NCG551138_Complete File - Historical_20200512

PAT IMCCRORY
< ret�u
dretReso"u rr°es
Certified Mail #7015 1520 0003 5463 0639
Return Receipt Requested
August 22, 2016
Dylan Roue
1997 Goodman Lake Rd.
Morganton, NC 28655
SUBJECT:
NOTICE OF DEFICIENCY
Tracking Number: NOD-2016-PC-0395
Permit No.NCG551138
1997 Goodman Lake Road
Burke County
Dear Permittee:
The North Carolina Division of Water Resources conducted an inspection at 1997 Goodman Lake Road on
August 4, 2016. This inspection was conducted to verify that the facility is operating in compliance with the
conditions and limitations specified in NPDES WW Permit No. NCG551138. A summary of the findings and
comments noted during the inspection are provided in the enclosed copy of the inspection report.
The Compliance Evaluation inspection was conducted by Division of Water Resources staff from the Asheville
Regional Office. The following deficiency(s) was noted during the inspection:
Inspection Area Description of Deficiency
Disinfection-Tablet Chlorine tablets were not present in chlorination tubes.
[NCG550000 Part I. A. 4. Permit Conditions (Operations & Maintenance) All system
components, including but not necessarily limited to, septic tanks, surface sand
filters, other filter components, pump/recirculation tanks, disinfection units and the
outfalls shall be maintained at all times and in good operating order.]
Permit Permit expired. Permittee is not the current homeowner. Change of ownership
required.
Effluent Sampling Permittee has not conducted the required annual sampling event.
[NCG550000 Part I. A. Effluent Limitations and Monitoring Requirements (see table
in NCG550000 permit)].
State of North Carolina I Environmental Quality I Water Resources
2090 U.S.70 Highway,Swannanoa,NC 28778
828-296-4500

Corrective Measures for the deficiencies noted above:
Disinfection-Tablet: Provide proof of purchase for chlorine tablets.
Permit: Complete attached Permit Name/Ownership Change form.
Effluent Sampling: Sample and report results to the Asheville Regional Office.
Compliance Issue(s)c
During the inspection the home owner indicated the septic tank had been pumped within the past few months.
Please provide a copy of the septic tank pumping record.
Remedial actions should have already been taken to correct this problem and prevent further occurrences in the
future. The Division of Water Resources may pursue enforcement action for this and any additional violations of
State law.
To prevent further action, please respond in writing to this office within 30 days upon receipt of this Notice
regarding your plans or measures to be taken to address the indicated deficiencies and compliance issues.
If you should have any questions, please do not hesitate to contact Mikal Willmer with the Water Quality
Regional Operations Section in the Asheville Regional Office at 828-296-4500 or by email at
[e-mail].
Sincerely,
G. Landon Davidson, P.G., Regional`Supervisor
Water Quality Regional Operations Section
Asheville Regional Office
Division of Water Resources, NCDEQ
ATTACHMENTS: Inspection Report
Permit Name/Ownership Change Form
Cc: WQS Asheville Regional Office-Enforcement File
NPDES Compliance/Enforcement Unit- Enforcement File
G:\WR\WQ\Burke\Wastewater\General\NCG55 Single Family Residences\551138 Roue SFR\Inspect August 4, 2016\NOD-2016-PC-0395.docx
State of North Carolina I Environmental Quality I Water Resources
2090 U.S.70 Highway,Swannanoa,NC 28778
828-296-4500

?
United States Environmental Protection Agency Form Approved.
E D Q Washington,D.C.20460 OMB No.2040-0057
1 /� Water Compliance Inspection Report Approval expires 8-31-98
Section A:National Data System Coding(i.e.,PCS)
Transaction Code NPDES ydmo/day Inspection Type Inspector Fac Type
1 IN 1 2 15 I 3 I NCG551138 (11 12 16/08/04 17 181"1 191 c 1 201
Lfj
Inspection Work Days Facility Self-Monitoring Evaluation Rating 61 QA -Reserved —
67 70[__j I� L
71 72 74 75 80
N
� 73 W
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) 10:40AM 16/08/04 05/01/31
1997 Goodman Lake Road
Exit Time/Date Permit Expiration Date
1997 Goodman Lake Rd
• 11:20AM 16/08/04 07/07/31
Morganton NC 28655
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
Karen Weatherman,2710 Laurel Pointe Nebo NC 28761///
Yes I
Section C:Areas Evaluated During Inspection(Check only those areas evaluated)
® Permit ■Operations&Maintenance ® Records/Reports ® Self-Monitoring Program
■ 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
Mikat Willmar ARO WQ//828-296-4686/
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

1 1 `
NPDES yr/mo/day Inspection Type
31
NCG551138 I11 12 16/08/04 17 18 1,_1 (Cont.)
Section D:Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
The inspector(Mika)Willmer) met onsite with the owner, Dylan Roue. Linda Wiggs with DWR was also
present.
Current owner was unaware of system and permit requirements. Owner was provided with name
ownership change form, a copy of the current permit and an SFR technical bulletin. Inspector asked
owner to provide a copy of receipt for chlorine tablets when purchased and a copy of annual sample
results as soon as possible.
Effluent pipe is inaccessible. Outfall is located down a steep enbankment on DOT right-of-way.
Inspectors recommended sampling from chlorine contact chamber. Owner was provided with a list of
laboratories that test for BOD,TSS and Fecal Coliform.
Recommended owner cap cleanout pipe located after chlorine contact chamber.
Page# 2

Permit: NCG551138 Owner-Facility: 1997 Goodman Lake Road
Inspection Date: 08/04/2016 Inspection Type: Compliance Evaluation
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 ❑ ❑ O ❑
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment: Property around treatment units was well maintained.
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new ❑ ❑ ❑
application?
Is the facility as described in the permit? ■ ❑ ❑ ❑
#Are there any special conditions for the permit? ❑ ❑ ® ❑
Is access to the plant site restricted to the general public? ❑ ❑ . ❑
Is the inspector granted access to all areas for inspection? ® ❑ ❑ ❑
Comment: The current listed permittee is no longer the homeowner. The new owner, Dylan Roue,was
provided a change of ownership form during the inspection.
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: Owner stated septic tank was recently pumped, but could not provide receipt for work at the
time of the inspection.
Disinfection-Tablet Yes No NA NE
Are tablet chlorinators operational? ❑ ❑ ❑
Are the tablets the proper size and type? ❑ ■ ❑ ❑
Number of tubes in use? 0
Is the level of chlorine residual acceptable? ❑ ❑ ❑
Is the contact chamber free of growth, or sludge buildup? ❑ ❑ ❑
Is there chlorine residual prior to de-chlorination? ❑ ❑ ■ ❑
Comment: Current owner was unaware of SFR system components and requirements. The inspector
(Mika)Willmer)discussed with Mr. Roue the correct chlorine tablets to use and monitoring
frequency. The chlorination tubes appeared free of growth and operational: however,
chlorine tablets were not in use.
Page# 3

Permit: NCG551138 Owner-Facility: 1997 Goodman Lake Road
Inspection Date: 08/04/2016 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: Effluent pipe is inaccessible. Outfall is located a tenth of a mile from property down a steep
embankment on DOT right-of-way.
Effluent Sampling Yes No NA NE
Is composite sampling flow proportional? ❑ ❑ ■ ❑
Is sample collected below all treatment units? ❑ ❑ . ❑
Is proper volume collected? ❑ ❑ ® ❑
Is the tubing clean? ❑ ❑ ■ El
#Is proper temperature set for sample storage(kept at less than or equal to 6.0 degrees ❑ ❑ ® ❑
Celsius)?
Is the facility sampling performed as required by the permit(frequency,sampling type ❑ N ❑ ❑
representative)?
Comment: Owner was unaware of sampling requirement. Effluent pipe is inaccessible Annual
samples have to be taken from chlorine contact chamber. Mr. Roue will contact a laboratory
to have sampling completed for the year.
Page# 4

PAT MCCRORY
Governor
FS
DONA.L,D R. VAN DER VAAR.T
Secr at j'
S. JAY ZIMMER.MAN
Water Resources
ENVIRONMENTAL QUALITY ".ir::etor j
I
PERMIT NAME/OWNERSHIP CHANGE FORM.
I. CURRENT PERMIT INFORMATION:
Permit Number: NC00 / / / / or NCG5
1. Facility Name:
II. NEW OWNER/NAME INFORMATION:
1. This request for a name change is a result of:
a. Change in ownership of property/company
b. Name change only
c. Other(please explain):
2. New owner's name(name to be put on permit):
3. New owner's or signing official's name and title:
(Person legally responsible for permit)
(Title)
4. Mailing address: City:
State: Zip Code: Phone: ( )
E-mail address:
THIS APPLICATION PACKAGE WILL NOT BE ACCEPTED BY THE DIVISION UNLESS ALL OF THE
APPLICABLE ITEMS LISTED BELOW ARE INCLUDED WITH THE SUBMITTAL.
REQUIRED ITEMS:
1. This completed application form
2. Legal documentation of the transfer of ownership (such as a property deed, articles of
incorporation, or sales agreement)
[see reverse side of this page for signature requirements]
State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh,NC 27699-1617
919 807 6300 919-807-6389 FAX
http://portal.ncdenr.org/web/wq

Applicant's Certification:
attest that this application for a
name/ownership change has been reviewed and is accurate and complete to the best of my
knowledge. I understand that if all required parts of this application are not completed and that
if all required supporting information and attachments are not included, this application
package will be returned as incomplete.
Signature: Date:
THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING
INFORMATION & MATERIALS, SHOULD BE SENT TO THE FOLLOWING ADDDRESS:
NC DEQ/ DWR/ NPDES
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Version 1212015

ROY COOPER
'x
Govemor
MICHAEL S. REGAN
Secretary
Water Resources S. JAY ZIMMERMAN
ENVIRONMENTAL QUALITY
Director
April 1, 2017
Mr. Dylan Rowe
1997 Goodman Lake Road
Morganton, NC 28655
Subject: NPDES General Permit NCG550000
Transfer of NCG551138
1997 Goodman Lake Road
Burke County
Dear Mr. Rowe:
The Division hereby transmits Certificate of Coverage (CoC) NCG551138, issued under
NPDES General Permit NCG550000. This action is taken to show that you are now the
owner of the subject facility. This CoC 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 October 15, 2007 (or as
subsequently amended).
If any parts, measurement frequencies or sampling requirements contained in the
General Permit are unacceptable to you, you have the right to request an individual NPDES
permit upon written request within thirty (30) days following receipt of this letter. Unless
such a request is made, this transfer of the subject CoC shall be final and binding.
This CoC is not transferable except after notice to the Division. The Division may
require modification or revocation and reissuance of the CoC. This permit does not affect the
legal requirements to obtain other permits which may be required by any other Federal,
state, or local government. If you have any questions concerning this matter, please contact
Emily Phillips at [phone] or via e-mail [[e-mail]].
Sin rely,
S. Jay Zimmerman, P.G.
Director
cc: Asheville Regional Office' Lurces
�NPDES Unit Ater Resol�rcE�State ofNorth Carolina I Environmental Quality I Water Res 1617 Mail Service Center I Raleigh,NC 27699-1617
9198076300 919-807-6389 FAX 1onai ohttps://deq.nc.gov/about/divisions/water-resources/water-resources-permits/wastewatert ���1"rt-rt T'

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
CERTIFICATE OF COVERAGE NCG551138
Under GENERAL PERMIT NCG550000
TO DISCHARGE 100%-DOMESTIC AND SIMILAR WASTEWATERS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
NPDES
In compliance with the provisions 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,
Dylan Rowe
are hereby authorized to operate a wastewater treatment facility with a discharge of<1000
gallons per day); discharging from
1997 Goodman Lake Road
Morganton
Burke County
to receiving waters designated as Irish Creek [stream segment 11-35-3-(2)], a waterbody
currently classified WS-III located within sub-basin 03-08-31 of the Catawba River Basin, in
accordance with the effluent limitations, monitoring requirements, and other conditions set
forth in Parts I, II, and III of General Permit NCG550000 as attached.
This certificate of coverage shall become effective April 1, 2017.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day April 1, 2017. 4W
S. Zimmerman, P.G.
Director, Division of Water Resources
By Authority of the Environmental Management Commission

n pe on Date;', -ilea Start Time',JU-- 40' ' nd Time:
NGI_E,FWMICY A T T1=1 Y T iyi CH CKLflST
1412015
PeTCnittee:
�, r _ e ��n �rtiail- C��e cam,r . t Ies
Address- .�, .��
Phone: fi - °�-4 veil F�hcn :( ) - Count :
The Perrnittee is responsible#or the operation and maintenance of the entire wastewater treatment and dtsprasai system.
�F1t53't'� did oft
Yes No Apply investigate
1: is the current resident in the home the Permittee?
2, if not dyes the resident rant from the pennittee?
3. Change of Ownership form needed?(snail the form with the inspection letter)
4: is there a inspection and maintenance agreement with a oontractor?
5. if yes to#4 who is the contractor?
SEPTIC TANK The septic tank and filter.should be checked annually and pumipadicleaned as needed,El
0
6. is all wastewater from the home connected to the septic.tank?
7. Does the permitteetresident know where the septic tank is located? � n El
8. Has the septic tank been pumped in the lasts years?
9: if yes to#1`8 date, if known if proof,describe
1`0.Does the septic tank have an 1=FL ENT F1L.T or ANITAR'Y T? (circle orle) mjAA-
11.if Yes to filter when was the-l"ilter cleaned? By whom?
SAND FILTER I TR i FNT PODS YES
O if no proceed to the next ion.
Accessible sand inter surfaces shall be raked and leveled every six months and any vegetative growth shall be removed msnua€ly.
'12.is system something other than a sandfilter? 3 t- t
13, if yes,what kind's(examples-Peet,Textile,Other or brand name-Advantex,etc.)
14. Does the perrnittee know where the sand lter is located? 0 El Q
1 S. Rees the sandf"ilter require maintenance?
it maintenance is requtreGl explain in the comment section,
r
Y14 NO if no proceed ter the"xt section.
e uitrau€Diet unit shall tie checked wzeekly.Tire lamps and sleeves should be cleaned or reply as needed tie isttsuTe prb rdis(nfeGtitlrl.
F1 El
.is U W rking?' 0 � 0
. Has the UV brit been serviced and hulks cleaned?
18.Who completes this weekly check for the UV?(Non-Discharge) NO if r10 proceed to the next section.
DISINFECTION 1 TABLETS YES
The tablet chlorinator unit shalt be checked weekly to ensure continuous and proper operation: F-1 C i' El
19.Does the permittee have the correct chlorine tablets?{if gone,mark No} Elm L�J
20. Dries the Permittee know the location of time chlorinator? Shc crc�� � � �
21.there chlorine tablets observed in the chlorinator? El � Q �
El
22FW
Are tablets ontac ng water?if possible poke them to determine. lid© Ili no proceed to the next cctic+n,
i is barge drily - YES
r unit shall be checked weekly to erzsuTe continuous acid proper operation. g—X perrnittee know where tote dect for is? El 0 0
perrnittee have the correct dechlor tablets? El 0 E3 0
2&Were dechlor tablets observed in the dechlorination chamber? Cl
2b.Are tablets cclntacting water?if t c,5sibie;poke there to determine.

Doesn't Did,Not
Yes idea Apply Investigate
P F TA K YES Lj NO it no proceed to the next section.
All pump and alarm sytea�s shall inspected monthly.(non-discharge)
27 Is the pump working?
28,Are the audible and visual high water alarms operational? El El
29. Does the per ittee know how to check the pump&high water alarm? 0
rAvisual
Last functional test:: PUMP AUDIBLE trlSt3AL
DISCHARGE GE Oi�Ll� YES NO if no proceed to the next section.
review of the outfall location shall be executer!twice each yeas(one at the time of sampling to ensure no visible solids or evidence of a malfunction.
Does the permittee know where the outfall is located? NAr-- Cr e.�w. � Q � Q
32.Were you able to locate the outfall?' ® 2f i
33 is the end of the discharge pipe visible and accessible? 0 E3 [�
34. is outlet discharging? �, rce:,af�a'�. Q
35. Is right of way maintained around the discharge point? C*► �� El F1 El
36,Any Lab Results available? S'h v Cr �"`°'� [ F]
37.Is there evidence of solids around the discharge point? F-1 0 F-1 5d
DRIP or SPPAY YES NO if no proceed to the next section.
The r€igation system shall be inspected monthly to.ensure the system is free of tears and equipment is operating as designed_
38.Is the system DIP or IRRIGATION(circle one)? If irrigation number of sprinkler beads.
39,Are the buffers;adequate? M 0 F-1 ,
44. is the site free of pending and runoff'?' Q EJ 0
41.Does the application equipment appear to.be working properly? �' � F1 a'
42.Is there a Minimum two wire fence surrounding entire Irrigation area?
GeNEkAt -
43.are the treatment units locked and or secured? ,
44_Has resident had any sewage problems? if yes explain in the comment section_ � � � Q
45.Does the system match the permit description?If no explain in the comment section,
46.Is the system!compliant'? L.'A` ",ea- '' n
47 Is the system failing? if yes,take pictures if possible, F-1 Q
48. If system is failing,any sign of children or animals contacting sewage?
NOD Sent#: - NOV Sent
Comments: Photos Taken? y 'YES UNO
5 \t 0-'h1ct
.� •>1�Ce.�s�.� f
LINSIP' "
ECTf € Slf.-NATURiE:

t
United States Environmental Protection Agency Form Approved.
E /� Washington,D.C.20460 OMB No.2040-0057
/1 Water Compliance Inspection RepO1t Approval expires8-31-98
Section A:National Data System Coding(i.e.,PCS)
yr/mo/day Inspection Type Inspector Fac Type
Transaction Code NPDES
I NCG551138 I11 12 16/08/04 17 18 u 19 S 20 u
1 [� � 2 15 ' 3
211 1 L I I I I I I I i t I I l l l i i 1 1 1 1 i i l i l l l f6
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA -- -Reserved
67 70 L_J 71 L J 72 LI N j 73 LJ
J 74 75 80
Section B:Facility Data J LJ
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) 11:00AM 16/08/04 05/01/31
1997 Goodman Lake Road Exit Time/Date Permit Expiration Date
1997 Goodman Lake Rd 11:30AM 16/08/04 07/07/31
Morganton NC 28655
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
Karen Weatherman,2710 Laurel Pointe Nebo NC 28761/// No
Section C:Areas Evaluated During Inspection(Check only those areas evaluated)
Permit Operations&Maintenance 0 Records/Reports Self-Monitoring Program
Facility Site Review Effluent/Receiving Waters
Section D:Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Agency/Office/Phone and Fax Numbers Date
Name(s)and Signature(s)of Inspector(s)
Mikal Willmar ARO WQ//828-296-4686/
Agency/Office/Phone/Office/Phone and Fax Numbers Date
Signature of Management Q A Reviewer Y
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.
Page# 1

NPDES yr/mo/day Inspection Type �
31 NCG551138 h� 12 16/08/04 17 18 ((( ��I
Section D!Summary of Finding/Comments(Attach additional sheetsof narrative and checklists as necessary)
Page# 2

aK
C
Permit: NCG551138 Owner-Facility: 1997 Goodman Lake Road
Inspection Date: 08/04/2018
Inspection Type: Compliance Evaluation
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 ❑ ❑ ER. ❑
Solids, pH, DO, Sludge Judge,and other that are applicable?
Comment:
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new ❑ ❑ ❑
El
application?
Is the facility as described in the permit? ❑ El
#Are there any special conditions for the permit? ❑ ® ❑ ❑
Is access to the plant site restricted to the general public? ❑ ❑ ® ❑
Is the inspector granted access to all areas for inspection? M ❑ ❑ ❑
Comment:
Septic Tank Yes No NA NE
(If pumps are used)Is an audible and visual alarm operational? ❑ ❑ 93 ❑
Is septic tank pumped on a schedule? ® ❑ ❑ ❑
Are pumps or syphons operating properly? ❑ ❑ ® ❑
Are high and low water alarms operating properly? ❑ ❑ ®- ❑
Comment:
Disinfection-Tablet Yes No NA NE
Are tablet chlorinators operational? � -e. c ❑ ❑
Are the tablets the proper size and type? 'S' ��e. - ❑ ❑ ❑ ❑
Number of tubes in use?
Is the level of chlorine residual acceptable? ❑ ❑ ❑
Is the contact chamber free of growth,or sludge buildup? ❑ ❑ ❑
Is there chlorine residual prior to de-chlorination? ❑ ❑ ❑
Comment:
Effluent Plpe Yes No NA NE
Is right of way to the outfall properly maintained? s'�'�
Are the receiving water free of foam other than trace amounts and other debris? ❑ ❑ ❑ Q.,
If effluent (diffuser pipes are required) are they operating properly? ❑ ❑ 0 ❑
Page# 3

.x
Permit: NCG551138 Owner-Facility: 1997 Goodman Lake Road
Inspection Date: 08/04/2016 Inspection Type: Compliance Evaluation
Effluent Pipe Yes No NA NE
Comment:
Effluent Sampling Yes No NA NE
Is composite sampling flow proportional? ❑ ❑ 13 ❑
Is sample collected below all treatment units? ❑ 2 ❑ ❑
Is proper volume collected? ❑ ❑ 0
El
Is the tubing clean? ❑ ❑ IN ❑
#Is proper temperature set for sample storage(kept at less than or equal to 6.0 degrees ❑ ❑ [a ❑
Celsius)?
Is the facility sampling performed as required by the permit(frequency,sampling type ❑ ® ❑ ❑
representative)?
Comment:
v
Ica
Page# 4

M A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
Fax to: Mr. Matthew Gupton
(828-432-2466 fax)
Burke County Health Department
Environmental Health Section
From: Wanda Frazier
Environmental Specialist
NCDENR-DWQ-SWPS
Date: 12-22-2011
Re: Single Family Residence wastewater systems
NPDES permit #: NCG551138
Stephen D. & Tracy A. Boutin SFR
(formerly: Karen Weatherman SFR)
And
NPDES permit #: NCG551137
Jeffrey S. & Wendy G. Kyro SFR
am faxing you some more detailed information regarding these facilities.
Please call me at 828-296-4662 to discuss and schedule a joint inspection.
Thanks,
4
SURFACE WATER PROTECTION SECTION —ASHEVILLE REGIONAL OFFICE One
Location: 2090 U.S. Highway 70, Swannanoa, North Carolina 28778 NorthCarolina
Phone: [phone]\FAX: [phone]\Customer Service: 1-877-623-6748 ;Wura!!'y
Internet: www.ncwaterquality.org
An Equal Opportunity\Affirmative Action Employer

W/a Michael F7Eor
William G.'n North Carolina Department of Environment and
C' G -
Alan W.Klimek,l'.E.Director
Division of Water Quality
Asheville Regional Office
SURFACE WATER PROTECTION
November 3, 2005
Mr. Stephen Boutin
1997 Goodman Lake Rd
Morganton, North Carolina 28655
SUBJECT: Compliance Evaluation Inspection
Boutin Residence
Permit No: NCG551138
Burke County
Dear Mr. Boutin:
Enclosed please find a copy of the Compliance Evaluation Inspection form from
the inspection conducted on October 26, 2005. Larry Frost of the Asheville Regional
Office conducted the Compliance Evaluation Inspection. The facility was found to be in
Compliance with permit NCG551138.
Please refer to the enclosed inspection report for additional observations and
comments. If you any questions, please call me at 828-296-4500 Ext.4658.
Sincerely,
Lar rost
En ironmental Chemist
Enclosures
cc: Central Files
Asheville Files
Post-it®Fax Note 7671 Date t ` pag°es► `l
TO From ,
Co./Dept. Co.
Phone# Phone# �9
Fax# Fax#
NorthCarolina
Naturally
2090 U.S. Highway 70,Swannanoa, NC 28778 Telephone:[phone] Fax: [phone] Customer Service 1 877 623-6748

United States Environmental Protection Agency Form Approved.
EPA
n Washington,D.C:20460 OMB No.2040-0057
cr/� Water Compliance 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
1 I NI 2 I 111 12I 117 18I CI 20I_SI I I I
Remarks
21111111111111111111111111111111111111111111111116
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA ---------------------------Reserved----------------------
67 I 169 701 1 711 I 721 NJ 73 I__I 1L_�74 751 I I I I 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)
11:55 AM 05/10/26 05/01/31
Karen Weatherman
1997 Goodman Lake Rd Exit Time/Date Permit Expiration Date
Morganton NC 28655 12:05 AM 05/10/26 07/07/31
Name(s)of Onsite Rep resentative(s)/Titles(s)/Phone and Fax Number(s) Other Facility Data
Name,Address of Responsible Official/Title/Phone and Fax Number
Contacted
Karen Weatherman,1997 Goodman Lake Rd Morganton NC
28655//828-584-9320/ No
Section C: Areas Evaluated During Inspection(Check only those areas evaluated)
Permit Operations&Maintenance i Facility Site Review
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 C
Larry Frost ARO WQ//828-296-4500 Ext.4658/ 11IM0' J
Signature of Management�A R viewer Agency/Office/Phone and Fax Numbers Date
(A/cj-
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.

3
NPDES yr/mo/day Inspection Type
I11 I 1
NCG551138 12 05/10/26 I17 18IC1
Section D: Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
The grounds are well maintained. I recommended maintenance list is attached.
There was no chlorine tablets in the chlorinator, you nmust keep tablets in them to ensure the wastewater from
Your system is disinfected, prior to entering the stream.

Permit: NCG551138 Owner-Facility: Karen Weatherman
Inspection Date: 10/26/2005 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 ■ 1=l
Is the facility as described in the permit? ® ❑ ❑ n
Are there any special conditions for the permit? n n o
Is access to the plant site restricted to the general public? ❑ n . rl
Is the inspector granted access to all areas for inspection? n n n
Comment:According to Burke County records it appears that this permit has changed hands and is not properly
permitted.
Operations&Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ❑ n
Does the facility analyze process control parameters,for ex:MLSS,MCRT,Settleable Solids,pH,DO,Sludge n (] ■ [1
Judge,and other that are applicable?
Comment:
Disinfection-Tablet Yes No NA NE
Are tablet chlorinators operational? n o o
Are the tablets the proper size and type? n 0 0
Number of tubes in use? 0
Is the level of chlorine residual acceptable? ❑ n n
Is the contact chamber free of growth,or sludge buildup? n n
Is there chlorine residual prior to de-chlorination? (_1 ❑ n
Comment:Tablet chlorinators are empty,they must have tablets to ensure that the waste water is disinfected
properly.

0 hael F.Mic Ec. x
Easley Governor
O;00 '' m Ro Jr.,Secwarlp
`Q North Carolina Department` �lvi nt a . Na ral Resources
Alan W. IIm�E.Dir`` a6
' m ibri ofWatersQua7ity- -
Asheville Regional Office
SURFACE WATER PROTECTION
October 27, 2005
Mr. Stephen Boutin
1997 Goodman Lake Rd
Morganton, North Carolina 28655
SUBJECT: Compliance Evaluation Inspection
Boutin Residence
Permit No: NCG551138
Burke County
Dear Mr. Boutin: 2x,-, e�-5 )
Enclosed lease find Cco of Compliance Evaluation Inspection r
N NY N N form from
the inspection conducted on .a Larry Frost of the Asheville Regional
Office,conducted the Compliance Evaluation Inspection. The facility was found to be in
Compliance with permit NCG551138.
Please refer to the enclosed inspection report for additional observations and
comments. If you any questions, please call me at 828-296-4500 Ext.4658.
Sincerely,
Lar Frost
E vironmental Chemist
Enclosures
cc: Central Files
Asheville Files
o Ni-thCarotina
Naturally
2090 U.S.Highway 70,Swannanoa, NC 28778-Telephone:[phone] Fax: [phone] Customer Service 1 877 623-6748

United States Environmental Protection Agency
Form Approved.
EPA
p/� Washington;D.C.20460 OMB No.2040-0057
Water Compliance Inspection Re Ort Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/d y Inspection Type Inspector Fac Type
N 2 5 3 NCG551138 11 12 05/ Cs+ "Z 17 18 C 19 g 20
1I_I III I I I - - 1 11 I_I 1 1
Remarks
21111111111111111111 111111111111111111111111111116
Inspection Work Days Facility Self-Monitoring Evaluation Rating 61 QA -------------------—------Reserved-------------------
671 169 701111 71 11 721 NJ 73' L174 751 1 1 1 1 1 1 1 80
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)
11:55 AM 05/11/26 05/01/31
Karen Weatherman
1997 Goodman Lake Rd Exit Time/Date Permit Expiration Date
Morganton NC 28655 12:05 AM 05/11/26 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
Contacted
Karen Weatherman,1997 Goodman Lake Rd Morganton NC
28655//828-584-9320/ No
Section C: Areas Evaluated During Inspection(Check only those areas evaluated)
Permit E 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 W4//828-296-4500 Ext.4658/ �,11 ';P 5
Signature of Management Q A Reviewer` Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.

NPDES yr/mo/day Inspection Type
3I 1
NCG551138 I11 121
O5/7.1/26 I17 18ICI
Section D: Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
The grounds are well maintained. A recommended maintenance list is attached.
There was no chlorine tablets in the chlorinator, you nmust keep tablets in them to ensure the wastewater from
Your system is disinfected, prior to entering the stream_
To properly permit this, system please fi.1.1 out and mail in the attached form.

Permit: NCG551138 Owner-Facility: Karen Weatherman
Inspection Date: 11/26/2005 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 applications 1=l
Is the facility as described in the permit? ® ❑ F1 R
Are there any special conditions for the permit? ❑ F1 ® (1
Is access to the plant site restricted to the general public? ❑ ❑ ® 1111
Is the inspector granted access to all areas for inspection? Q ❑ ® n
Comment:According to Burke County records it appears that this permit has changed hands and is not properly
permitted.
Operations&Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? e 0 ❑ Q
Does the facility analyze process control parameters,for ex:MLSS,MCRT,Settleable Solids,pH,DO,Sludge ❑ ■ Cl
Judge,and other that are applicable?
Comment:
Disinfection-Tablet Yes No NA NE
Are tablet chlorinators operational? (=1 ® ❑ ❑
Are the tablets the proper size and type? ❑ ® 0 0
Number of tubes in use? 0
Is the level of chlorine residual acceptable? ❑ (] Q
Is the contact chamber free of growth,or sludge buildup? ❑ ❑ I_1
Is there chlorine residual prior to de-chlorination? 1=l 1=1 1=l
Comment:Tablet chlorinators are empty,they must have tablets to ensure that the waste water is disinfected
properly.

04 BuaxE o �-='
�UI7.E0 O
�� BURKE COUNTY
CA °�~ HEALTH DEPARTMENT
700 East Parker Road DAVID L. RUST,JR.
P.O. Drawer 1266 - Director
Morganton, NC 28680-1266
Telephone[phone]
Fax[phone]
... rpp
Mrs. Karen Revis
2710 Laurel Pointe
Nebo,NC 28761
A6 Vl,'7 eV
November 6, 2001
Dear Mrs. Revis,
You received a National Pollution Discharge Elimination System(NPDES)
permit to install a single-family, sand filter, discharge,wastewater system for your
dwelling located at the above address. This is under the name of Weatherman. The
permitting agency for this single-family, sand filter,discharge, wastewater system is the
North Carolina Department Of Environment and Natural Resources (NCDENR),
Division of Water Quality/Water Quality Section. Their address in Raleigh is 1617
Mail Service Center,Raleigh,
lei h,NC 27699-1617 and the phone number is(919) 733-5083.
The contact person in Raleigh is Mr. Mack Wiggins and his extension number is 542.
The regional office and contact people for NCDENR,Division of Water Quality are Mr.
Jim Reid or Mr. Jerry Freeman. Their address is 59 Woodfin Place, Asheville NC 28801
and their phone number is [phone].
The single-family, sand filter, discharge, wastewater system has been properly
installed effective November 5, 2001 in accordance with the parameters of the North
Carolina Department Of Environment and Natural Resources (NCDENR), Division of
Water Quality/Water Quality Section and the regional office for NCDENR, Division of
Water Quality. The single-family, sand filter, discharge,wastewater system was installed
by D&D Grading &Backhoe Inc, 3989 Old Brittain Road,Hickory,NC and the existing
on-site wastewater treatment and disposal system, including the tanks, have been
abandoned. Both these agencies have on file detailed design specifications on your new
system. I will forward to these two agencies certification certifying that the dwelling's
system has been installed in accordance with the NPDES Permit. Your wastewater from
the dwelling is no longer in violation of any 130A state laws or 15A NCAC 18A .1900
rules.
"Promoting Health,Protecting the Environment"

NN, -
Your single-family, sand filter, discharge, wastewater system is a gravity flow,
dual,sand filter system. The wastewater from your house exits and enters a 1000-gallon
Norwesco,Inc. polyethylene septic tank. Two risers, extending above grade level
protrude from the tank for access to the filter and for pumping purposes. A second
identical tank with risers exists in order to decrease the pump and hull times required in
the event the sand filter are taken out of service for repairs. A Bull valve exists just
before the tanks to control which tank receives the wastewater. Wastewater leaving the
septic tank then goes through two sand filter beds utilizing a 13 X 25 foot(325 sq. ft.)
primary sand filter with wastewater exiting the primary sand filter going to a 10 X 20 foot
(200 sq. ft.)secondary sand filter. These two filter beds have PVC vent pipes protruding
above ground level. The beds also utilize distribution boxes to equally distribute and
receive wastewater to and from the beds. After the wastewater exits the secondary sand
filter it receives post chlorination using an Aquaward, model A200 tablet feeder. It has
two PVC tablet feed tube protruding above grade level. A contact chamber follows this,
which is the well tile protruding above grade level. The treated wastewater then flows to
the creek just within the road right-of-way. At the creek, your wastewater line (one of
two lines, side by side,protruding out from the rock)is the 4-inch PVC pipe, it is the one
that is further away the road. Two yearly bacterial samples per year will be taken from
this discharge point.
You will be required to take two water samples per year of the water from the
discharge pipe at the creek;provided the treated wastewater is flowing,and send the
results to NCDENR,Division of Water Quality 59 Woodfin Place, Asheville NC 28801
Attention to:Mr.Jim Reid or Mr. Jerry Freeman. This agency will monitor your system
and I would suggest you contact them regarding sample time and any other information
you might need about their policies and procedures. A local laboratory that will take/do
these samples is Water Tech: P.O. Box 1056 Granite Falls,NC 28630 and their phone
number is [phone].
The single-family,sand filter, discharge,wastewater system has a few general
requirements that need to be adhered to for the proper operation/maintenance of this
system. These are:
1. The septic tank will need to be pumped out once every 3 to 5 years depending
on your use of the system.
2. You will need to maintain continuous chlorination of the wastewater by
insuring that chlorination tablets are always inside the chlorination unit.
3. You will never want to create a situation that will cause the surface water to
pond over the tanks or sand filter beds.
4. You are required to maintain a grass surface only on top of the sand filter
structures/ component parts. Extreme care must be taken when mowing the
grass so as not to break off any of the protruding PVC pipes that are a part of
the system.
5. Any and all general information and requirements for operation and
maintenance of the single-family, sand filter, discharge, wastewater system
are in effect for the lifetime of the system's functioning for the dwelling. Any
future owners, should the property be sold or exchanged, will be required to

adhere to the general information and requirements for operation and
maintenance of the wastewater system.
Should you have any questions that I might be able to answer about the single-
family, sand filter, discharge, wastewater system or about anything related to its design,
installation, operation and maintenance, please feel free to contact me Monday through
Friday between 8:00 AM and 5:00 PM at [phone] or feel free to stop by our
Environmental Health office located at 200 Avery Avenue in downtown Morganton.
Sincerely,
Roger A. Wesley, RS/REHS
Environmental Health Supervisor
Cc: Dave Rust, Health Director
Mr. Redmond Dill, County Attorney
Mr. Mack Wiggins
Mr.Jim Reid/Mr. Jerry Freeman
Mr. Dennis Newton

CR Michael F.Easley
Q61 Governor
rWilliam G.Ross Jr.,Secretary
Department of Environment and Natural Resources
Kerr T.Stevens,Director
Division of Water Quality
Engineer's Certification
I, ,c''Zzad ,i �s`��as a duly registered Professional Engineer in the State of North Carolina, having
been authorized to observe (periodically, weekly,full time)the construction of/the 1
project, lr�,�l9lxrJ �4 .��, �vy��t�r�•4e--7 for the
Project Name Location
Permittee hereby state that, to the best of my abilities, due care and diligence was used in the observation of the
construction such that the construction was observed to be built within substantial compliance and intent of the approved
plans and specifications.
Signature Registration No.
Date
Engineer's Certification
as a Registered Environmental Health Specialist
in the State of North Carolina,having been authorized to observe (periodically, weekly,
full time) the construction of the project, W ATH
Project Name
for the Permittee hereby state that, to the
Location
best of my abilities, due care and diligence was used in the observation of the
construction such that the construction was observed to be built within substantial
compliance and intent of the approved plans and specifications.
Signature / - Registration No.
Date / o.
NLbE R

Facility information
NPDES permit M NCG551138 Burke County
Facility name: Stephen D. & Tracy A. Boutin SFR
(formerly: Karen Weatherman SFR)
WWTP type: 360 gpd wastewater treatment system consisting
of gravity flow to dual 1000 gallon Norwesco, Inc.
polyethylene septic tanks (one primary tank and
one reserve tank with bull valve) with risers &
Zabel A-1800 filter and 1 ft x 1 ft surface diversion
dam; distribution box with speedy levels; 325 sq
ft (13' x 25') primary sand filter(with a loading
rate of not more than 1.15 gpd/sq ft) located in
the back yard; 200 sq ft (10' x 20') secondary
sandfilter (with a loading rate of not more than
2.30 gpd/sq ft) located on the left-side of the
home; 30 mil polyethylene trench liner; Geo cloth
fabric liner stone cover, under the 1 ft mounded
cover soil, tapering & extending 5 ft from the
edge of the sand filter bed walls; Aquaward ® A-
200 tablet chlorinator with dual feeder tubes;
chlorine contact chamber; rip rap aeration 4-inch
pvc discharge into Irish Creek (WS-III). There are
two discharge pipes there, one for another SFR.
The discharge pipe for this residence is the one
that is further away from the road.
A to C: Issued 7-6-2001
Tax info: Tax pin # 178505094230
(Sold 1-25-2002 to the Boutins)
Acres: 0.623
Deerfield Subdivision
Dwelling: 3-bedroom, primary residence, no
basement
former owner: Karen Weathermen (Karen Revis)
2710 Laural Pointe, Nebo, NC 28761
828-584-9320 (h)

Certification: by Dennis Newton - dated 11-5-2001
Installer: D&D Grading & Backhoe, Inc.; 3989 Old Brittain
Road; Hickory, NC
Health Department: Letter from Burke Co HD on 11-6-2001, indicating
proper installation & compliance effective
11-5-2001 - Roger A. Wesley, registered sanitarian
WWTP location: 1997 Goodman`Road (north of Oak Hill);
Morganton, NC 28655
Responsible official: Stephen D. & Tracy A. Boutin
Responsible 11 's title: owner
Official's location: 1997 Goodman Road (north of Oak Hill);
Morganton, NC 28655
Mailing address: 1997 Goodman Road (north of Oak Hill);
Morganton, NC 28655
Phone numbers
828-
Permit information
Date issued: 1-31-05
Expiration date: 7-31-07 expired
Last inspection: 10-26-2005 by Larry Frost
Billing: Past due $290
Stream information
Stream: Irish Creek
River basin: Catawba River Basin
Sub-basin:
Hydrologic Unit Code:
Quad: Oak Hill, NC
Grid: D 11 SE
Latitude: 350 48' 12"
Longitude: 810 45' 47.5"
Stream classification: WS - III
Drainage area sq mi: 1.2
Instream Waste Conc.:
Average stream flow: cfs
Summer 7Q10 cfs:

Winter 7Q10 cfs:
30Q2 cfs:
Other information
Directions: From Morganton, travel north on Highway 181.
Turn right on Goodman Lake Road (NCSR 1410).
Travel on Goodman Lake Road - 0.9 miles to
where the road crosses Irish Creek. The
discharge pipe is located on the left (upstream
side of the culvert).
Permit requirements:
Part 1.A. Initially (in 2001) monitoring / analyses (analyses were
required to be performed by a NC certified lab) four times a
year.
Parameter Sample t a Permit Limits
Flow estimate
BOD grab 30 mg/I monthly average / 45 mg/I daily maximum
TSS grab 30 mg/I monthly average 145 mg/I daily maximum
Fecal coliform grab 200 col/ml mo. ave. / 400 col/ml da. max.
*TRC grab 17 ug/I
(*TRC = Total residual chlorine)

Central Files: APS__ swp__ �
1212211
Permit Number NCG551138 Permit Tracking Slip
Program Category Status Project Type
NPDES WW Expired Renewal
Permit Type Version Permit Classification
Single Family Domestic Wastewater Discharge COC 2.00 CDC
Permit AffiliationPhm�ryR�vie�er ^
ohudea.vveaver
Coastal SVVRule
Permitted Flow
Facility
Facility Name Major/Minor Region
1997 Goodman Lake Road Minor Asheville
Location Address County
18A7 Goodman Lake Rd Burke
Morganton NC 28655 Facility Contact Affiliation
Owner
Owner Name Owner Type
Individual
Weatherman Karen Owner Affiliation
Karen Weatherman
2710 Laurel Pointe
Nebo NC 28781
oo»enu|vu
Orim|vsuw AppRwcoivvu Draft Initiated Issuance Public Notice |mauo Effective Expiration
07/06/01 01/31/05 01/31/05 01/31/05 07/31/07
Regulated Activities Requested/Received Events
Domestic,other RO staff report received
Private residence,single family nO staff report requested
OutfaY| 001
vvoteruvuv m
wnm� munmIndex Number Current Class oubunoin
Irish Creek VVS ||\ 03 k 11-35'3'(2) ' '08'31

Facility information
NPDES permit #: NCG551138 Burke County
Facility name: Stephen D. & Tracy A. Boutin SFR
(formerly: Karen Weatherman SFR)
Billing: past due since 7-1-2007
$290 due now
r
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Burke Co., NC --Printable Map - Page 1 of 2
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Parcels
Record No.: 46957 Map: 11 Page: 58 Blk. Lot: 2161
PIN:178505094230 Deed Reference: Bk. 1083 Pg. 213
Parcel Address: 1997 GOODMAN LAKE RD Land Area: 0.62 acres
Parcel Owner: Assessed Value:$89,672
BOUTIN STEPHEN D &TRACY A Building Value: $80,682
1997 GOODMAN LAKE RD Land Value: $8,990
MORGANTON NC 28655 Other Value: $0
Sales Amount: $89,000
Sales Date: 1/25/2002
http://arcims.webgis.net/ncBurke/printable.asp?process=idl&x2=1180439.28625&y2=759174.3885625... 10/27/2005

Rand McNally - Get Directions Page 1 of 2
qq,,NAUX
Back
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...................................................................................................................................................................................................................................
Swannanoa, NC 28778
to
1997 Goodman Lake Rd
Morganton, NC 28655-9515
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Find it in the 2006 Road Atlas
Swannanoa, NC Morganton, NC
•page 74, grid section L-6, • page 74, grid section E-3
Western North Carolina map • page 74, grid section D-3
• page 74, grid section K-6,
Western North Carolina map
• page 74, grid section E-1
Estimated Total Driving Time: Estimated Total Driving Distance: Total Number of Steps:
1 hour, 10 minutes 54 miles 14
Step Directions Distance
1 You are at Swannanoa,NC.
...................................................................................................................................................................................................................................
2 Go SW on Riverwood Rd for 0.18 miles 0.2 miles
...................................................................................................................................................................................................................................
3 Turn hard left onto US-70 (Black Mountain Hwy) 0.4 miles
...................................................................................................................................................................................................................................
4 Turn right onto Patton Cove Rd 0.4 miles
...................................................................................................................................................................................................................................
5 Turn left on ramp to I-40 E 0.2 miles
...................................................................................................................................................................................................................................
6 Continue on I-40 E 43.6 miles
...................................................................................................................................................................................................................................
7 Bear right onto off-ramp at exit 103 to US-64 0.2 miles
..............................................................................................................................................................................................................................
http://www.randmcnally.com/rmc/directions/dirPrintDirections.j sp?ref=dirn&col=color&sStartName=&... 10/19/2005

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�QF W ATF94 Michael F. Easley
Governor
Cq r William G.Ross Jr.,Secretary
Department of Environment and Natural Resources
4� "C Kerr T.Stevens,Director
Division of Water Quality
July 6,2001 ji i
Ms. Karen Weatherman -
2710 Laurel Pointe i P Ul t sE
Nebo, NC 28761 s :
Subject: General Permit NCG550000
Cert. of Coverage NCG551138
Authorization to Construct
Karen Weatherman Residence
Burke County
Dear Ms.Weatherman:
In accordance with your application for an NPDES discharge permit received May3, 2001 by,the Division, we
have issued the Certificate of Coverage under the state-NPDES general permit for Karen Weatherman. Authorization is
hereby granted by this letter for the construction of a 360 GPD wastewater treatment system consisting of two 1000 gallon
septic tanks, distribution box with speedy levels, 325 square foot (13'X 25') primary sandfilter,with a loading rate of not
more than 1.15 GPD/square foot, 200 square foot(10'X 20') secondary sandfilter with a loading rate of not more than 2.30
GPD/square foot,chlorinator, chlorine contact tank and rip rap aeration with a discharge of treated wastewater into Irish
Creek classified WS-III waters in the Catawba River Basin. All elbow piping must be of the long sweeping type. All
cleanouts are to be housed in meter boxes below the surface. This system must be at least 10 feet from the dwelling and
property lines and at least 100 feet from water supply wells on and off the site. The system must also be constructed and
located above a 100 year flood. The trench must be lined with a minimum 30 mil polyethylene liner.
The Division of Water Quality is aware that your system will be installed to meet additional conditions required by
the Division of Environmental Health-Public Water Supply Section.. These conditions are not a part of this general permit.
If you have questions associated with these additional conditions please contact Jerry Freeman in the Asheville Regional
Office of the Public Water Supply Section at(828)251-6208.
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 and letter requesting coverage under an
individual permit. Unless such demand is made,this decision shall be final and binding. Please take notice this permit is
not transferable. Part II, E.4. addresses the requirements to be followed in case of change of ownership or control of this
discharge.
The Authorization to Construct is issued in accordance with Part III, Paragraph 2 of NPDES Permit No.
NCG550000, and shall be subject to revocation unless the wastewater treatment facilities are constructed in accordance
with the conditions and limitations specified in Permit No. NCG550000.
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.
The Asheville Regional Office, telephone number 828/251-6208, shall be notified at least forty-eight (48) hours in
advance of operation of the installed facilities so that an in-place inspection can be made. Such notification to the regional
supervisor shall be made during the normal office hours from 8:00 a.m. until 5:00 p.m. on Monday through Friday,
excluding State Holidays.
��
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Customer Service Division of Water Quality 1617 Mail Service Center Raleigh,NC 27699-1617 [phone]
1 800 623-7748

Q �Q Michael F.Easley
`QC� pG Governor
tq f William G.Ross Jr.,Secretary
y Department of Environment and Natural Resources
C3 'C Kerr T.Stevens,Director
Division of Water Quality
Upon completion of construction and prior to operation of this permitted facility, a certification must be received
certifying that the permitted facility has been installed in accordance with the NPDES Permit,the Certificate of Coverage,
this Authorization to Construct and the approved plans and specifications. Mail the Certification to the Stormwater and
General Permits Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617.
A copy of the approved plans and specifications shall be maintained on file by the Permittee for the life of the
facility.
The sand media of the sandfilters must comply with the Division's sand specifications. The engineer's certification
will be evidence that this certification has been met.
A leakage test shall be performed on the septic tank and dosing tank to insure that any exfiltration occurs at a rate
which does not exceed twenty(20) gallons per twenty-four (24) hour per 1,000 gallons of tank capacity. The engineer's
certification will serve as proof of compliance with this condition.
Failure to abide by the requirements contained in this Authorization to Construct may subject the Permittee to an
enforcement action by the Division of Water Quality in accordance with North Carolina General Statute 143-215.6A to
143-215.6C.
The issuance of this permit does not preclude the Permittee from complying with any and all statutes, rules,
regulations,or ordinances which may be required by the Division of Water Quality 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, please contact Mack Wiggins, telephone number
919/733-5083.
Sincerely,
Kerr T. Stevens.
cc: Central Files
Asheville Regional Office, Water Quality
Roosevelt Childress, EPA
Point Source Compliance Enforcement Unit
Burke County Health Department
A
f .
Customer Service Division of Water Quality 1617 Mail Service Center Raleigh,NC 27699-1617 [phone]

�,0F W AT IY Michael F.Easley
�0 G Governor
r William G.Ross Jr.,Secretary
>_ y Department of Environment and Natural Resources
O Kerr T.Stevens,Director
Division of Water Quality
Engineer's Certification
I, ,as a duly registered Professional Engineer in the State of North Carolina, having
been authorized to observe (periodically,weekly, full time) the construction of the
project, , for the
Project Name Location
Permittee hereby state that,to the best of my abilities, due care and diligence was used in the observation of the
construction such that the construction was observed to be built within substantial compliance and intent of the approved
plans and specifications.
Signature Registration No.
Date
WNW
4%
Customer Service Division of Water Quality 1617 Mail Service Center Raleigh,NC 27699-1617 [phone]

r
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
CERTIFICATE OF COVERAGE
GENERAL PERMIT NO.NCG551138
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,
Karen Weatherman
is hereby authorized to operate and construct a wastewater treatment facility that consists of two septic tanks,
distribution box, primary sandfilter, secondary sandfilter, chlorinator, chlorine contact tank, rip rap aeration and
associated appurtenances with the discharge of treated wastewater from a facility located at,the
Karen Weatherman Residence
1997 Goodman Lake Road
north of Oak Hill
Burke County
to receiving waters designated as Irish Creek in the Catawba 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 July 6,2001
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 6,2001
l�`d{:p silt
Kerr T.Stevens,Director
Division of Water Quality
By Authority of the Environmental Management Commission

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Oarkers
Name: Discharge Point-NCG551138
Short Name: Dschrg
Coordinates: 035 48' 13.0" N, 081°45'48.4"W
Comment: Karen Weatherman Residence, Subbasin-030831, Catawba River Basin, Burke County,
Irish Creek, Class-WS-III, Quad DI1SE

1
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SAND FILTER PLAN ADDENDUM
May 29, 2001
WEATHERMAN PROPERTY:
Address: 1997 Goodman Lake Road
Morganton,NC 28655 (Burke County)
Tax Map#: 11-5 8-2-161
Acres: 0.623
Subdivision: Deerfield Subdivision
Lot Number: 1
Dwelling: 3-bedroom,primary residence,no basement
PROPERTY OWNER:
Ms. Karen Weatherman(Karen Revis)
2710 Laural Pointe
Nebo,NC 28761
Home phone# - [phone]
After a plan and site review by the Asheville Public Water Supply section of the NC
Department of Environment, Health, and Natural Resources, changes and clarifications
were ordered to the sand filter discharge system design by that office. The following
changes and clarifications are to be made to the sand filter discharge system:
1. Surface water is to be diverted off the sand filter beds by mounding the soil cover
over the beds above grade level.
2. Eave trough water coming off the roof is to be piped past any sand filter component
part or line using solid piping.
3. Surface water is to be diverted around the septic tanks using surface diversion ditches
or mounded soil to act as a barrier.
4. In order to decrease the pump and hull times required in the event the sand filter are
taken out of service for repairs a second 1000 gallon Norwesco, Inc. polyethylene
septic tank, with risers, will be installed to act as a,reserve volume holding tank. Its
installation will be next to the other septic tank and connect to the inlet line and the
outlet line using two bull valves that can be manually operated.
Corrected drawings showing these changes are attached with this addendum.
5. Sampling shall be increased from once per year to four times per year.
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SAND FILTER PLAN ADDENDUM
May 28, 2001
WEATHERMAN PROPERTY:
"AMress: m 1997 Goodman Lake Road
Morganton,NC 28655 (Burke County)
Tax Map#: 11-58-2-16 i
Acres: 0.623
Subdivision: Deerfield Subdivision
Lot Number: 1
Dwelling: 3-bedroom,primary residence, no basement
PROPERTY OWNER: �
Ms. Karen Weatherman(Kasen Revis)
2710 Laural Pointe ' };
20-t-1 + .w
Nebo,NC 28761
Home phone# - [phone]
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The following change is to be made to the submitted Weatherman sand filter plans:
1. The liner to be used in the bed of the primary and secondary sand filters is to be of 30
mil minimum thickness.
2. As stated on the April 2 1'addendum a Geo cloth fabric liner will be used to cover the
top laver of stone before the fill/cover soil is added.
Corrected drawing(s) showing this change are attached with this addendum.

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SOC PRIORITY PROJECT: Yes No X
IF YES, SOC NUMBER
TO NPDES UNIT
WATER QUALITY SECTION
ATTENTION: Mack Wiggins
DATE: April 26, 2001
NPDES, STAFF REPORT AND RECOMMENDATION
COUNTY Burke
PERMIT NUMBER NCG551138
P -ART I" GENERAL INFORMATION
1.Facility and Address: Weatherman Residence
1997 Goodman Lake Rd
Morganton NC 28655
Mailing l
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a in Karen Weatherman
2710 Laurel Point
Nebo NC 28761
2 . Date of Investigation: October 27, 2000
3 . Report Prepared By: Tames R. Reid
4 . Persons Contacted and Telephone Number: David Rust, Roger Wesley
828-438-5430
5 . Directions to Site: From Morganton, travel North on Highway 181 to
right on Goodman Lake Road (SR 1410) . Travel on Goodman Lake Road
approximately 0 . 9 mile to the point where the Road crosses Irish
Creek. The discharge pipe is located on the left (upstream side the
culvert) .
6 . Discharge Point(s) , List for all discharge points:
Latitude 350 48 ' 12" Longitudes 810 45 ' 47 . 5"
Attach a USGS map extract and indicate treatment facility site and
discharge point on map.
U.S.G.S. Quad No. D11SE U.S.G.S. Quad Name Oak Hill
-1-

7 . Site size and expansion area consistent with application?
X Yes No If No, explain:
8 . Topography (relationship to flood plain included) : above flood
plane
9 . Location of nearest dwelling: approx. 50 feet
10 . Receiving stream or affected surface waters : Irish Creek
a. Classifications WS-III
b. River Basin and Subbasin No. : CTB 030831
C. Describe receiving stream features and pertinent downstream
uses: Tributary to water supply, recreation, wildlife,
agriculture
PART II - DESCRIPTION OF DISCHARGE AND TREATMENT WORKS
1., a. Volume of wastewater to be permitted 0 . 00036 MGD (Ultimate
Design Capacity)
b. What is the current permitted capacity of the Wastewater
Treatment facility? New facility
C. Actual treatment capacity of the current facility (current
design capacity N/A
d. Date(s) and construction activities allowed by previous
Authorizations to Construct issued in the previous two years:
N/A
e. Please provide a description of existing or substantially
constructed wastewater treatment facilities: N/A
f. Please provide a description of proposed wastewater treatment
facilities: 1000 gallon polyethylene septic tank with Zable A-
1800' filter, distribution box, 325 sq ft primary sand filter,
200 sq ft secondary filter, and Aquaward brand -t
chlorinator. -ab��+-
g. Possible toxic impacts to surface waters:
-2-
�4--

h. Pretreatment Program (POTWs only) N/A
in development approved
should be required not needed
2 . Residuals handling and utilization/disposal scheme septage hauler
a. If residuals are being land applied, please specify DWQ Permit
Number
Residuals Contractor
Telephone Number
b. Residuals stabilization: PSRP PFRP OTHER
C. Landfill:
d. Other disposal/utilization scheme (Specify) : Licensed
septage hauler
3 . Treatment plant classification (attach completed rating sheet) : I
4 SIC Codes (s)
Primary Secondary
Main Treatment Unit Code: 460-7
PART III OTHER PERTINENT INFORMATION
1. Is this facility being constructed with Construction Grant Funds or
are any public monies involved. (municipals only) ? No
2 . Special monitoring or limitations (including toxicity) requests: No
3 . Important SOC, JOC, or Compliance Schedule dates: (Please indicate)
Date
Submission of Plans and Specifications N/A
Begin Construction
Complete Construction
-3

4 . Alternative Analysis Evaluation: Has the facility evaluated all f
1 0
Y Y
the non-discharge options available. Please provide regional
perspective for each option evaluated. Yes,
Spray Irrigations insufficient land area
Connection to Regional Sewer System: Not available
Subsurface: unsuitable soil
other disposal options: not available
5. Other Special Items: None
PART IV - EVALUATION AND RECOMMENDATIONS
Issue certificate of coverage. Drainage area above the point of
discharge is 1 . 2 sq mi ._ Only 0 .45 sq mile is required. Site meets DWQ' s
requirements for single family dwellings.
ignature of Report Prepares
ater Qu ity Regional Supervisor r 0tDa
-4

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.. . . ,.
II
WATER POLLUTION CONTROL SYSTEM OPERATORS
CERTIFICATION COMMISSION
CLASSIFICATION
RATING SHEET FOR WATER POLLUTION CONTROL SYSTEMS
FACILITY INFORMATION:
NAME OF FACILITY:
MAILING ADDRESS: r 2ze-) Gz ��cG ZL74
r
COUNTY: i3u
CONTACT PERSON: a l-e� G ,T1fr TELEPHONE:
PERMIT NO: Check One: NC WQ HEALTH DP
ORC: TELEPHONE: ( )
RATING INFORMATION: (Before completing this section,please refer to pages 2-4)
PERMITTED FLOW: tJ,d6)6, Io MGD BNR. YES NO
CHECK CLASSIFICATION: WASTEWATER: 1 1z 2 3 4
COLLECTION: 1 2 - 3 4
SPRAY IRRIGATION SUBSURFACE LAND APPLICATION
PHYSICAL/CHEMICAL GRADE I GRADE II
RATED BY: REGION: ' DATE:
REGIONAL OFFICE TELEPHONE NUMBER: ( l / EXT:

JUN-13-2001 13 27 FROM DE WATER QUALITY SECTION TO ARO P.03iO3
May 4,2001
MEMORANDUM
To: Hornlean Chen
Division of Environmental Health
From, Mack Wiggins
Subject: Review of the discharge locations for the following;
Karen Weatherman Residence
Burke County 4 : 1 12 2001
NCG551138
U';iR - YvATER GUAL"
PO;NT SOURCE BRANCH
Please indicate Mow your agency's position or viewpoint on the facility listed above.
Attached is the staff report for the facility. We cannot issue the permit without your
concurrence. please return this form at your earliest convience_
RESPONSE:
_ This agency has reviewed the draft permit and determined that the proposed
discharge will not be sufficiently close to any existing or known proposed
public water supply intake so as to create an adverse effect on water duality_
We concur with the issuance of this permit provided the facility is operated
and maintained properly, the stated effluent limits are met prior to discharge,
and the discharge does not contravene the designated water quality standards.
Concurs with issuance of the above permit, provided the following conditions
a e met: - I( 9 Ti
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Opposes the issuance of the above permit, based on reasons stated below, or
attached:
FA_. [ T 't'1 i&p Cr
too SA t ow it tit
N PR - ` 4-
7 - A-
L Q t t
Signed Date:
cc: lrie
UN 2001
TOTAL P.03