. Directions to Site : From the intersection of N.C. Secondary Roads 2402 and
2403, travel east on N.C. Secondary Road 2402 .55 miles to Driftwood Court.
Turn left on Driftwood Court and travel to intersection, turn right and travel
.l mile to end of cul-de-sac. Site is located 100 feet west of the Swannanoa
River.
6 . Discharge Point - Latitude : 35036'18"
Longitude: 82028'18"
Attach a USGS Map Extract and indicate treatment plant site and
discharge point on map.
USGS Quad No . or USGS Quad Name Oteen
7 . Size (land available for expansion and upgrading) : N/A
8. Topography (relationship to flood plain included) :
Flat and located within the floodplain - 100 feet west of the
Swannanoa River.
9 . Location of nearest dwelling: 100 feet.
10 . Receiving stream or affected surface waters : Swannanoa River.
a . Classification : C
b . River Basin and Subbasin No . : FBR 040302
C . Describe receiving stream features and pertinent downstream
uses : Average flow is 160 cfs. The Swannanoa River is swift moving
with a rocky bottom. It serves wildlife, agriculture and is an industrial
water supply for Sayles Bleacheries.

PART II -- DESCRI ON OF DISCHARGE AND TREATi. T WORKS
1 . Type of wastewater: 100 % Domestic
% Industrial
a . Volume of Wastewater : .00030 MGD
b. Types and quantities of industrial wastewater: N/A
C . Prevalent toxic constituents in wastewater : N/A
d . Pretreatment Program (POTWs only) N/A
in development approved
should be required not needed
2. Production rates (industrial discharges only) in pounds N/A
a. highest month in the last 12 months _
b. highest year in last 5 years
3. Description of industrial process (for industries only) and.
applicable CFR Part and Subpart : N/A
4. Type of treatment (specify whether proposed or existing) :
1,200-gallon septic tank and 300-square foot subsurface sand filter
trench.
5. Sludge handling and disposal scheme : Licensed septic tank pumping
company.
6. Treatment plant classification: N/A

PART III - OTHER.."'PERTINENT INFORMATION
1 . Is this facility being constructed with Construction Grants Funds
(municipals only)? No
2. Special monitoring requests : None
3. Additional effluent limits requests : None
4. Other:
PART IV - EVALUATION AND RECOMMENDATIONS
It is recommended that the permit be issued.
signatu&k of reRoirj prepay r
4Wr Quae-ity Regional upereisor

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State of North Carolina
Department of Natural Resources and Community Development
Asheville Regional Office
James G. Martin, Governor S. Thomas Rhodes, Secretary
DIVISION OF ENVIRONMENTAL MANAGEMENT
WATER QUALITY SECTION
August 25 , 1986
Ms. Lucy Lee Colford
43 Driftwood Court
Asheville, North Carolina 28805
Subject: Required Renewal
NPDES Permit Number NCO048020
Wastewater Treatment Facility
Renewal Colford Residence (Formally
David Tenpenny Residence Lot #9)
Buncombe County, North Carolina
Dear Ms. Colford:
Enclosed is a copy of the regulations regarding the issuance of
permits for discharges to surface waters from single family dwellings .
If , at any time, the property is sold, an application must be
submitted to this agency by the new owners indicating a change of
ownership. In addition GS 143-215 .1(c) of -the General Statutes
requires that an application for renewal be submitted 180 days prior
to the expiration of the permit; in this case, September 30 , 1985 .
Please send an application consisting of a letter requesting
renewal of the permit with documentation proving ownership and a
$25 . 00 check for processing to:
Permits and Engineering Unit
N. C. Division of Environmental Management
Post office Box 27687
Raleigh, North Carolina 27611-7687
If you should have any questions please call me at 704/253-3341 .
Sincerely yours
-a_'C'L
KB: ls Kerry Becker
Enclosure Environmental Technician
Interchange Building„ 59 Woodfin Place, F.O. Box 370, Asheviile, N.C. 28802-0370 A Telephone [phone]
An nnnortnni,.' At irmitive Action FmiA-Pr

DIVISION OF ENVIRONMENTAL MA EMENT
ENVIRONMENTAL OPERATIONS SECTION
February 27, 191
Per. Joe En4erle
County Engineer
Buncombe County Courthouse
Asheville, North Carolina 28807
subject. Certification of Completion o
Wastewater Treatment System
David R. Teapenny
Driftwood Court
Buncombe County
Dear Mr. Cnderl e e
This will certify that the wastewater disposal system serving the
residence at 9 Driftwood Court, Buncombe County, North Carolina#
consisting of a Is2nO gallon septic tank and 300 square foot subsur-
face sand filter
. Has been inspected by the Division of Environ-
mental Management,
2. Has been constructed in accordance with the
tems and conditions of NPDES Permit No.
CDD 2 , (attached)
. Has been designed to comply with North Carolina
General Statute 114 - 15.1 and 1130-160.
Should you require any further information in this regard, please
advise.
Very truly yours,
R. 01 Ger Id, P. E.
C ►r%inat r
permand Engineering Group
DG:ar
Attachment
cc Buncombe County Health Department
A. C. Tur na e, Jr. ,.
Michael R. Flarkery

C"tV
pobwaftry 200 490,
RECEIVED
. ubftae, -Y., sy Offer Xmuw Aye-er Quality Division
. " ,► C
� * CO 9
FEB 26 1981
Western RegionalOffice
,DVOIA Impemy MA As fat" Asheville, North Carolina
Wrifftwmdto Lot to
SWA nitr
beer X60 fit'
"d the vomits ouutumd rs follow
remAto ludleato that tU Saud we in this vVeleatt
1 w4 vJU be g1wantbo eaUeatleft and W01444ft O
1 to : offito after tto Sftds bqwa 4 ` for
t %bis project.
s
a
David TAss"Ietoo
I :

�RSW
. David R. T YS,
48 Gra*m000d am"
RE
. p
Aohwrl.U,*, North Cwoljm U$03 ti . 17
Ater `ity Division
POTTAt .
ba ion to st t DEC 3 U 1980
00 Driftwood I. Western Pe�i
Court *Xor,al C?ffiCe
county d�evddde, j'�jorth C,:rcit��
Door Mr. lampeanyt
The ft"I PlAne and spseAfleatims jt PJ4*t reviewed
and fomd is be sett as . Aut*)Vtfttlxm to hereby granted for fte 4mWtnfttjoS
of a .1 an vast"Ater trestamt Sv*t of a I'm saum septic tank
and 30 square X*00t Subswffts SOW fllt*rto SOM the reoldesca at 9 Driftwood
Court,
Autborl"tion to cmastvuat ObAU be stAkject to revowAtim = *# the
era► tsr trOOtumt f"IMUS are constructed to aceor4mme with the cmdItIons
YO
t .
t
• RoyDavis
. A. 0. V Jr
ov"LUo le.gloma Off e

Nai4­rh Carolina Departrr£ent of Natural
1141, ResourceaWaAmunity Development
�+ �t
James B. Hunt, t.'�o r�wy D�`t,s'o Howard N. Lee, Secretary
\14ater DIVISION OF ENVIRONMENTAL MANAGEMENT
Mr. David R. Tenpenny, Sr. -t October 20, 1980
48 Greenwood Road ��'� �` PROJECT:
Asheville, North Carolina 28803 tcnal vi-W id Tenpenny (Owner)
y\1'esterne;o h C-aro n ividual Home Discharge System
mhevdse' Buncombe County
Dear Mr. Tenpenny:
Receipt of the following documents submitted for project review is hereby
acknowledged:
Application for a permit
X Detailed Engineering Plans
Specifications
Other
Your project has been assigned to Mr. W. Lee Fleming, Jr. of the Engineering
Unit, and will be reviewed "In-turn" based on the date your project was received by our
Unit. You will be advised of any recommendations, comments or other matters to be re-
solved, should this be necessary, prior to the issuance of a permit. The submitted
project documents will be reviewed with respect to the proposed wastewater facilities
and does not commit this Division to approving any expansion of these treatment facili-
ties or increase flows from such facilities at any future time.
If any of the items listed below are checked, with the exception of recommendations
of Regional Supervisor, the received project documents are incomplete and the indicated
item(s) must be received before a detailed engineering review can begin:
Application for a Permit (Copies Enclosed)
X Detailed Engineering Plans (signed and sealed by a N.C. P.E.)
X Specifications (signed and sealed by a N.C. P.E. )
X Recommendations of Regional Supervisor (site investigation) .-
X Other letter requesting an authorization to construct
North Carolina Administrative Code, Title 15, 2H, Section .0208, directs our Unit
"That, if acceptable or complete plans are not resubmitted within sixty (60) days of
this letter, the application packet is to be returned to the applicant as incomplete."
Based on this requirement, your application will be scheduled for return as incomplete
on N/A , if the information requested above has not been received by
our office on or before this date. Should questions arise concerning the submitted
project, please contact the review engineer listed above at [phone].
Qd PA-- /u00- Co vV- 1r/'�4 f7 ,a io z -g0
ANFb X*s fie'-e-v "A14. I'vo Fule4�x ACAO& Sincerely,
OS p e eesx*x 1 (0.
�#A_p W. Lee Fleming, Jr. ,'P.E. , Supervisor
cc. Mr. Roy Davis State Engineering Unit
Wastewater Management Program
Environmental Operations .
WLF/mcb
P. O, liux 27687 Raleigh, North_Carulma 2 76 1 1
An I q ual Oppo r I u n i ty .Affirmative Acriun Employer

R E C EIVED
Water Quality Division
OCT 27 1980
DIVISION OF ENVIRONMENTAL MANAMENT
Westerrn Re�_ional Office
October 20, 1980 Asheville, North. Carolina
. David Teapenny, Sr.
48 Greenwood Road
Asheville, North Carolina 28003
SUBJBCTs Permit No. NCO048011
.L.Wiftwood coin
Permit 0048}20
.2.Driftwood court
Bot
Y Woods Subdivision
e county
Dear . "e'en nny a
in accordance with your application for discharge Permits received
September 15, 1980, we are forwarding herewith the subject State-NPDES
Permits. sus Permits are issued pursuant to the requirements of North
aroli.na and the U.S. Savironmental Progection Agencydated October 19, 1975.
if any parts, requirements, or limitations contained in these Permits
e unacceptable to you, you have the right to an ad judicatory hearing
before a hearing officer upon written demand to the Director within 30
days following receipt of those Permits, identifying cific issues
to be contended. unless such demand is made, these Permits shall be final
and binding.
Please take notice that these Permits are not transferable. Part 11,
D.2. addresses the requirements to be followed in case of change in
ownership or control of these discharges.
These Permits do not affect the legal requirement to obtain other
Permits which may be required by the Division of Znvironmental Management.
if you have any questions concerning these Permits, please contact us.
Yours very truly,
N AGE, JR.
�� ftil S. Grigg
leirector
cc; PAY. George Harlow, SPA
hevil.le ragional Office
Asheville Regional Office Manager

ir
,. Anit No. NC 0048020
j STAFF REPORT AND RECOMMENDATIONS
Date: October 2,. 1980
1 .
PART I - INSPECTION OF WASTEWATER TREATMENT PLANT SITE - PROPOSED
1. Facility: David Tenpenny House
9 Driftwood Court
Asheville, North Carolina
2. Inspected by: Mike Parker
3. Persons contacted: Mr. David Tenpenny
Building Contractor
4.- Directions to site: From the intersection of North Carolina Secondary
Roads 2402 and 2403,' travel east on NCSR 2402 .55 mile to Driftwood-
Court. Turn left on Driftwood -Court and .travel to intersection, turn
right and travel 0.1 mile to end of road. The site is located -100 feet
west of Swannanoa River.
5 Latitude: 350 00' 53" Longitude: 820 271 .18
11
PART II - 'WASTEWATER TREATMENT WORKS - PROPOSED
' 1.. Description of waste treatment facility: I.t is proposed to construct
and operate a 1,200- gallon septic tank and a 300 square foot subsurface _
sand filter trench to serve the proposed house at 9 Driftwood Court,
Buncombe County, forth Carolina.
2.' Final. disposition of sludgge: Will be by a .commercial septic tank cleaning
firm in accordance with the rules and regulations of the Buncombe County
Health Department.
PART III EVALUATION AND RECOMMENDATIONS
Mr. David Tenpenny has made application for the construction of a septic
tank subsurface sand filter trench to serve a proposed house at9 Driftwood Court,
Botany Woods:. Subdivision, .Buncombe County, North Carolina.
Because of the proximity to a small stream and poor subsurface strata,
the Buncombe County Health Department will not approve a conventional septic tank
nitrification field for the house. The proposed location is in an area of Buncombe
County in-which sewer service is not available. The dilution ratio is estimated.
to be greater than 20 to 1; therefore, disinfection is not necessary.
It is recommended that the permit be issued.
PREPARED BY: Michael R. Parker yrr•R fJ.

NORTH CAROLINA DEPT. ` ATURAL RESOURCES AND COMMUNITY`=UCVELOPMENT
-ENVIRONMENTAL MANAGEMENT COMMISSION
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM APPLICATION NUMBER
APPLICATION FOR PERMIT TO DISCHARGE - SHORT FORM G FOR a o o 012. O
AGENCY
USE DATE RECEIVED
To be filed only by services, wholesale and retail trade,
and other commercial establishments including vessels
YEAR M0, DAY
Do not attempt to complete this form without reading the accompanying instructions
Please print or type
1. Name, address, and telephone number of facility producing discharge
A. Name 1411 F _ .E LJPEMMY SR-
B. Street address 4-2? An
C. city .A ft\j ILLS D. State C-.rI
E. CountytP �M � F. ZIP Z�
G. Telephone No. r Q 4- RECEIVED
Area
Code Water Quality Division
2. SIC SEP 15 10
(Leave blank)
v✓estern Regional Office
3. Number of employees
Asheville, North Carolina
4. Nature of business �..1-+1OM L o
5. (a) Check here if discharge occurs all year K or
(b) Check the month(s) discharge occurs:
1.o January 2.0 February 3.0 March 4.o April 5,o May
6.0 June 7.0 July 8.o August 9.E3 September 10.0 October
11.o November 12.o December
(c) How many days per week:
1.01 2.0 2-3 3.0 4-5 4. 6-7
6. Types of waste water discharged to surface waters only (check as applicable)
Flow, gallons per operating day Volume treated before
discharging (percent)
Discharge per
operating day 0.1-999 1000-4999 5000-5999 10,000- 50,000 N"one 0.1- 30- 65- 95-
49,999 or more 29.9 64.9 94.9 100
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
A. Sanitary, daily
average
B. Cooling water, etc.,
daily average
C. Other discharge(s),
daily average;
Specify
D. Maximum per operat-
ing day for combined
discharge (all types)

7„ If any of the types of was ntified in item 6, either treated or un
treated, are discharged to s other than surface waters, check bel
as applicable.
Wdste water is discharged to: 0.1-999 1000-4999 5000-9999 10,000-49,999 50,000 or more
(1) (2) (3) (4) (5)
A. Municipal xwer system
It. IInrL-ryrriunrl we l l
C. Septic tank
U. Evaporation lagoon or pond
E. Other:. specify:
8. Number, of separate discharge points:
A. l B.02-3 C.o 4-5 D.o 6 or more
9. Name oft receiving water or waters
10. Does your discharge contain or is it possible for your discharge to contain
one or more of the following substances added as a result of your operations,
activities, or processes: ammonia, cyanide, aluminum, beryllium, cadmium,
chromium, copper, lead, mercury, nickel, selenium, zinc, phenols, oil and
grease, and chlorine (residual).
IV
A.c3 yes B i o
I certiey that I am familiar with the information contained in the application and
that to the best of my knowledge and belief such information is true, complete, and
accurate.
Printed Name of Person Signing
Title
Date Application Si d
Z/A\ _�__ -."2
Signature of Appttclant
North. Carolina General Statute 143-215.6(b) (2) provides that: Any person who knowingly makes
any false statement representation, or certification in any application, record, report, plan,
:)r other document files or required to be maintained under Article 21 or regulations of the
Environmental Mar-agement Commission implementing that Article, or who falsifies, tampers with,
-)r knowly renders inaccurate any recording or nonitoriAg device or method required to be
operated or maintained under Article 21 or regulations -of the Environmental Management Co-+mtissiol
implementing that Article, shall be -guilty of a misdemeanor punishable by a fine not to exceed
110,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001 provid,,
punishment by a fine of"not more t'.:an 510,000 or imprisonment not more than 5 years, or bnth,
nor a similar offlense.)

Au .
to.
{
IIJ fl
L

Nor'n ), Carolina Department of Natural
Resources &CommunityDevelopment a
James B. Hunt,Jr., Governor Howard N. Lee, Secretary
September 16, 1980
Mr. David R. Tenpenny,. Sr.
48 Greenwood Road
AshevilTe, North Carolina 28803
Subject: NPDES Permit Applications
David R. Tenpenny, Sr. Properties
Botany Woods Subdivision
Buncombe County, North Carolina
Received: September 15, 1980
Dear Mr. Tenpenny
The North Carol i na`Department of Natural Resources and Community
Development hereby acknowledges. the receipt of subject permit applica-
tions. These applications have been forwarded to the Department's
Division of Environmental Management for appropriate action. You can
expect the Division of Environmental Management to contact you concern
ing issuance of the permits.
Should you have any questions or require any assistance regarding
these permits, please do nett hesitate .to .contact the Division of
- Environmental Management in. this office.
Thanking you for your cooperation in this matter, I am
Sincerely,
f A A . � T
R. Wayne McDevitt
Regional Manager
Asheville Regional Office
RWM a
cc:A. C. Turnage„dr.
Roy M. Davis
Asheville Regional Office Interchange Building, 159 Woodfin Street,P.O.Box 370,Asheville,N.C.28801 .Telephone [phone]
An Equal Opportunity Afflrmotive Action Employer

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Buncombe County GIS Page 1 of 1
-. Search By Deed or Plat _
Sales Report Buffer Export Map Export to Google Map -
arA
Search Results
Export to Excel Priat Results
PROPCARD PROPERTY CARD
4988/0583 �� �.�,, " �. n•;. �1 i I s€' �' i iii �.` iii � �" I �i� i i, iii i
DEEDBOOK/DEEDPAGE: (http://registerofd
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0159/0159
PLATBOOK/PLATPAGE: (http://registerofd
bAutoSearch=tru
Sales Report: Sales Report
r :'� 'i�i a' €ih( �'i i••.. �"`�. at"•Ii"i s r.€ � n,: (t
PINNUM: 96790047310000 n `� ( r" t a i E-€ r a• IIII "�',ri i t'n r '� s
OWNER: CAC DIAZ LLC
CONDOBUILDING: �
SURNAME: BOTANY WOODS
SUBLOT: 9 a ADS ,.#±- �
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HOUSENUMBER: 00043
NUMBERSUFFIX: IIGt I h6� ��' i IIII G I a
tgr'R ' — :iii nit iii IOiiO�i ,` t L to II��4ii�il" Blip' Ili
DIRECTION:
w i44i���1r<.Giiif r `: iuh all a a� i.� li..
STREETNAME: DRIFTWOOD
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STREETTVPE: CT
ACREAGE: 1.13999998
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CITY: rf iirilit �€ ;il�i�lr g , i i
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SCHOOLDISTRICT:
CAREOF:
t :H���4 a* I'tlr iilil�lit IIII ) itr; it a iiiii r i�lti
ADDRESS: 5O8 SAVONA AVEii
CITYNAME: CORAL GABLES
STATE: FL
ZIPCODE: 33146
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CLASS: 100 htt J/is but'�i t >ir� NI (�I)
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TOTALMARKETVALUE: 170000
APPRAISEDVALUE: 170000
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http://gis.buncombecounty-orgibuncomap/ 11/4/2015

Central Files: APS SWP
07/06/11
Permit Number NCG55015 Permit Tracking Slip
Program Category T"r �� F
Status Project Type C'eJAJD60V
NPDES WW Active Renewal
7,
Permit Type Version ermit Classification
Single Family Dom stic Wastewater Discharge3.00 COC
Primary Reviewer Per Contact Affiliation
charles.weaver
Coastal SW Rule �
Facility Name Major/Minor Region
43 Driftwood Court Minor Asheville
Location Address County
43 Driftwood Ct Buncombe
Asheville NC 28805 Facility Contact Affiliation
Owner
Owner Name Owner Type
., Individual
David Reboussin " 7�W Owner Affiliation
r^ David Reboussin
135 Staffordshire Ct
� s✓l ,Dates/Events Winston Salem NC 27104
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
09/30/93 02/13/07 07/27/07 08/01/07 07/31/12
Regulated Activities
Private residence,single family
Outfall 001
Waterbody Name Stream Index Number Current Class Subbasin
Swannanoa River 6-78 C 04-03-02

AT+}; Division of Water Quality/Water Quality Section
�i National Pollutant Discharge Elimination System
NCDENR
NORTM CAROUNA.MppRTMENT OE
ENVIRONMENT P^" \AL RE50URCE5 NCG550000
NEWAL FORM FOR EXISTING PERMITTED FACILITIES
Ay '" it application for continued coverage under General Permit NCG550000:
Certificate of Coverage NCG55 O kS'X
c �v Pf
)rmation in items 1 &2 as correct, or note any corrections that should be made.)
(Please print or type)
�rtailing address* of property owner:
Owner Name C Ar G 1 ' Pr 2_ C, L �,,t.,�.. 1 o r 3 e-
Street Address
5, 08 S R V o N A- Ave-o" V e.
City F Lu Vt 0X X.
Co &Arc. CVd.S te..S /
Telephone (Home) S o x L 6 S -3$8 8 (Mobile) !4 4A Fi- 0 4 3
(e-mail address) ck i q 2-• rgQ C_et o L. Co AX
Address to which all permit correspondence will be inailed
2) Location of facility producing discharge*:
Street Address c.( *3, 0 r; j_--'w o o G T`
City: S N e V ; 1Ue
County u h C-0 v-, b C.
Telephone (Home) $6"07 87 0 4 3 �I- (Mobile)
If the facility is not yet constructed, give the street'address or lot ntimbe.r where the structure will.be
built..
3) Description of Discharges
a) Type of facility producing waste (please check one): LW
1
❑ Primary residence
El-"'Vacation/second home 1 i OCT 2 2012 I
❑ Undeveloped property
❑ Other [describe]: 0` t
E
Page 1 of 2

NCG550000 renewal form
4) Please check the components that comprise the wastewater treatment system:
[!'Septic tank 0 Dosing tank ❑ Primary sand filter V Secondary sand filter
❑ Recirculating sand filter(s) ❑ Chlorination ❑ Dechlorination
❑ Other form of disinfection: ❑ Post Aeration(describe)
5) Other Information:
a) When was the septic tank last pumped out? % ys Acy- P-, o
NOTE: the septic tank must be humped out at least once every 3-15 years
� nG.r
b) Is the facility [home] occupied year-round, or only seasonally. S�a S o ` 2
c) Approximately how many people use the facility when it is occupied? 2-
d) When was the wastewater system installed?
6) Certification:
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing: .-1 o r 2�
(Signature of Applicant) (Date Signed)
North CarolinaGeneral Statute 143-215.6 b (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any
application, record, report,plan or other document filed or required to be maintained under Article
21 or regulations of the Environmental Management Commission implementing that Article, or who
falsifies, tampers with or knowingly renders inaccurate any recording or monitoring device or
method required to be operated or maintained under Article 21 or regulations of the Environmental
Management Commission implementing that Article, shall be guilty of a misdemeanor punishable
by a fine not to exceed $25,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C.
Section 1001 provides a punishment by a fine of not more than $25,000 or imprisonment not more
than 5 years, or both,for a similar offense.)
Mail this completed form and a copy of the receipt for your last septic service to:
Mr. Charles H. Weaver, Jr.
NC DENR/DWQ /NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
Page 2 of 2

2465 Riceville Rd, Asheville,N , 28805 to 43 Driftwood Ct, Asheville,NC 28805 - Goo... Page 1 of 2
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Driving directions to 43 Driftwood Ct, Asheville, NC 28805
2465 Riceville Rd
Asheville, NC 28805
1. Head southeast on Riceville Rd toward Dillingham Cir 0.9 mi
2. Take the 1 st right onto Old Farm School Rd 1.6 mi
3. Slight left at Lower Grassy Branch Rd 0.3 mi
4. Turn left at Botany Dr 0.6 mi
5. Turn left at Driftwood Dr 0.1 mi
6. Turn right at Driftwood Ct 0.1 mi
Destination will be on the left
43 Driftwood Ct
http://maps.google.com/maps?ie=UTF-8&hl=en&tab=wl 10/19/2010

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commission,errors concerning the content of the data,and relative and positional accuracy of the data.

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BUNCOMBE COUNTY NORTH CAROLINA
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STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG550152
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,
Jorge L. Diaz
CAC Diaz LLC
is hereby authorized to discharge domestic wastewater [<1000 GPD] from a facility located
at
43 Driftwood Ct
Asheville
Buncombe County
to receiving waters designated as the Swannanoa River, a class C stream in subbasin 04-03-02 of
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 hereof.
This certificate of coverage shall become effective October 10, 2012.
This Certificate of Coverage shall remain valid for the duration of the General Permit.
Signed this day October 10, 2012
for Charles Wakil , P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

A7jA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue,Governor Charles Wakild, P.E., Director Dee Freeman, Secretary
October 10, 2012
Jorge L. Diaz
CAC Diaz LLC
508 Savona Ave
Coral Gables, FL 33146
Subject: Renewal of coverage/General Permit NCG550000
43 Driftwood Ct
Certificate of Coverage NCG550152
Buncombe County
Dear Permittee:
In accordance with your renewal application [received on October 2, 2012], the Division is renewing
Certificate of Coverage (CoC)NCG550152 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 Asheville 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]].
Sincerely,
for Charles Wakil =P -
cc:
1617 Mail Service Center,Raleigh,North Carolina 27699-1617
512 North Salisbury Street,Raleigh,North Carolina 27604 t � Qh a
Phone: [phone]/FAX [phone] Internet:www.ncwaterquality.org
An Equal Opportunity/Affirmative Action Employer—501/6 Recycled/1 01/6 Post Consumer Paper
� f

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG550152
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,
Jorge L. Diaz
CAC Diaz LLC
is hereby authorized to discharge domestic wastewater [<1000 GPD] from a facility located
at
43 Driftwood Ct
Asheville
Buncombe County
to receiving waters designated as the Swannanoa River, a class C stream in subbasin 04-03-02 of
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 hereof.
This certificate of coverage took effect August 1, 2013.
This Certificate of Coverage shall remain valid for the duration of the General Permit.
Signed this day August 20, 2013
for Th s;A-. Reeder/
Director
Division of Water Quality
By Authority of the Environmental Management Commission

14CDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Pat McCrory,Governor Thomas A. Reeder, Director John E. Skvarla III,Secretary
August 20,2013
Jorge L.Diaz
CAC Diaz LLC
508 Savona Ave
Coral Gables, FL 33146
Subject: Transfer of coverage/General Permit NCG550000
43 Driftwood Ct
Certificate of Coverage NCG550152
Buncombe County
Dear Permittee:
The Division has reissued General Permit NCG550000. Therefore,the Division is hereby renewing
your Certificate of Coverage (CoC)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]. A copy of the renewed General Permit is also attached.
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 Asheville Rerrional 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]].
;Thomas
y,
RECEIVE®
for A. Reeder
AUG 2 6 207
cc As7xe�ll�Regzonal Qffice%'Surface Water Protection
IVPDE'S i%le
DWQ/Surface Water Protection Section
Asheville Regional Office
1617 Mail Service Center,Raleigh,North Carolina 27699-1617 One
512 North Salisbury Street,Raleigh,North Carolina 27604 NorthCaTolina
Phone: [phone]!FAX [phone]/Internet:www.ncwaterquality.org
An Equal Opportunity/Affirmative Action Employer-50%Recycled/10%Post Consumer Paper NaturallY

M FILE V ,
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P.E. Dee Freeman
Governor Director Secretary
September 18, 2012
CERTIFIED MAIL
RETURN RECEIPT REQUESTED 7010 1870 0003 0874 9346
CAG"D:iaz'`LLC
508 Savona Avenue
Coral Cables, Florida 33146
Subject: NOTICE OF VIOLATION
NOV-2012-PC-0319
Complaint Inspection
43 Driftwood Court/ (Botany Woods,
Asheville NC, 28805)
Permit No. NCG550152
Buncombe County
Dear Mr. Diaz:
Enclosed please find a copy of the Inspection Report from the inspection conducted
September 7, 2012, by Janet Cantwell and Jeff Menzel of the Asheville Regional Office. The
treatment facility was found to be in violation of Permit NCG550152 for the following:
Compliance issues found during the inspection are:
Inspection Area Compliance Issue
Facility Site Review Unable to locate sand filter bed and discharge pipe
Permit Permit has expired
As stated in the inspection report, an evaluation of your WWTP system should be done
and the septic tank should be pumped Please keep the receipt from the septic pumper.
A Renewal Form and a copy of your permit are enclosed. Please send a copy of the
renewal form to this office when you send in your form to Raleigh.
SURFACE WATER PROTECTION—ASHEVILLE REGIONAL OFFICE One
Location:2090 U.S.Highway 70,Swannanoa,NC 28778 NorthCarolina Phone:[phone]\FAX:[phone]v NaturalllJ
Internet:www.ncwaterauality.ora

CAC Diaz LLC
September 18, 2012
Page Two
Please refer to the enclosed Inspection Report for any additional observations and
comments.
To prevent further action, carefully review these violations and deficiencies and respond in
writing to this office within fifteen (15) working days of receipt of this letter. You should
address the causes of noncompliance and all actions taken to prevent the recurrence of similar
situations. If you should have any questions, please do not hesitate to contact Janet Cantwell
at 828/296-4500.
Sincerely,
6Z� 11v*' "qtr�—
Chuck Cranford, Regional Supervisor
Surface Water Protection Section
Attachment
cc: DWQ Asheville Files w/attachment
DWQ Central Files w/attachment
Point Source / Enforcement w/attachment
S:,SWP\Buncombe\Wastewater\General\NCG55 Single Family Residence\550152 David Reboussin\NOV-2012-PC-0319.doc

United States Environmental Protection Agency Form Approved:
EPA
n Washington,D.C.20460 OMB No.2040-0057
Water Complianre lnspprfinn Report C /`1 Approval expires 8-31-98
Section A: National Data System Coding(i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 INI 2 151 31 NCG550152 111 121 12/09/07 117 181 C 1 191 S I 201 1
Remarks
2111111111111111111111 1111111111111111111111111116
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA ---------------------------Reserved----------------------
671 1 69 701 1 711 1 72L 73I I 174 751 1 I 1 1 1 1 180
Section B: Facility Data W
Name and Location of Facility Inspected(For Industrial Users discharging to POTW,also include Entry Time/Date Permit Effective Date
POTW name and NPDES permit Number)
43 Driftwood Court 03:25 PM 12/09/07 07/08/01
43 Driftwood Ct Exit Time/Date Permit Expiration Date
Asheville NC 28805 03:50 PM 12/09/07 12/07/31
Name(s)of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s) Other Facility Data
Name,Address of Responsible Official/Title/Phone and Fax Number
Contacted
' 1
No
Section C: Areas Evaluated During Inspection(Check only those areas evaluated)
Permit Facility Site Review
Section D: Summary of Finding/Comments Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s)a*Signature(s) c s Agency/Office/Phone and Fax Numbers ateJanet Can ARO WQ//828-296-4500 Ext.4667/Jeff Menz ARO WQ//828-296-4500/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.
Page# 1

NPDES yr/mo/day Inspection Type 1
3� NCG550152 I11 12I 12/09/07 17 1slC,
Section D: Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
The permit has expired.
A completed renewal form must be submitted.
Inspectors were unable to locate the WWTP system/septic tank/sand filter and the discharge pipe.
An evaluation of your WWTP system should be done and the septic tank may need to be pumped.
Page# 2

r
Permit: NCG550152 Owner-Facility: 43 Driftwood Court
Inspection Date: 09/07/2012 Inspection Type: Compliance Evaluation
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application? fl ■ Cl
Is the facility as described in the permit? ❑ fl n ■
#Are there any special conditions for the permit? ❑ ■ Cl 0
Is access to the plant site restricted to the general public? ❑ ■ 0 I]
Is the inspector granted access to all areas for inspection? ■ 0 n 0
Comment: The permit for your WWTP/septic tank/sand filter has expired.
A completed renewal form must be submitted.
Inspectors were unable to locate the WWTP system/septic tank/sand filter and the
discharge pipe.
An evaluation of your WWTP system should be done and the septic tank may need to
be pumped.
Page# 3

North Carolina Department of Environmental Quality,
at McCrory Donald R.van der Vaart
'Governor Secretary
November 9, 2015
Jorge Diaz
508 Savona Ave
Coral Gables, FL 33146
SUBJECT: Compliance Evaluation Inspection
43 Driftwood Court
Permit No:NCG550152
Buncombe County
Dear Mr. Diaz:
Enclosed please find a copy of the-Compliance Evaluation Inspection form from the inspection conducted on
November 6,2015. The facility appeared to be in compliance with permit NCG550152. However,I have attached
a schematic to assist a septic hauler in finding your septic tank, since you indicated it is unknown when it was
pumped last.
Please refer to the enclosed inspection report for additional observations and comments. If you or your staff
have any questions,please call me at 828-296-4500.
Sincerely,
Linda Wiggs
Environmental Senior Specialist
Asheville Regional Office
Enc.Inspection Report
Site Schematic
cc: MSC 1617-Central Files-Basement
Asheville Files
G:\WR\WQ\Buncombe\Wastewater\General\NCG55 Single Family Residence\550152 Jorge Diaz\CEI.1 1-2015.Ltr.docx
Water Quality Regional Operations—Asheville Regional Office
2090 U.S.Highway 70,Swannanoa,North Carolina 28778
Phone:[phone] FAX:[phone]
Internet:http:l/Oortal.nedenr.org/web/Wq
An Equal Opportunity\Affirmative Action Employer

United States Environmental Protection Agency Form Approved.
EPA Washington,D.C.20460
.OMB No.2040-0057
WaterCompliance'Inspection Report __ Approval expires8-31-98
Section A:National Data System Coding(i.e.,PCS)
Transaction Code NPDES yr/mo/day : Inspection Type Inspector Fac Type
IN 1 2 15 I 3 I NCG550152 I11 121 15/11/06 17 18'c I 19' G f 20I
Inspection Work Days facility Self-Monitoring-Evaluation Rating B1 QA - --Reserved---------
67 I- 70 L_j 71 Lj 72 I , 73 LLJ74 75I1 III 180
Section B:Facility Data
Name and Location of Facility Inspected(For Industrial Users discharging to POTW,also include Entry Time/Date Permit Effective Date
POTW name and NPDES permit Number) 10:30AM 15/11/06 13/08/01
43 Driftwood Court
Exit Time/Date Permit Expiration Date
43 Driftwood Ct P
Asheville NC 28805 11:00AM 15/11/06 1&o7/3,
Name(s)of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)- Other Facility Data
Name,Address of Responsible Official/Title/Phone and Fax Number
Jorge Diaz,508Savona Ave Coral Gables FL 3 3 1 46//3 05-6 6 5-3 8 88/ Contacted
No
Section C:Areas Evaluated During Inspection(Check only those areas evaluated)
■ Operations&Maintenance ® Records/Reports ® Facility Site Review ■ Effluent/Receiving Waters
Section D:Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s)and Signature(s)of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Linda S Wiggs ARO WQ!/828-296-4500 Ext.4653/
Signature of Management Re ' Agency/Office/Phone and Fax Numbers, Date
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.
Page# 1

NPDES yr/mo/day Inspection Type 1
31 NCG550152 I11 12 15/11/06 17 18 I�j
Section D:Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
Mr. Diaz uses this property as a second home. No one was present during the inspection, however Mr:
Diaz was contacted prior by phone.
Depending on the use of the home the septic tank should be pumped every 3-5 years.Attached is a
schematic of the system to assist the septic pumping company with locating the septic tank'.
The discharge pipe to the river was not located:
The following questions acronyms are NA-Not Applicable and NE-Not Evaluated
Page# 2

Permit: NCG550152 Owner-Facility: 43 Driftwood Court
Inspection Date: 1110612015 Inspection Type: Compliance Evaluation
Effluent Pipe Yes No NA NE
Is right of way to the outfall properly maintained? ❑ ® ❑ ❑
Are the receiving water free of foam other than trace amounts and other debris? ® ❑ ❑
If effluent (diffuser pipes are required) are they operating properly? ❑ ❑
Comment: The effluent pipe was not located.
Operations& Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? - ® ❑ ❑ ❑
Does the facility analyze process control parameters,for ex: MLSS, MCRT,Settleable ❑ ❑ ® ❑
Solids, pH, DO,Sludge Judge,and other that are applicable?
Comment: The Property is well maintained. The septic tank needs to be pumped if it hasn't been
pumped in the last 3-5 years.
Septic Tank Yes No NA NE
(If pumps are used)Is an audible and visual alarm,operational? ❑ ❑ ® ❑,
Is septic tank pumped on a schedule? ❑ ®, ❑ ❑
Are pumps or syphons operating properly? ❑ ❑ ® ❑
Are high and low.water alarms operating properly? ❑ ❑
Comment: Mr. Diaz was not sure when the septic tank had been pumped The septic tank should be
Pumped since it is unknown when it was last pumped Then depending on use of the home
the septic tank should be pumped every 3-5 years.
:
Page# 3

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PAT MCCRORY
y; Governor
DONALD R.VAN DER VAART
« Secretary
Water Resources S.JAY ZIMMERMAN
ENVIRONMENTAL QUALITY
RECEIVED
October 26, 2016 _.
Division of Water Resource
Mr. Jorge Diaz NOV - 1 2016
508 Savona Avenue
W-'Mnr Ott- tv Regional Operatior7s �
Coral Gables, FL 28805 Rnoiorlal ott1Ce
.. .
Subject: Wastewater Disposal at
41 Driftwood Court, Asheville
Certificate of Coverage(CoC)NCG550151
Buncombe County
Dear Mr. Diaz:
An audit of annual fee payments for NPDES permittees has noted unpaid fees for the subject facility.
Payment of annual fees is required by Part II B. (12) of your NPDES permit NCG550000, as well as 15A
NCAC 21-1.0105 (b)(2).
The following unpaid invoices are enclosed for the years 2013-2015, totaling$180 in overdue annual fees:
2015PR003610, 2015PR003646, 2015PR007936. Payment instructions are provided on the invoice(s).
Please submit payment by December 12, 2016.
Due to a coding problem within our permit database(BIMS), annual fee invoices for several CoCs
(including yours)were not sent. Depending on the CoC, there could be only one or 5+unsent invoices. The
invoices you are receiving cover those un-billed years.
If you have questions concerning this matter or would like to discuss payment options,please do not hesitate
to contact me at 919-807-6479 or [e-mail]. If you have any questions about how to
make payments,please contact Teresa Revis at 919-807-6316 or [e-mail].
We appreciate your assistance in this matter.
Sincerely,
'J NJJA&offiel-
Meredith Wojcik
Division of Water Resources, DEQ
cc: Asheville Regional Office,DWR WQRO
NPDES General Permit Files
Teresa Revis,DWR Budget Office
State of North Carolina I Environmental Quality I Water Resources
1611 Mail service Center I Raleigh,North Carolina 27699-1611
919 707 9000

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NCG550152 David Reboussin
Single Family Residence Permit
43 Driftwood Court; AVL, NC
Buncombe County
Annual Fees
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Permit Annual Fee 12010 09101120/0 08f31 011 September 090012010'2010PROO8001 60.00 !6o.DD ,',$n Op iPaid
Permit Annual Fee -�2009 09101f2OO9 O8f312D10 Se temper 1Gf152009 2009PROG9655
p ;.&➢.➢.Q.........;.Q.Q.Q➢........,i;.Q.Q➢...........J Paid
PerrnC.rnoel f'ee ' .... ;6Q1210O t U5>3 ; ➢ $.Q➢
Perm tannual Fee 2007, 021010007 08t31121308 September 1112'l2007 2007PR01100G IPad
-Perm¢trnual Fes 2006 091Ot/2036 D8131f2O07 Sepie .per 1_r39f2006 2302PROl 0929 Pad ,
PerMII.Annual Fee 2005 OWIGI2095 OW3112006 Septerroer 1:f'W0052065PRO10424 E5000 9�;➢.➢9_Pad
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rkr,:4J Urir[wooa court
Subject: RE: 43 Driftwood Court
From: "Roland Reboussin" <[e-mail]>
Date: Tue, 26 Sep 2006 12:37:21 -0400
To: "'Larry Frost"' <[e-mail]>
CC: "'David M. Reboussin"' <[e-mail]>
Thank you for your email. It was a surprise but also a relief.
Just for information, my wife and I spent all day yesterday, Monday, down at
the Health Department, Office of Environmental Health, going through the
septic tank inspection sketches of Botany Woods; we also spent time at the
court house, Registry of Deeds, finding the "original" owner of this
property. All was to no avail. There were sketches of some of the other
houses on Driftwood Court, but none for ours. I looked through the sketches
several time and so did my wife. The clerk said that that was the most that
could be done, and so we had reached a dead end.
Thus, I suppose we will take your advice and assume for now that there is no
discharge pipe on our system. I am concerned that there could be along term
problem here, but after all, the system has been fine for twenty five years
until now.
Thanks again for your time and your help in this matter. Roland Reboussin
-----Original Message----- !,e�60
From: Larry Frost [mailto:[e-mail]] O
Sent: Monday, September 25, 2006 2:34 PM
To: Roland Reboussin ® /t
Subject: Re: 43 Driftwood Court
Mr. Reboussin
It is very possible that your system does not discharge. In this case �P
please disregard my email. Furthermore, if it were my home, I would not
worry about tying to the sewer, I would just make sure I paid my annual
fee to the state to keep the permit current. , J
I checked your file and we have no drawings of your system and I doubt
that the county has any records on an older system like yours.
If you have other concerns or questions just let me know.
Larry
Roland Reboussin wrote:
Reference your email to me of May 30, 2006, which should appear below.
After spending the summer (including an unexpected month back in Florida)
unsuccessfully trying to find a firm to install the chlorinator and holding
tank on our septic system, I talked today with Mr.Ken Deaver of TEE K�2 C-
EnvironmPn+al. He came to our house to show me how to do the sampling that
is required for our system. However, we were unable to locate the discharge
pipe for the system; at his request, I had put dye into the system
yesterday, but to no avail, and he was not able to locate the discharge
today.
Mr.Deaver suggested that I contact you with the following two questions:
Is it possible that because of the relatively low usage of our system, the
discharge fluids are just seeping into the ground under the sand filter?
Not
one of the five drain pipes that we could find had any fluid seeping out at
all.
Do you have a copy of our permit? Mr. Deaver is thinking that the permit
may
1 of 3 9/26/2006 1:57 PM

SNOW th
e specifications of the septic system. If we knew the length,
breadth, and depth of the system, we would at least know where to begin
digging to search for the discharge pipe. It seems that digging for the
pipe
could severely damage the entire system.
Mr. Deaver also said that if you do not have a copy of the permit, I can
likely get a copy, and especially the system dimensions, from the Buncombe
County Health Department.
It also turns out that Mr. Deaver's firm, KAYCE Environmental, installs
chlorinators and holding tanks and we intend to proceed with that, but of
course we must find the discharge pipe first.
Please be assured that we do not want to pollute the river and we will do
whatever it takes to deal with this.
Deaver pointed out that another possibility would be to pump our sewage up
the cliff to Botany Woods and into the city sewer system. It is my
understanding that one house down here on Driftwood court already does do
that. Do you have an opinion about this?
Roland Reboussin, 43 Driftwood Court [e-mail]
-----Original Message-----
From: Larry Frost [mailto:[e-mail]]
Sent: Tuesday, May 30, 2006 1:02 PM
To: Roland Reboussin
Subject: Re: 43 Driftwood Court
Mr. Reboussin
Your home has what is known as a single family sand filter, your permit
number is NCG550152. The system is a older discharging system, the
discharge is to the Swannanoa River. The system consists of a septic
tank, a sand filter and a discharge pipe. It is very important that you
know the location of your septic tank and have it pumped every 3 or 4
years, this will protect your sand filter from getting plugged with
solids. Likewise, it is very important that you know the location of
your sand filter and keep it free of woody vegetation(ie. trees and
scrubs) , the roots from these plants can permanently damage your sand
filter. Lastly your discharge pipe, at the river, should be located and
kept clear of debr* if it were to get plugged it may cause a backup,
and flood your system. I would also like to recommend that if you do not
currently have a tablet chlorinator and hold tank prior to your system
discharge you consider installing one. Many of the older systems did not
have these items, but are currently required. Their purpose is to
disinfect your treated wastewater prior to reaching the river.
Testing, your permit requires that you do annual testing of your
discharge (at the river) . You should be testing for BOD, Total Suspended
Residue, and Fecal Coliform. All results are to be maintained by the
owner, on site, for a minimum of 3 years. If you are in need of a lab
please check the yellow pages under "laboratories-testing", they are the
ones that analyze wastewater.
If you would like more information or have any questions please let me
know. Have a great summer.
Larry
Roland Reboussin wrote:
2 of:3 9/26/2006 1:57 PM

RE:43 Driftwood Court
Mr. Frost -- This is a follow-up to the telephone message I left for
you this morning. It may not have been the clearest.
Along with our children, David and Dan Reboussin, I own the house at
43 Driftwood Court, in Oteen. At some point last year, you sent a
letter to David, saying that the septic tank here was not up to code,
and you told him that we should have it tested.
My wife and I are here for the summer and are finally able to turn our
attention to this. My understanding is that the tank needs to be
tested once a year, but what I do not know, is just what kind of
testing it requires. If you could let me know about this, we can have
the testing done in the next few weeks. The tank was pumped out a year
or two ago by Duane Lyda. Would his firm be an appropriate one to do
the testing?
You can contact us by email ([e-mail]
<mailto:[e-mail]>) or by cell phone: [phone]. The
phone here at the house is 298-6758 but there is no answering machine.
Roland Reboussin
Larry Frost - L:ar.ry.Frost@ncmai1_.net
....................................._._.............................................................................................
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office
Division of Water Quality - Water Quality Section
2090 U.S. 70 Highway
Swannanoa, NC 28778
Tel: [phone]
Fax: [phone]
3 of 3 9/26/2006 1:57 PM

F N1 A
T J °� " Michael F.Easle ,G"overr
�C\ Q Tt
s Secretaryr
North Carolina Department of Envir n andur Resources
r yA an W kltmeiC P,E Director -
Division of Water Quality
Asheville Regional Office
SURFACE WATER PROTECTION
October 19, 2005
David Reboussin
135 Staffordshire Court
Winston-Salem, North Carolina 27104
SUBJECT: Compliance Evaluation Inspection
Reboussin Property
Permit No: NCG550152
Buncombe County
Dear Mr. Reboussin:
Enclosed please find a copy of the Compliance Evaluation Inspection form from
the inspection conducted on October 18, 2005. Larry Frost of the Asheville Regional
Office conducted the Compliance Evaluation Inspection. The facility was found to be in
Compliance with permit NCG550152.
Please refer to the enclosed inspection report for additional observations and
comments. If you have any questions, please call me at 828-296-4500.
Sincerely,
Lar, Frost
E vironmental Chemist
Enclosure
cc: Central Files
Asheville Files
NoorthCarolina
Jhatura!!y
2090 U.S.Highway 70,Swannanoa,NC 28778 Telephone:[phone] Fax: [phone] Customer Service 1 877 623-6748

r�
United States Environmental Protection Agency
EPA Washington,D.C.20460 Form Approved.
OMB No.2040-0057
Water Com liance Ins ection Report Approval expires 8-31-98
Section A: National Data System Coding(i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 I NI 2 151 31 NCG550152 Ill 121 05/10/18 117 18I cI 191 SI 20I I
21 Remarks
111111111111111111111111111111111116
Inspection Work Days Facility Self-Monitoring Evaluation Rating 81 CIA -------------------—-----Reserved------------—-----_
671 1 69 701 1 711 1 721 NJ 731 IL_J 174 751 11 1 1 1 I 180
Section B: Facility Data
Name and Location of Facility inspected(For Industrial Users discharging to POTW,also include Entry Time/Date Permit Effective Date
POTW name and NPDES permit Number)
Reboussin property 10:11 AM 05/10/18 05/03/02
43 Driftwood Ct Exit Time/Date Permit Expiration Date
Asheville NC 28805
10:18 AM 05/10/18 07/07/31
Name(s)of Onsite Representative(s)/Titles(s)/Phone and Fax Number s
Other Facility Data
Name,Address of Responsible Official/Title/Phone and Fax Number
David Reboussin,135 Staffordshire Ct Winston Salem NC Contacted
27104//336-765-8265/ No
Section C: Areas Evaluated During Inspection(Check only those areas evaluated)
Permit Operations&Maintenance ■Facility Site Review
Section D: Summary of Find in /Comments Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s)and Signature(s)of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Larry Frost ARO WQ//828-296-4500 Ext.4658/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
Roger C Edwards "► ' 828-296-4500 Ext.4656/ �
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.

r
NPDES yr/mo/day Inspection Type 1
3I NCG550152 I11 12I 05/10/18 L17 181
C1
Section D: Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
The facility is, to the best the inspector's knowledge, over grown with ivy, shrubs and trees. It is
recommended that the owners investigate the location of the filter more fully with a plumber and identify
areas that should be protected from roots.
Maintenance schedule attached.

Permit: NCG550152 Owner-Facility: Reboussin property
Inspection Date: 1 0/1 812 0 0 5 Inspection Type: Compliance Evaluation
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application? n n ■ n
Is the facility as described in the permit?
■ n ❑ n
Are there any special conditions for the permit? n n ■ n
Is access to the plant site restricted to the general public? n n ■
Is the inspector granted access to all areas for inspection? ❑ ❑ ■ ❑
Comment:
Operations&Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ■ f1 n n
Does the facility analyze process control parameters,for ex:MLSS,MCRT,Settleable Solids,pH,DO,Sludge
Judge,and other that are applicable? ❑ ❑ ■ n
Comment:Owner should be concerned about the plant growth in the filter area.

✓' y�d �STA1Fo- �``
State of North Carolina
r\ r ]- i T 1 t 1 I ♦ T
"CP111 L111C11L U1 C11V11011111C11L, 1 1Cd1L11/ d11U i NdWldl 1\CJUUI'CCJ
Asheville Regional Office
James G. Martin, Governor Ann B. Orr
William W. Cobey, Jr., Secretary Regional Manager
DIVISION OF ENVIRONMENTAL MANAGEMENT
WATER QUALITY SECTION
March 20, 1992
Ms. Lucy Lee Colford
43 Driftwood Court
Asheville, North Carolina 28801
i
Subject: Compliance Evaluation Inspection
Status: In Compliance
-,NPDES Permit Number NCO048020
{Bunco County
Dear Ms. Colford:
A Compliance Evaluation Inspection was conducted March 20, 1992,
of the septic tank/ subsurface sandfilter trench serving your
residence. Since the facility grounds and the receiving stream
indicated no problems, the wastewater treatment facility appears to be
operating properly and is, therefore, considered to be in compliance
with its NPDES permit.
If, in the future, the residence is sold, please inform the new
owners that they will need to apply for a new permit. NPDES permits
are not transferable.
If you should have any questions, please contact either me at
704-251-6208.
Sincerely yours,,
Linda Wiggs
�► Environmental Technician
cc : Dan Ahern, EPA
lsw
Interchange Building, 59 Woodfin Place, Asheville, N.C. 28801 • Telephone [phone]
An Equal Opportunity Affirmative Action Employer

C "dates nvuonmenta! ion Agency �` Form Approved
rotect
j wast"gron.0 C_20460
OMB No. 2040-0003
-®EPA NPDES Compliance Inspection Report Approval Expires ?-31-85
Section A: National Data System Coding
ransaction Code NPDES yr/mo/day Inspection Type Ins ector Fac Type
,U �f��C�lolol I�lola10111 1J91a1�11 -O 17 11 1 2d
Remarks
Illllllllllllllll11111111111111111111111illlll
66
Reserved Facilitv Evaluation Rating BI GA ------------------Reserved----- ------
67WLj 69 70 j 71H 7�_j 7k_i_J 74 75� I 80
Section 6:Facility Data
ame and /Location of Facj)ity Ins cted Entry Time Permit Effective Date
6/ or 0 ❑ AM PM G , 5� 4
to •3 v
3 r i �� t�/oOD C Exit Time/Date Permit Expiration D to
to.3 S 3�z01°l� 5 —
ame(s) �ia—
of On-SiteRepresentative(s) Title(s) Phone No(s)
ame,Address of Responsible Official „ Title
Phone No. -7 o(�-a- -2-5:2- Contacted o °
70y- J-�— 'f ❑ Yes No
Section C:Areas Evaluated During Inspection
(S=Satisfactory,M=Marginal,U=Unsatisfactory,N=Not Evaluated)
Permit N Flow Measurement Pretreatment $ Operations&Maintenance
Records/Reports Laboratory N Compliance Schedules S Sludge Disposal
Facility Site Review Effluent/Receiving Waters r4 Self-Monitoring Program Other:
Section D:Summary of Findings/Comments(Attach additional sheets it necessary)
lames)and Sig tature(s)of Inspector(s) Agency/Office/Telephone / Date 3/
IZ
iign f eviewer Agency/Office Date
2a
'nem //40Z2
Regulato ffice Use Only
fiction Taken Oate Compliance Status
❑ oncompliance
Com liance

-011
, mod
� p
State of North Carolina
Department of Environment, Health, and Natural Resources
Asheville Regional Office
James G. Martin, Governor Ann B. Orr
William W. Cobey, Jr., Secretary Regional Manager
DIVISION OF ENVIRONMENTAL MANAGEMENT
WATER QUALITY SECTION
September 8, 1991
Ms. Lucy Lee Colford
43 Driftwood Court
Asheville, North Carolina 28801
Subject.: Compliance Evaluation Inspection
Status: In Compliance
NPDES Permit Number NCO048020
Buncombe County
Dear Ms. Colford:
A Compliance Evaluation Inspect' n was conducted August 14, 1991,
o,k-, the septic tank/ subsurface sandfilter trench serving your
residence. Since the facility grounds and the receiving stream
indicated no problems, the wastewater treatment facility appears to be
operating properly and is, therefore, considered to be in compliance
with its NPDES permit.
If, in the future, the residence is sold, please inform the new
owners that they will need to apply for a new permit. NPDES permits
are not transferable .
If you should have any questions, please contact either me at
704-251-6208.
Sincerely y o�V��--
Kerry S. Becker
Environmental Technician
cc: Dan Ahern, EPA
ksb
Interchange Building, 59 Woodfin Place, Asheville, N.C. 28801 •Telephone [phone]
An Equal Opportunity Affirmative Action Employer

i
ited States Environmental Protection Agency Form Approved
Washington,D.C.20460
NW E A N PD ES Compliance Inspection Report OMB No. 2040-0003
P N Approval Expires 7-31-85
Section A: National Data System Coding
Transa tion Code PDES yr/mo/day Inspection Type Inspector Fac Type
1 2LU n�CI U 14 I Flo l 2l yl „ 11 /I DI S 1 j ,7 I19LsJ 20L4
Remarks
1 � 111111111111111111IIIIIIIIIIIIIIIIIIII1II1111
Reserved Facility Evaluation Rating 81 CIA ------------------Reserved-----------------
66
6A_J__LJ 69 7�3 71u 72u 7k_Lj 74 7d I I I I I 180
Sedtion B:Facility Data
Name and Location of -Facility Inspected Entry Time 11 AM PM Permit Effective Date
�` )-�40-6 Co A r 35� �u-ue,l S 2 7
Y3 ' &"2 Exit Time/Date Permit Expiration Date
, 0, / 3s'S 414 3/, /Y S 2
Name(s)of On-Site Representative(s) Title(s) Phone No(s)
Name,Ad/dressQf Responsible Official Title �+
Phone No. 7o cl- a S_a' 5--,2 5"2 Contacted °
skit � YES A l'ao�/�
7D - 2 - q`) 7 ❑ Yes 1' No
Section C:Areas Evaluated During Inspection
(S=Satisfactory,M=Marginal,U=Unsatisfactory,N=Not Evaluated)
Permit Flow Measurement /J Pretreatment Operations&Maintenance
Records/Reports Laboratory A Compliance Schedules S Sludge Disposal
1v"- - -
S Facility Site Review s Effluent/Receiving Waters Self-Monitoring Program Other:
Section D:Summary of Findings/Comments(Attach additional sheets if necessary)
0 I
0-4d
Q ed -�rQ I S
w � ,15
, N?DES
Name(s)and Sioatature(s)of Inspector(s) Agency/Office/Telephone Date
" 67
°1
Sign a of Reviewer Agency/Office Date
'v t✓
Regulatory Office Use Only
Action Taken Date Compliance Status
�Co❑ o
ncompliance
m liance

rx STATF
State of North Carolina
Department of Natural Resources and Community Development
Asheville Regional Office
James G. Martin, Governor Ann B. Orr
William W. Cobey, Jr., Secretary Regional [Manager
DIVISION OF ENVIRONMENTAL MANAGEMENT
WATER QUALITY SECTION
September 15, 1989
Ms. Lucy Lee Colford
43 Driftwood Court
Asheville, North Carolina 28801
Subject: Compliance Evaluation Inspection
Status: In Compliance
Lucy Lee Colford Residence
NPDES Permit Number NCO048020
Buncombe County
Dear Ms. Colford:
A Compliance Evaluation Inspection was conducted September 11,
1989, of the septic tank/subsurfa►ce sandfilter trench serving the
residence at 43 Driftwood Court. The facility grounds and the
receiving stream indicated no problems. The wastewater treatment
facility appears .to be operating satisfactorily and. is considered to be
in compliance with its NPDES Permit.
If, in the future, the residence is sold, please inform the new
owners that they will need to apply for a new permit. NPDES Permits
are not transferable.
If you have any questions, please contact either Mr. Max Haner or
me at 704/251-6208.
Sincerely yours,
Kerry S. Becker
Environmental Technician
Enclosure
xc: Dan Ahern, EPA
Max L. Haner
Interchange Building,59 Woodfin Place, Asheville, N.C. 28801 •Telephone [phone]

� I
Unitea States Environmental Protection Agency Form Approved
A Washington,D.C.20460
®�® 03
1i1PDES Compliance Inspection Report OMB No.lExpir s 7-3
P Approval Expires 7-31-85
Section Ai National Data System Coding
Trans tion Code NPDES yr/mo/day Inspection Type Inspector Fac Type
Remarks
1IIIIIIIIiIIIIIIIflfIIllIIIIIIIIIIIIlIIIIIIIIII
66
Reserved Facility Evaluation Rating CBI QA -- ------Reserved-----l------------
67��69 7 7,[ 7kPjJ 71—Lj 74 7� 1 1 1 I I I80
Section B:Facility Data
Nam e and Location of Facility Inspected Entry Time Permit Effective Date
I u c '� I c� AM ❑ PM
�. P 7
Exit Time/Date Permit Expira ton Date
3 � 2,
Name(s)of On-Site Representative(s) Title(s) Phone No(s)
Name,Address of Responsib a Official Title
F Phone No. G ly- ? Contacted
70 - - ❑ YesK1' No
Section C:Areas Evaluated During Inspection
(S=Satisfactory,M=Marginal,U=Unsatisfactory,N=Not Evaluated)
Permit Flow Measurement Al,I Pretreatment Operations&Maintenance
Records/Reports Laboratory Compliance Schedules Sludge Disposal
Facility Site Review Effluent/Receiving Waters Self-Monitoring Program Other:
Section D:Summary of Findings/Comments(Attach additional sheets if ne-essary/)
C i /. f 'i fit f st/ s 5/ ✓ /�v c ,�/e .t s st P �L
fr
0
Name(s)and§ighature(s)ofinspector(s) Agency/Office/Telephone Date
Si pataye of'Review r OF
Agency/Office Date 0
•.:. s°"k.... itiegF013�♦�17fA" v�.a.Y•p.' si r k
Action Taken 7 Date pitance,5tatus

ow
ro
State of North Carolina
.Department.of Natural Resources and Community Development
Asheville Regional Office
James G. Martin; Governor. David R. Spain
S. Thomas Rhodes, Secretary . Regional Mariager
_DIVISION OF ENVIRONMENTAL MANAGEMENT
WATER QUALITY SECTION
October 14, 1988
Ms, .Lucy Lee Colford
43 Driftwood Court
Asheville, North .Carolina 2H01
.Subject: Cbmpliance .Zvaluaton '.i.nspection
'Status In Compliance
Lucy Lee 'Colford Residence
NPDES Permit Number NC00480'20
Buncombe County
Dear Ms. Colf ord c
,
A Compliance Evaluation Inspection was conducted on September 30,
.... .... . .
1988, .'Of the septic tank/subsurface' zandfilter serving your ..residence.
The f ac�iilt a _ . ,
y .ppeared .to �3ae ��perf�rrm�in� as=�r3csigned and was I consdered
In .compliance.
If you have any questions, please contact Mr. Max Haner',or :me at
704/251-6208, 'extension 225 or :258xespectively ,
Sincerely yours,
Kerry S. Becker
Environmental Technician
KSB: 1s
Enclosure
xc: Dan Ahern, EPA
-Max L.. Haner
Interchange Building, 59 Woodfin Place, P.O. Box 370, Asheville,;-N.C.28802-0370•Telephone [phone]

�"'r""""'� rr,t Fates nv+ronmenFal awn Agency Form Approved
" Washington,-O.C 204tiU
4EIOMS No.2040-0003
it
N.PESornphancens� cti©n Repo /1<pproval Exp,reS -31.85
$i3cti6n At datiornai"10ata ry4stom Godine
Transactiori�>4ode NPDES yr/motday haspection Type #nspector Fac ype
Remarks
66
-Reserved Facility Evaluation Rating B1 (lA --• •-••Reser"d
Sectiori B:Facility Data
Name and tio/n`' R FacilFty inspected Entry Time AM D.PM Permit Effective Date
�3 BR C d,7 a r le fd iKl�l! (Lt1LC/t Exit Time/Date, Permit,Expiration Date
arnafs o . n- ite espraser�tdritre{sy : 'Title(s) PhoAe NOW.
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1.3///)Ie T uca C Lrn -Pf+®ne No. r 5 = .S'�'S: a,,. Contacted
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:IS,=SaastsF M=Marw"Ol;U=UnswisfmdrV;fv­",Jvatuwed)
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Records;/Reports laboratory Complance•Schedulas' 5 SOudge`GispRsal
Facility Site Review imuent/Raeeiving W Self-Monitoring Program Other.
" 'Seetion O-Suenmsry•O't Findings/Corraneets(Attach additional sheets d necassary)
1, 11
Name(s)and Signature(s)of Inspector(s) Age ncy/Office/Telephon6 Date
re of Reviewer Agenayl.C2ftice Date
Raguiatory,Qtfice`Uae'OMy,
Action'Taken" Date Go pi,anoe aius
77,
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