NCG550381_Regional Office Historical File 20200520

ROY COOPER
Go..
MICHAEL S.REGAN
NC Secretary
Waterftwwres S.JAY ZIMMERMAN
m e aaMOML umraua ooean.
September 5,2017
Donna Lipuma
732 Hidden Valley Rd.
Clyde,NC 28721
SUBJECT: Ownership Change/Inspection Follow-up ®d0y
732 Hidden Valley Rd.
Certificate of Coverage: NCG550381
Haywood County,NC
Dear Ms. Lipuma:
Our records indicate the deficiencies listed on the inspection report conducted on October 28,
2016 have not been addressed. In February of this year,we discussed what steps to take to bring
your system back into compliance. Additionally, on February 17, 2017, a letter was mailed to
732 Hidden Valley Dr., which contained an ownership change form and the NCG550000
General NPDES Permit. I attempted to call on.May 3, 2017 to further discuss this matter;
however, the number on file appears to have been disconnected.
We request you contact the Asheville Regional Office as soon as possible to discuss the status of
the system and to determine what steps have been taken to bring the system back into
compliance. I have attached the ownership change form and NCG550000 Technical Bulletin. I
can be reached directly by phone at 828-296-4686 or by email at [e-mail].
Your help in resolving this matter is appreciated.
Sincerely,
0ocu5l sew qqq
COWMSE02434M-
.
Mikal Willmer
Environmental Specialist
Asheville Regional Office
Attachments:Ownership Change Form
NCG550000 Technical Bulletin
cc- MSC 1617-Central Files _
WQ Asheville Files
State ofNoeh C=Iim I Eevirm enml Qeality I Water Resources
2090 U.S.70 Highw,Swannanoa,NC 28779
828-296-4500

0:\WR\WQ\Haywood\Wastewater\GeneralWCO55 SFR\NCG550381-DonY.&Lipuma\Inspect.October28,2016\NCO550381-
Inquiry Letter-2nd mailing.doox

ROY COOPER
Gorernor
_. . . MICHAEL S.REGAN
re
Secretary
warerRewurces S.JAY ZIMMERMAN
ENVIRONMENTAL OUALnY DhK,Iar
PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION:
Permit Number: nc vSS v� st
1. Facility Name: 'T''1'1 tar.�r Vale R ,i .
II. NEW OWNERMAME INFORMATION:
1. This request for a name change is a result of:
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://poftal.ncdem.org/web/wq

Applicant's Certification:
I, 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
1
Version 1212015

®�A
NCDENR
NORTH CAROLINA DIVISION OF WATER QUALITY
Revised May 24,2010
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 chlormation/dechlotmation (or equivalent means of
domestic wastewater may be covered under this permit disinfection)and post-aeration apparatus.
with the approval ofthe 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.
• Dechlormation 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 Maintaining Your Septic Tank
with 15A 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 dramfield. Both the septic tank and
in Part I, 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 Yom'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 D:1) • 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 you garbage disposal.
system that could significantly increase the quantity • Do not pow 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 II, Section • Keep automobiles and heavy equipment off of the
E:3) septic tank and drain field.
• Submission o£mommaing reports is not required. All
monitoring information must be retained on site for a Chlorination and Dechlormation Tablets
periodof3years, (Part B,Section E:H
If the treatment system has a chlorinator or dcchlorinator,
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 slicking up from the chlorinator/dechlorinator
constructed) systems site 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 rate is when measuring the value of pH. pH
Signs of Septic System Problems values should be measured in the field because they
may change considerably between when the sample
Some of thesigns 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 time 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?
Right-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
penalties from obtaining all necessary right-of-way or expiration of the General Permit, you will receive a
casement rights to discharge wastewater on or across renewal notice in the mail from the Division.
another property.
Contact Us
Freauently Asked Onestions
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 H, pax: [phone]
Section EA)
{ You may also contact your local Regional Office at:
2) Do I need to employ a certified wastewater
treaysttment plant operator to manage and run the Asheville: [phone]
sem? Mooresville: [phone]
Not at this time. The Division's Operator Training Winston-Salem: [phone]
and Certification Unit does not currently plan to Raleigh: [phone]
classify these types of facilities for the purposes of Fayetteville: [phone]
needing a certified operator. The requirement was Washington: [phone]
left in the permit at this time with clarification,in the Wilmington: [phone]
event that classification was assigned in the future.
(Part 11,Section C:1) The NPDES Permitting Program can be found online at
htt ,//aortal nodrn e/ b/ / wo/ns/nnd .Another
3) Where do I find my stream classification? source of information is the DENR Customer Service
The stream classification, Le, W S-IV, C,Tr, etc. can Center.They may be reached at 1-877-NC ENR 4 U(]-
usually be found in the Certificate of Coverage. .If 877-623-6748). An additional source of information is
you are unsure of your stream classification,you can the North Carolina Division of Pollution Prevention and
contact the NPDES Permitting Program. Environmental Assistance. They have information on
how to minimize pollutants at various types of industries.
They may be reached at(919)715-6500.

ROY COOPER
G,,rcrnnr
MICHAEL S. REGAN
seeernr,
WaterRaourm S. JAY ZIMMERMAN
WARQ or4 M4VAaev:
Director -
February 17,2017
Dona Lipuma
732 Hidden Valley Rd.
Clyde,NC 28721
SUBJECT: Ownership Change Form
732 Hidden Valley Rd.
Permit No: NCG5500381
Haywood County,NC
Dear Ms. Lipuma:
Attached, you will find the form you requested and will need to complete in order to transfer the
NCG5500381 Certificate of Coverage under your name. You can submit this, along with a copy
of the deed or bill of sale,to the Raleigh address indicated on the back of the form. Once you have
submitted the form, please let me know by phone or email, as this process can take a couple of
months to update in our system. Also, as a reminder, the NCG550000 permit has an associated
annual fee of$60. I have also attached a copy of the General NPDES Permit for your records,
.. .: . If:you have any questions, please feel free to contact me at 828-296-4686 or by email at
[e-mail].
Sincerely
Mikal Willmer
Environmental Specialist
Asheville Regional Office -
Enclosure: Name/Ownership Change Form
NCG550000 General NPDES Permit
cc: MSC 1617-Central Files
WQ Asheville Files
G:\WR\WQ\Haywood\Wastewater\General\NCG55 SFR\NCG550381-Dony&Lipuma\inspect.October 28,2016\NCG550381-
Name0vn ership Change Form Letter.doex
State ofNonh Carolina I Environmental Quality I Water Resou ces
2090 Us.70 Highway,Swarmanoa,NC 28778
828-296-4500

FRT MCCRORY
Nor
DONALD A. VAN'DF-R VAARI
SNnfm .
WMterkesourmN
c{auin*WWfai WAL" 5. SAY:21MMERMAN
Certified Mail #7015 1520 0003 5463 1315
Return Receipt Requested
November 21, 2016
Sherlea Dory & Dona Upuma
732 Hidden Valley Rd.
Clyde, NC 28721
SUBJECT: NOTICE OF DEFICIENCY
Tracking Number: NOD-2016-PC-0572
Permit No. NCG550381
732 Hidden Valley Road
Haywood County
Dear Permittee:
Your property located at 732 Hidden Valley Rd. has a General NPDES permit with the State of North Carolina. This
permit is for a Single Family Residence (SFR) wastewater treatment system that discharges into a waters of the
State. As owners, you are responsible for maintaining this system in compliance with the current NCG550000
permit. A copy of this permit can be found online at http://dea nc oov/about/divisions/water-resources/water-
resources-permits/wastewater-bra nch/n pdes-wastewater/general-perm its
The North Carolina Division of Water Resources conducted an inspection at 732 Hidden Valley.Road on
October 28, 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. NCG550381. 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 (ARO). The following deficiencies were noted during the inspection:
Inspection Area Description of Deficiencies
Effluent Sampling Annual sampling records were not available at the time of inspection. [NC43550000 Part I.
A. Effluent Limitations and Monitoring Requirements (see
table in NCG550000 permit))
Effluent Pipe Effluent pipe was damaged and clogged with sediment. [NCG550000 Part I. A. 4.
(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 Owner is not the listed permittee. Change of ownership needed,
Septic Tank Septic tank maintenance records were not available at the time of inspection. [NCGSS0000
Part I. A.3. Permit Conditions(Operations&Maintenance) Septic tanks shall be
inspected at least yearly to determine if solids must be removed or if other
maintenance is necessary. Septic tanks shall be pumped out every five years or
when the solids level is found to be more than 1/3 of the liquid depth in any
compartment.]
Corrective Measures for deficiencies noted above:
Effluent Sampling: Sample or document no discharge and submit to ARO.
Permit: Complete and submit enclosed Name/Ownership Change Form to Raleigh.
Septic Tank: Provide receipt of septic tank maintenance records to ARO.
Effluent Pipe: Repair effluent pipe. Submit documentation of repair to ARO.
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.
A Technical Bulletin, detailing the key points of the NCG550000 permit, is attached for your records. If you should
have any questions, please do not hesitate to contact Mal Willmer with the Water Quality Regional Operations
Section in the Asheville Regional Office at 828-296-4686 or by email at [e-mail].
Sincerely,
c- G. Landon D don, P�Supervisor
Water Quality Regional Operations Section
Asheville Regional Once
Division of Water Resources, NCDEQ
ATTACHMENTS: Inspection Report
Name/Ownership Change Form
Technical Bulletin
Cc: WQS Asheville Regional Office-Enforcement File
NPDES Compliance/Enforcement Unit-Enforcement File
G:\WR\WQ\Haywood\Wastewater\General\NCG55 SFR\NCG550381-bony&Lipuma\Inspect.October 28, 2016\NOD-2016-PC-0572.doc

Unitad states Environmental Protection Agency Form Approver).
EPA Washington,D.c 20460 OMB No.2040-0057
Water Compliance Inspection Report Approval rosettes 8-31-98
Section A:National Data System Coding(i.e.,PCS)
Transaction Code NPDES stir tlay Inspection Type Inspector Fee Type
1 IN I 2 Is 1 3 1 NCG550381 111 12 16/10,28 17 1s L 19 1 c 1 20I I
211 1 1 1 I I 1 I I I 11 1 1 1 1 1 I I 1 I I I I I I 1 I 1 I 1 1 I I 1 11 I 1 1 1 1 IB6
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 CA —Reserved —
671�I 70 L 71 I 72 L 73 I 74 75I I I I I80
Section 8:Facility Data
Name and Location of Faculty Inspect"(For Industrial Users discharging to POTW,also lnclutle Entry TlmelDate Permit Effective Data
POTW name and NPDES permit Number) 12'80PM 10I10I28 13I08101
732 Hidden Valley Read
732 Hidden Vly Rd Exit mmelDam Permit Exaltation Date
Clyde NC 28721 01 U0PM 16110128 18107131
Name(a)a Onsite Representative(s)?itles(s)IPhone and Fax Numbers) Other Facility Data
111
Name,Address of Responsible OfGciayfitle/Phone and Fax Number
"5, her\eux Qan� 4 y�M L;p4yrlc>„ Contacted
No
Section C:Areas Evaluated During Inspection(Check only those areas evaluated)
Permit E Operations 8 Maintenance E Self-Monitoring Program E Facility Site Review
EHIuentlRectiving Waters
Section D:Summary of Finding/Comments(Attach additional sheets of partitive and checklists as necessary)
(See attachment summary)
Names)and Signature(s)of lnspecti Age aylOrce/Phare and Fax Numbers Data
Daniel J Boss /"""-���'2 ARO WQ11828-298.46581
Mika] Wilmer �.l a ARO M11828-296-46861 It, it
Signature of Management Q A Reelewer LJ Agency/OfhcelPhone and Fare Numbers Date
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.
Paget

NPDES yrlmolday Inspeolion Type - (Cont.) 1
3
NCG550301
{
12
i8110128 17 18 u
Section D:Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
Inspectors Mikal Wllmer and Dan Boss with the Asheville Regional Office(ARO)conducted a
Compliance Evaluation Inspection on 10/28/2016 at 732 Hidden Valley Rd. The inspectors were unable
to contact or meet the current owners onsite. The property appeared to be well maintained.
We were unable to acquire sampling records or septic tank maintance records.The effluent pipe was
damaged with cracks and was filled with sediment
No discharge was occuring at the time of the Inspection.
The current owner is not the listed permittee. Change of ownership is needed.
1
Page# 2

Permit NCG550381 Owner-Facility: 732 Hidden Valley Road
Inspection Date: 10128/2016 Inepectlon Type: Complienca Evaluation -
Operations& Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? M ❑ ❑ ❑
Does the facility analyze process control parameters,for ex: MLSS, MORT, Settleable ❑ ❑ ❑
Solids,pH, DO, Sludge Judge,and other that are applicable?
Comment: Property was well maintained.
Permit .Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new ❑ ❑ 0 ❑
application?
Is the facility as described in the permit? -0 ❑ ❑ ❑
#Are there any special conditions for the permit? ❑ ❑ 0 ❑
Is access to the plant site restricted to the general public? ❑ ❑ 0 ❑
Is the inspector granted access to all areas for inspection? 0 ❑ ❑ ❑
Comment: Current listed permiltee is not the owner. Change of ownership is needed. -
Septic Tank Yes No NA NE
(If pumps are used)Is an audible and visual alarm operational? ❑ ❑ ■ ❑
Is septic tank pumped on a schedule? ❑ 0 ❑ ❑
Are pumps or syphons operating properly? ❑ ❑ M ❑
Are high and low water alarms operating properly? ❑ ❑ ❑
Comment: Septic tank maintenance records were not available at the time of inspection
Effluent Pipe Yes No NA NE
Is right of way to the oulfall properly maintained? 0 ❑ ❑ ❑
Are the receiving water free of foam other than trace amounts and other debris? 0 ❑ ❑ ❑
If effluent (diffuser pipes are required) are they operating properly? ❑ ❑ M ❑
Comment: Sediment in outfall pipe. Pipe was also damaged.
Effluent Sampling Yes No NA NE
Is composite sampling flow proportional? ❑ ❑ M ❑
Is sample collected below all treatment units? - ❑ ❑ 0 ❑
Is proper volume collected? ❑ ❑ ■ ❑
Is the tubing clean? ❑ ❑ ■ ❑
#Is proper temperature set for sample storage(kept at less than or equal to 6.0 degrees ❑. ❑ 0 ❑
Celsius)?
Page# 3

Permit NCG550381 - Owner.Facility: 732 Hidden Valley Road
1 Inspection Date: 1012MO16 Inspection Type: Compliance Evaluation
Effluent Sandolina Yes No NA NE
Is the facility sampling performed as required by the permit(frequency,sampling type - ❑ M ❑ ❑
representative)?
Comment: Annual sampling records were not available at the time of inspection The system was not
discharging during the inspection.
1
Page# 4

Inspection Date: 10-' &-\�p Start Time: t`�`3� End Time:
SINGLE FAMILY WASTEWATER SYSTEM CHECKLIST
1/5/2015
Permittee: d- Ocnc� Permit: nCl>. SS o3& )
Address: 735 PrtdR .., Vu\\w \QA E-mail-
Phone:(O:ru)- Cell Phone:= County: i
S(�T— The Permittee is responsible for the operation and maintenance of the entire wastewater treatment and dispose ystem.
Doesn't Did Not
Yes No Apply Investigate
1. Is the current resident in the home the Permittee? Lj Li
2. If not does the resident rent from the permittee? ❑. ❑
El El
3. Change of Ownership form needed?(mail the form with the inspection letter) 0
4. Is there a inspection and maintenance agreement with a contractor? El 0 EJ El
5. If yes to#4 who is the contractor?
SEPTIC TANK The septic tank and titers should be checked annually and pumped/cleaned as needed.
6. Is all wastewater from the home connected to the septic tank? ❑ ❑
7. Does the permittee/resident know where the septic tank is located? ❑ EJ El ❑
8. Has the septic tank been pumped in the last 5 years? El 1:1 El ❑
9. If yes to#8 date, if known If proof, describe
10. Does the septic tank have an EFFLUENT FILTER or SANITARY T? (circle one)
11. If Yes to filter when was the filter cleaned? By whom?
SAND FILTER I TREATMENT PODS YES Nj�- NO If no proceed to the next section.
Accessible sand filter surfaces shall be raked and leveled every six months and any vegetative growth shall be removed manually.
12. Is system something other than a sand filter?
13. If yes,what kind? (examples-Peat, Textile, Other or brand name-Advantex, etc.)
14, Does the permittee know where the filter is located? ❑ El El ❑
15. Does the filter require maintenance?
If mainlenace is required explain in the comment section.
DISINFECTION I UV YES Lj NO JZ If no proceed to the next section.
The.ultraviolet unit shall be checked weekly.The lamps and sleeves should be cleaned or replaced as needed to ensure proper disinfection.
16. Is UV working? El ❑
El El
17. Has the UV Unit been serviced and bulbs cleaned?
18. Who completes the weekly check for the UV?( Non-Discharge)
DISINFECTION/TABLETS YES NO If no proceed to the next section.
The tablet chlorinator unit shall be checked weekly to ensure continuous and proper operation.
19. Does the permittee have the correct chlorine tablets?(If none, mark No) ❑ El ❑
20, Does the Permittee know the location of the chlorinator? ❑ ❑ El ❑
21. Were chlorine tablets observed in the chlorinator? EJ El 1:1 El
22. Are tablets contacting water? If possible poke them to determine. El El El El
DECHLOR(Discharge only) YES NO Lt If no proceed to the next section.
The dechlodnator unit shall be checked weekly to ensure continuous and proper operation.
23. Does the permiltee know where the dechlor is? El El El ❑
24. Does the permittee have the correct dechlor tablets? ❑
25. Were dechlor tablets observed in the dechlorination chamber? ❑

Doesn't Did Not
Yes No Apply Investigate
26 Are tablets contacting water? If possible poke them to determine. ❑
1 PUMP TANK YES NO If no proceed to the next section.
All pump and alarm sylems shall be Inspected monthly.(nonAischarge)
27, Is the pump working?. ❑ ❑ ❑ ❑
28. Are the audible and visual high water alarms operational? ❑ ❑ El ❑
29. Does the permittee know how to check the pump&high water alarm? ❑ ❑ ❑ ❑
30. Last functional test?
DISCHARGE ONLY YES TI NO If no proceed to the next section.
A visual review of the oulfall location shall be executed twice each year(one at the time of sampling to ensure no visible solids or evidence of a malfunction.
31. Does the permittee know where the outfall is located? ❑ ❑ ❑ ❑
32. Were you able to locate the oulfall? EB ❑ E:1 ❑
33. Is the end of the discharge pipe visible? If not, explain why. ® ❑ ❑
34. Is outlet discharging? 0 ® ❑ ❑
35. Is right of way maintained around the discharge point? ® ❑ ❑ ❑
36. Any Lab Results available? ❑ ❑ , ❑ ❑
37. Is there evidence of solids around the discharge paint? ❑ 'I ❑ ❑
DRIP or SPRAY YES NO If no proceed to the next section.
j The irrigation system shall be inspected monthly to ensure the system Is free of leaks and equipment is operating as designed.
1 38. Is the system DRIP or IRRIGATION (circle one)? If irrigation number of sprinkler heads.
39. Are the buffers adequate? ❑ ❑ ❑ ❑
40. Is the site free of ponding and runoff? ❑ ❑ ❑ ❑
41, Does the application equipment appear to be working properly? ❑ ❑ ❑
El
42, Is there a minimum two wire fence surrounding entire irrigation area? ❑ ❑ ❑ ❑
GENERAL
43.Are the treatment units locked and or secured? ❑❑ 0 I�I El ElElt� ❑
44. Has resident had any sewage problems? If yes explain in the comment section. -
45. Does the system match the permit description? if no explain In the comment section. ® ❑ ❑ ❑
46. Is the system compliant? ❑ ❑ ❑ ❑
47. Is the system failing? If yes,take pictures if passible. ❑ ® ❑ ❑
! 48. If system is failing, any sign of children or animals contacting sewage? ❑ ❑
NOD Sent#: - :1rn�o -�_- o� 3- NOV Sent
Comments: Photos Taken? 'YES NO Lj
(c'-' . b6'. b1.t SoF, Icn4
in's rzo c m sC h r
C'aro(- Z 4

���
ICE I�R d.
North Carolina Department of Environment and Natural Resourc Le
Division of Water Quality
Pat McCrory Thomas A.Reeder John E.Skvarla, III
Governor Acting Director Secretary
July 23, 2013
Brian R. Dix
N C Group LLC
14300 Hatten Lane
Gulfport MS 39503
SUBJECT: Compliance Evaluation Inspection
732 Hidden Valley Road
Permit No: NCG550381
Haywood County
Dear Mr. Dix:
Enclosed please find a copy of the compliance evaluation inspection conducted on
July 10, 2013. No violations of permit requirements or applicable regulations were
observed during this inspection.
Please refer to the enclosed inspection report for additional observations and
comments. If you or your staff have any questions, pl se all me at 828-296-4500.
Sincerely,
Jeff Menzel
Environmental Specialist
Enclosure
cc: Central Files
Asheville Files
SURFACE WATER PROTECTION—ASHEVILLE REGIONAL OFFICE
Location:2090 U.S.Highway 70,Swannanoa,NC 28778 NOnTLbCaiGtlrl3
Phone::ww .nmat00\FAx:ora 299-7043 Naturally
Internet:Ha w.nod\Wastewat.om
S:\SWP\HeywooC\WaatewateAGeneral\NCG55 SFR\NCG550381 CEI 2013.tloc

unites statetNaaehin9bn,oL.2oaEo an Age
Form Approved.
EPA OMB No.2040-0057
Water Gamplianrp. Int;pPirtinn RPpOrt —]Approval expires 8-31-98
Section A: National Data System Coding(i.e., PCS)
Transaction Coda NPDES yrlmolday, Inspection Type Inspector Fac Type
t Ir,J 2I ,1 3I NCG550381 I11 12I 13/07/10 I17 181 r1 181c1 201 I
LJ J Remarks LJ Ll LJ
21I1IIIIIIIIIIIIIIIIIIIIIIIIIIIIII Jill IIII Jill III6
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 CIA -------------------Reserved-----------------
67I I69 701 I 711 ty I 721n�I ]3II I 174 75I I I I I I80
LJ Section B: Facility Data LJ
Name and Location of Facility Inspected(For Industrial Users discharging to POTW,also include Entry Time/Date Permit Effective Date
POND name and NPDES permit Number)
732 Hidden Valley Read 12:00 PM 13/07/10 12/08/01
732 Hidden Vly Rd Exit Time/Date Permit Expiration Date
Clyde NC 28721 12:30 PM 13/07/10 13/07/31
Nams(s)of Onsite Representative(s)/Titles(syPhone and Fax Numbers) Other Facility Data
///
Name,Address of Responsible OfficielRltle/Phone and Fax Number
Brian R Dix,14300 Hatton Ln Gulfport MS 395031/228-539-00541 Contacted
No
Section C: Areas Evaluated During Inspection Check only those areas evaluated
Facility Site Review M Effluent/Receiving Waters
Section D: Summary of Finding/Comments Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(.)and Signa'tl (.) Inspector(.) Agency/Ofice/Phone and Fax Numbers Dale
Jeff Menzel ARO WO//828-288-4500/ 7/1qli,
Signature of Management O A Reviewer Agency/Office/Phone and Fax Numbers D to
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.
Page p 1

NPDES yr/mo/day Inapsdim Type
31 NGG550381 I11 12I 13/07/10 I17 18I^I
Section D: Summary of Finding/Comments(Attach additional sheetsof narrative and checklists as necessary)
No problems were noted with the subsurface sandfilter. The owner should be sure that the septic is
pumped at least once every five years. Additional comments concerning sandfilters are on the attached
technical bulletin.
Page# 2

permit: NCG550381 Owner�Facility: 732 Hidden Valley Road
Inspection Date: 0 7/1 02 01 3 Inspection Type: Compliance Evaluation
Effluent Pipe Yes No NA NE
Is right of way to the ouffall properly maintained? ■ 0 0 0
Are the receiving water free of foam other than trace amounts and other debris? ■ 0 0 ❑
If effluent (diffuser pipes are required) are they operating properly? ❑ 0 ■ 0
Comment: The facility was discharging at the time of inspection.
Page# 3

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
Brian R. Dix
NC Group,LLC
14300 Herten Lane
Gulfport,MS 39503
Subject: Renewal of coverage/General Permit NCG550000
732 Hidden Valley Road
Certificate of Coverage NCG550381
Haywood County
Dear Permittee:
In accordance with your renewal application [received on March 8,2007],the Division is renewing
Certificate of Coverage(CoC)NCG550381 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.
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 Toys.
Fields [919 733-5083,extension 551 or tova.fields@ncmail nett or Susan Wilson [919 733-5083,extension 510
or susan.a.wilson@ncmail net].
Sincerely,
for Colson H. Sullins ,
ee: Central Files E (va h�
Asheville Regional Office/Surface Water Protection I III
NPDESfile --
1 JUL 1 1 7001 i [
1617 Mail Service Center,Raleigh,North Carolina 27699 1617
512 North Salisbury Street,Resign,Noah Contra 27604 rtvRi� C tN'__LO111R
Phone: [phone]a3/FAX[phone]/intemet,w .newaterquallty.org _ 1C] 4rC.aro,lIn
An Equal Opportunity/Affirmative Action Employer-50%Recycledl Post Consumer Paper �-

STATE OF NORTH CAROLINA
1 DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG550381
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,
j Brian R. Dix
NC Group, LLC
is hereby authorized to discharge domestic wastewater [360 GPD] from a facility located at
732 Hidden Valley Road
Clyde
Haywood County
to receiving waters designated as Bald Creek in subbasin 04-03-05 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.
d
Signed this day July 27, 2007.
V
for Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

NCDENR JAN 1 6 2007
North Carolina Department of Environment an� N tur Resources
Division of Water Quality WATER QUALITY SFCTIQN
Michael F. Easley,Governor
Alan W. Klimek, P.E.,Director i
January 9, 2007
Jane Watson
321 Harvey St
Punta Gorda, FL 33950
Subject: Renewal Notice/General Permit NCG550000
Certificate of Coverage NCG550381
Haywood 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 August 1, 2002.
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 for 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
seuarately by the Division's Budget Office. No money is required for this
Procedure. The Annual Fee is like the fee you annually pay the DNW 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
wr 1
512 North Salisbury Street,Raleigh,North Carolina 27604 N Cal'011llfl
Phone, 919733-5083,extension 511/FAX [phone]/chance [e-mail] '/
An Equal Opportunity/Affirmative Action Employer—50%Recycled/10%Post Consumer Paper Naturally turrylly

NCG550381 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 t4.e,address listed below the signature block.
If you have any questions concerning this matter, please contact me aE'Me teleplioke 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,
�- v��
Charles H. Weaver,Jr.
NPDES Unit
i
cc: Central Files
(,Asheville Regional Office/Larry Frosd
NPDES file

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor NCDENR
William G. Ross Jr., Secretary
Alan W. Klimek, P.E., Director NORTM CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
July 26,2002
JANE J WATSON
WATSON JANE-RESIDENCE
321 HARVEY ST
PUNTA GORDA, Fl, 33950
Subject: Reissue-NPDES Wastewater Discharge Permit
Watson Jane-Residence
COC Number NCG550381
Haywood County
Dear Permittee:
In response to your renewal application for continued coverage under general permit NCG550000,the Division of
Water Quality(DWQ)is forwarding herewith the reissued wastewater general permit Certificate of Coverage
(COC). This COC is reissued pursuant to the requirements of North Carolina General Statute 143-215.1 and the
Memorandum of Agreement between the state of North Carolina and the U.S.Environmental Protection Agency,
dated May 9, 1994(or as subsquently amended).
The following information is included with your permit package:
' A copy of the Certificate of Coverage for your treatment facility
* A copy of General Wastewater Discharge Permit NCO550000
* A copy of a Technical Bulletin for General Wastewater Discharge Permit NCG550000
Your coverage under this general permit is not transferable except after notice to DWQ. The Division may require
modification or revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal
requirements to obtain other permits which may be required by DENR or relieve the permittee from responsibility
for compliance with any other applicable federal,state,or local law rule,standard,ordinance,order,judgment,or
decree.
Please note that effective January 1, 1999 the fees for all permits issued by DWQ were changed. This changed the
fee for your wastewater general permit coverage from a$240 fee paid once every five years to a yearly fee of$50.
If you have not already been billed this year for the yearly fee,you will receive a bill later this year.
If you have any questions regarding this permit package please contact Mack Wiggins of the Central Office
Stormwater and General Permits Unit at(919)733-5083,ext.542
Sincerely,for Alan W.Klimek,P.E.
cc: Central Files
Stormwater&General Permits Unit Files
Asheville Regional Office
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] FAX [phone]
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 -
Michael F. Easley, Governor NCDENR
William G. Ross Jr., Secretary
Gregory J. Thorpe, Ph.D., Acting Director NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL.RESOURCES
11/26/01 .
JANEI WATSON 41JEG I 0 2001 l;'
WATSON JANE-RESIDENCE
321 HARVEY ST
PUNTA GORDA, FL 33950 I"
r tire..
Subject: NPDES Wastewater Permit Coverage Renewal
Watson Jane-Residence
COC Number NCG550381
Haywood County
Dear Permittee:
Your residence or facility is currently covered for wastewater discharge under General Permit NCG550000. This
permit expires on July 31,2002. Division of Water Quality(DWQ)staff is in the process of rewriting this permit
with a scheduled reissue in the summer of 2002. Once the permit is reissued,your residence or facility would he
eligible for continued coverage under the ruismed permit.
In order to assure your continued coverage under the general permit,you must apply to the DWQ for renewal of
your permit coverage. To make this renewal process easier,we are informing you in advance that your permit will
be expiring. Enclosed you will find a general permit coverage renewal application form. This will serve as
your application for renewal of your permit coverage. The application must be completed and returned with the
required information by February 01,2002 in order to assure continued coverage under the general permit.There is
no renewal fee associated with this process.
Failure to request renewal within this time period may result in a civil assessment of at least$250.00. Larger
penalties may be assessed depending on the delinquency of the request. Discharge of wastewater from your
residence or facility without coverage under a valid wastewater NPDES permit would constitute a violation of
NCGS 143-215.1 and could result in assessments of civil penalties of up to$10,000 per day.
If the subject wastewater discharge to waters of the state has been terminated,please complete the enclosed
rescission request form. Mailing instructions are listed on the bottom of the form. You will be notified when the
rescission process has been completed.
If you have any questions regarding the permit coverage renewal IN please contact the Asheville Regional
Office at 828-251-6208 or Mack Wiggins of the Central Office Stormwater Unit at(919)733-5083,ext. 542
Sincerely,
&-wnc—
Bradley Bennett,Supervisor
Stormwater and General Permits Unit
cc: Central Piles
Stormwater and General Permits Unit Files
Asheville Regional Office
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] FAX [phone]
An Equal Oppodunity Affirmative Action Employer 50%recycled/10%post-consumer paper

State of North Carolina
Department of Environment,
Health and Natural Resources A • �/
Division of Water Quality
James B. Hunt, Jr., Governor ID FEE N R
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director July 21, 1997
Jane J. Watson
321 Harvey Street
Punta Gorda,FL 33950
Subject: Certificate of Coverage No. NCG550381
Renewal of General Permit
Watson,Jane-Residence
Haywood County
Dear Permittee:
In accordance with your application for renewal of the subject Certificate of Coverage,the Division is forwarding
the enclosed General Permit. This renewal is valid from the effective date on the permit until July 31,2002. 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 have
the right to request an individual permit by submitting an individual permit application. Unless such demand is
made, this Certificate of Coverage shall be final and binding.
The Certificate of Coverage for your facility is not transferable except after notice to the Division. Use the enclosed
Permit Name/Ownership Change form to notify the Division if you sell or otherwise transfer ownership of the
subject facility. The Division may require modification or revocation and reissuance of the Certificate of Coverage.
If your facility ceases discharge of wastewater before the expiration date of this permit, contact the Regional
Office listed below at [phone]. Once discharge from your facility has ceased, this permit may be rescinded.
This permit does not affect the legal requirements to obtain other permits which may be required by the Division of
Water Quality, 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 the NPDES Group at the address below.
Sincerely,
cc Central Files A.Preston Howard,Jr.,P;5,
6_
Asheville Regional Office
NPDES Group
Facility Assessment Unit
Q '
P.O. Box 29535, Raleigh, North Carolina 27626-0635 [phone] FAX[phone] p&[e-mail]
An Equal Opportunity Affirmative Action Employer 50%recycled /10%post-consumer paper

STATE OF NORTH CAROLINA -- -
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO.NCG550000
CERTIFICATE OF COVERAGE NO. NCG550381
TO DISCHARGE DOMESTIC WASTEWATERFROM 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,
Jane J. Watson
is hereby authorized to operate a wastewater treatment facility which includes a septic tank, sand filter
and associated appurtenances with the discharge of treated wastewater from a facility
located at
Watson,Jane-Residence
732 Hidden Valley Road
'I Clyde
Haywood County
to receiving waters designated as subbasin 40305 in 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 of General Permit No. NCG550000 as attached.
This certificate of coverage shall become effective August 1, 1997.
This certificate of coverage shall remain in effect for the duration of the General Permit. _
Signed this day July 21, 1997.
I�A. Preston Howard,Jr., P.E., Director
6 Division of Water Quality
By Authority of the Environmental Management Commission

aJATfi Michael F.Easley,Governor
William G Ross Jr.,Secretary
North Carolina Department of Envir an Nat al Reso�ypG',9,�„
;AISn W. ma P.E.DlrgctHy"
> r•. Divbt
i nc D
P Y
Asheville Regional Office
SURFACE WATER PROTECTION
November 21, 2006
Jane J Watson
321 Harvey St
Punta Gorda FL 33950
SUBJECT: Compliance Evaluation Inspection
Watson Residence SFR
Permit No: NCG550381
Haywood County
Dear Ms Watson:
Enclosed please find a copy of the Compliance Evaluation Inspection form from
the inspection conducted on November 7, 2006. Larry Frost and I of the Asheville
Regional Office conducted the Compliance Evaluation Inspection. The facility was found
to be in Compliance with permit NCG550381.
Please refer to the enclosed inspection report and technical bulletin for additional
observations and comments. If you have any questions, please do not hesitate to call me
at 828-296-4500.
Sincerely,
Keith Hayn s
Environmental Specialist
Enclosure
cc: Central Files
Asheville Files
IN
hCam ina
h r ,),hi
2090 U.S.Highway 70,Swannanoa, NC 28778 Telephone:[phone]D Fax:[phone] Customer Service 1 877 623-6748

United States Environmental Protection Agency Form Approvetl.
EPA Washington,o c.zwso OMB No 2040-0057
Water Compliance Inspection Re ort Approval expires 8a1-96
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day I Inspection Type Inspector Fac Type
1 1 141 2 U 31 NCG5503e1 11 121 06/11/01 17 1BIrl 191 c1 zol
Remarks LJ L LJ
2111111111111111IIIIII11111111111111111111111111ti
Inspection Work Days Facility Self-Monitoring Evaluation Rai B1 CA --------------------------Reserved--------------.------
67I 69 701 I 711 72 Lnj 731 174 75 I 190
Section B: Facility Data
Name and Location of Facility Inspected(Far Industrial Users discharging to POND,also include Entry Time/Date Permit Effective Data
POTW name and NPDES.permit Number)
[Vatsnn Sane- Residence
02:15 en (lb/11/07 02/0a/O1
732 hidden Vl.y Rd Exit Time/Date Permit Expiration Date
Clyde NC ::8921 02:35 EM Ofi/11/07 07/0'+/31
Names)of Onslte Representative(s)/Tltles(s)/Phone and Fax Numbers) Other Facility Data
Name,Address of Responsible Official/Title/Phone and Fax Number
aane J tuaCeon,321 xarvey St Pu:ca 1-1a 11, 33`)60//818-121-1,11/ Contacted
14.
Section C: Areas Evaluated During Inspection(Check only those areas evaluated)
Facility Site Review 0 Effluent/Receiving Waters
Section D: Summary of Finding/Comments Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Names)and Signatures)of Inspectors) Agency/OffcelPhone and Fax Numbers Date
Lary -iosa �✓ ARC wU//020-296-4500 Ezt.965x/ ///, X
Keith Sayne.10 ARC NQ//828-296-45t10/ Lt 1
Signature of Management A Revlewer Agency/Office/Phone and Fax Numbers Data
ao9ec C Edvarda LRO wQ//028-256-950C/ It �t
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.
Page# 1

NPDES yr/molday hn pmtlm Type
3_ L 5503E1 j11 12I 06/-Up9 j17 1a1-i -
Section D: Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
No problems were noted with the subsurface sandfilter. The owner should be sure that the septic is
pumped at least once every five years. Additional comments concerning sandfilters are on the attached
technical bulletin.
i
1
i
Page# 2

FACILITY
COUNTY CLASS
MAILING ADDRESS
Responsible Facility Operator
Official Representative
Telephone No. 44. %0(19
Where Located
Cert. Number
" Class
NPDES Permit No. NC Other Permit No.
❑ State ❑ Federal Date Issued
Date Issued
Expiration Date
Stream: Name
Class
7Q10
Sub-basin

ate of North Carolina r�
Department of Environment,
Health and Natural Resources •
Division of Environmental Management
Jaynes B. Hunt, Jr., Governor L
Jonathan B. Howes, Secretary ID FEE H N F1 A. Preston Howard, Jr., P.E., Director
September 30,1993
JANE J.WATSON
WATSON RESIDENCE (JANE)
321.HARVEY STREET
PUNTA GORDA FL 33950 Subject: WATSON RESIDENCE (JANE)
Certificate of Coverage NCG550381
General Permit NCG550000
Formerly NFDES Permit NC0064670
Haywood 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 NC0064670. 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,E.A. 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 Pennittee 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 pernuttee 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%posbconsumer paper

Page 2
JANE J. WATSON
WATSON RESIDENCE (JANE)
Certificate of Coverage No. NCG550381
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.
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
GENERAL PERMIT NO. NCG550000
CERTIFICATE OF COVERAGE No.NCG550381
TO DISCHARGE TREATED DOMESTIC WASTEWATERS FROM SINGLETAMILY RESIDENCES AND
SIMILIAR WASTEWATERS UNDER THE
NATIONAL POLLUNTANT 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,
WATSON RESIDENCE CANE)
is hereby authorized to discharge treated domestic wastewater from a facility located at
WATSON RESIDENCE (JANE)
Haywood County
to receiving waters designated as the BALD CREEK/FRENCH BROAD RIVER BASIN
in accordance with the effluent limitations,monitoring requirements,and other conditions set forth in Parts I,II,
III and IV of General Permit No. NCG550000 as attached.
This certificate of coverage shall become effective November 1, 1993.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day,September 30, 1993.
A. Preston Howar ,Jr.,P.E.,Director
Division of Environmental Management
By Authority of the Environmental Management Commission

w
V(
State of North Carolina
i/ 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
William W.Cobey,Jr.,Secretary Dirwror
November 14, 1991
Jane J. Watson
321 Harvey Street
Punta Gorda,FL 33950
Subject: NPDES Permit No. NCO064670
Jane J. Watson Residence
Haywood County
Dear Ms.Watson:
In accordance with your application for discharge permit received on May 23, 1990, 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 to an 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 B, 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 e
required by the Division of Environmental Management or permits required by the Division
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 Wiggins at
telephone number 919/733-5083.
Sincerely,
Original signed by
bale Overcash for
George T. Everett RECEIVED
cc: Mr. Jim Patrick,EPA Water (lunlitySechmi
I Asheville Regional Office NOV
{� Pollution Prevention U 1 n Igo1
P.O.Be.29535,Raleigh,North Carolina 27626-05 NO {6-0535 Telephone [phone]
i An Equal Oppormmty Affirmative Action Employer
II,,,I��/lllttltlll/1UX/ Asheville Regional 0ffiyta
A:ibeville, North Caroilm
Y

Permito. NC0064670
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH,AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE IMINATION 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,
Ms. Jane J. Watson
is hereby authorized to discharge wastewater from a facility located at
Jane J.Watson Residence
at Hidden Valley Road&North Fork Road
northeast of Crabtree
Haywood County
to receiving waters designated as Bald Creek 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 January 1, 1992
This permit and the authorization to discharge shall expire at midnight on November 30, 1996
Signed this day November 14, 1991
Original sighed by
Dale Overcash for
George T.Everett,Director
Division of Environmental Management
By Authority of the Environmental Management Commission

� n
Permit No. NC0064670
SUPPLEMENT TO PERMIT COVER SHEET
Ms. Jane J. Watson
is hereby authorized to:
1. Continue to operate an existing wastewater treatment system consisting of a septic tank, and a
subsurface sand filter trench located at Jane J. Watson Residence, at Hidden Valley Road&
North Fork Road, northeast of Crabtree ,Haywood County (See Part III of this Permit), and
Z. Discharge from said treatment works at the location specified on the attached map into Bald
Creek which is classified Class C waters in the French Broad River Basin.

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PART I
"Act" used herein means the Federal Water Pollution Control Act, As
Amended.
"DEM" used herein means the Division of Environmental Management of
the Department of Natural Resources and Community Development.
"EEC" used herein means the North Carolina Environmental Management
Commission.
Definitions
a. The monthly average, other than for fecal coliform bacteria, is the arithmetic mean of all the composite samples collected in a
one-month period. The monthly average for fecal coliform bacteria
is the geometric mean of samples collected in a one-month period.
b. The weekly average, other than for fecal coliform bacteria, is the
arithmetic mean of all the composite samples collected during a
one-week period. The weekly average for fecal coliform bacteria
is the geometric mean of samples collected in a one-week period.
C. Flow, M3/day (MGD): The flow limit expressed in this permit is the
24-hour average flow, averaged monthly. It 1s determined as the
arithmetic mean of the total daily flows recorded during the calendar
month.
d. Arithmetic Mean: The arithmetic mean of any set of values is the
summation of the individual values divided by the number of indi-
vidual values.
e. Geometric Mean: The geometric mean of any set of values is 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 indi-
vidual values. For purposes of calculating the geometric mean,
values of zero (0) shall be considered to be one (1) .

PART 11
A. MANAGEMENT REQUIREMENTS
1. 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. Any anticipated facility expansions, production increases,
or process modifications which will result in new, different, or
increased discharges of pollutants must be reported by submission
of a new NPDES application or, if such changes will not violate the
effluent limitations specified in this permit, by notice to the DEM
of such changes. Following such notice, the permit may be modified
to specify and limit any pollutants not previously limited.
2. Facilities Operation
The permittee shall at all times maintain in good working order and
operate as efficiently as possible all treatment or control facili-
ties or systems installed or used by the permittee to achieve com-
pliance with the terms and conditions of this permit.
3. Adverse Impact
The permittee shall take all reasonable steps to minimize any adverse
impact to navigable waters resulting from noncompliance with any
effluent limitations specified in this permit, including such accel-
erated or additional monitoring as necessary to determine the nature
and impact of the noncomplying discharge.
4. Bypassing
Any diversion from or bypass of facilities necessary to maintain com-
pliance with the terms and conditions of this permit is prohibited,
except (i) where unavoidable to prevent loss of life or severe
property damage, or (li) where excessive storm drainage or runoff
would damage any facilities necessary for compliance with the
effluent limitations and prohibitions of this permit. The permittee
shall promptly notify the Water Quality Section of DEM in writing of
each such diversion or bypass.
5. Removed Substances
Solids, sludges, filter backwash, or other pollutants removed in the
course of treatment or control of wastewaters shall be disposed of in
a manner such as to prevent any pollutant from such material from
entering waters of the State or navigable waters of the United
States.

PART II
6. Power Failures
In order to maintain compliance with the effluent limitations and
prohibitions of this permit, the permittee shall either:
a. Provide an alternative power source sufficient to operate
the wastewater control facilities;
or, if such alternative power source is not in existence,
b. Halt, reduce, or otherwise control production and/or all dis-
charges from wastewater control facilities upon the reduction,
loss, or failure of the primary source of power to said waste-
water control facilities.
B. RESPONSIBILITIES
1. Right of Entry
The permittee shall allow the Director of the Division of Environ-
mental Management, the Regional Administrator, and/or their author-
ized representatives, upon the presentations of credentials:
a. To enter upon the permittee's premises where an effluent
source is located or in which any records are required to
be kept under the terms and conditions of this permit; and
b. At reasonable times to have access to and copy any records
required to be kept under the terms and conditions of this
permit; to inspect any monitoring equipment or monitoring
method required in this permit; and to sample any discharge
of pollutants.
2. Transfer of Ownership or Control
This permit is not transferable. In the event of any change in con-
trol or ownership of facilities from which the authorized discharge
emanates or is contemplated, the permittee shall notify the prospcc-
tive owner or controller by letter of the existence of this permit
and of the need to obtain a permit in the name of the prospective
owner. A copy of the letter shall be forwarded to the Division of
Environmental Management.
3. Permit Modification
After notice and opportunity for a hearing pursuant to NCGS 143-215.1
(b) (2) and NCGS 143-215.1(e) respectively, this permit may be modi-
fied, suspended, or revoked in whole or in part during its term for
cause including, but not limited to, the following:

C)
PART II
a. Violation of any terms or conditions of this permit;
b. Obtaining this permit by misrepresentation or failure to
disclose fully all relevant facts; or
c. A change in any condition that requires either a temporary
or permanent reduction or elimination of the authorized
discharge.
4. Civil and Criminal Liability
Except as provided in permit conditions on "Bypassing" (Part II,
A-4) and "Power Failures (Part II, A-6) , nothing in this permit
shall be construed to relieve the permittee from civil or criminal
penalties for noncompliance pursuant to NCGS 143-215.6 or Section
309 of the Federal Act, 33 USC 1319.
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. 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 circumstance, is held invalid, the application of such provision
to other circumstances, and the remainder of this permit shall not
be affected thereby.
7. Expiration of Permit
Permittee is not authorized to discharge after the expiration date.
In order to receive authorization to discharge beyond the expiration
date, the permittee shall submit such information, forms, and fees
as are required by the agency authorized to issue permits no later
than 180 days prior to the expiration date. Any discharge without
a permit after the expiration will subject the permittee to enforce-
ment procedures as provided in NCGS 143-215.6 and 33 USC 1251 et seq. .

PART III
A. PREVIOUS PERMITS
All previous State water quality permits issued to this facility,
whether for construction or operation, or discharge, are hereby
revoked by issuance of this permit. The conditions, requirements,
terms, and provisions of this permit authorizing discharge under the
National Pollutant Discharge Elimination System govern discharges
from this facility.
B. CONSTRUCTION
No construction of wastewater treatment facilities or additions thereto
shall be begun until Final Plans and Specifications have been submitted
to the Division of Environmental Management and written approval and
Authorization to Construct have been issued. If no objections to Final
Plans and Specifications have been made by the DEM after 30 days follow-
ing receipt of the plans or issuance of this permit, whichever is latter,
the plans may be considered approved and construction authorized.
C. SPECIAL CONDITIONS
1. The Permittee shall be responsible for the following items regard-
ing the maintenance of the treatment system:
a. Septic tanks shall be maintained at all times to prevent
seepage of sewage or effluents to the surface of the ground.
b. Septic tanks need routine maintenance and should be checked
at least yearly to determine if solids need to be removed
or other maintenance performed.
c. Contents removed from septic tanks shall be discharged into
an approved sever system, buried or plowed under at an
approved location within 24 hours, or otherwise disposed of
at a location and in a manner approved. by the State or local
agency.
2. The permittee shall properly connect to an operational publicly-
owned wastewater collection system within I80 days of its availability
to the site.

n
Part III Permit No. NCO064670
D. In the event that violations of the fecal coliform requirements of the North Carolina water
quality standards occur as a result of this discharge, disinfection will immediately be required and
the permit amended to establish a colifonn effluent limitation.

f
State of North Carolina As")`°'Ii »,,>;,
rl Department of Natural Resources and Community Development
Lv/ Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27611
James G. Martin, Govemor. R. Paul Wilms
S. Thomas Rhodes, Secretary - January 16, 1986 Director
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Ms. Jane.Watson
Route 2, Box 215.0
Waynesville, North Carolina 28786
SUBJECT: Permit No. NCO064670
Jane Watson - Residence
Haywood County
Dear Ms. Watson:
In accordance with your application for discharge Permit 'received on October \
17, 1985, we are forwarding herewith the-subject State NPDES Permit: This Permit ' 1
is issued pursuant to the requirements of North .Carolina and the U.S. Environmental
Protection Agency dated December 6, 1983.
If any parts, measurement frequencies, or sampling requirements contained
i n'this 'Permit 'are unacceptable'to you, you may request a waiver or modifications
upon written demand to the Director within'thirty (30) days following receipt
of this 'Permit; identifying the specific 'issues to be contended. The filing of
this request will'not affect your rights.to request a hearing on these issues.
Unless such demand is 'made, this 'Permit 'shall be final and binding.
Please take notice that this 'Permit is 'not transferable. Part I1; B.2,
addresses the requirements to be followed incase 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 permits that may be required.
If you have any questions concerning this Permit, please contact Mr. Dale
Overcash, at telephone number 919/733-5083.
Sincerely,
ORIGINAL. SIGfVL'D BY
ARTHL;R MOUBERRY
FOf2
R. Paul Wilms
- cc: Mr. Jim Patrick, EPA Po wim rl Han Pays
Ar Ashevlile ' Rasp«ens,ltakon North CamNre27611-7667 Tderl ems<73sams
Regional Office
'.DO/gwt A^.F.quul OppumJry AlHrmative Action 6nrbyer..

Permit No. 0064670
STATE OF NORTH CAROLINA
DEPARTMENT OF NATURAL RESOURCES COMMUNITY DEVELOPMENT
DIVISION OF ENVIRONMENTAL MANAGEMENT
PERMIT
To Discharge Wastewater Under the NATIONAL
POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provisibns 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,
Jane Watson
is 'hereby authorized to discharge wastewater from a facility. located at
Jane Watson Residence
on Hidden Valley Road
Lot No. 55
Haywood County
to receiving waters designated as Bald Creek in'the French Broad River Basin'
in'accordance with effluent limitations, monitoring requirements, and other conditibns
set forth in'Parts 1, -11, and III hereof.
This 'permit 'shall become effective January 16, 1986.
This permit and the authorization to discharge shall expire at midnight on December
31, 1990.
Signed this 'day of January 16, 1986.
ORIGINAL SIGNED BY
ARTHUR MOUBERRY
FOR
R. PAUL WILMS, DIRECTOR
DIVISION OF ENVIRONMENTAL MANAGEMENT
BY AUTHORITY OF THE ENVIRONMENTAL
MANAGEMENT COMMISSION
. MI 8 11

Permit No. NC0064670
SUPPLEMENT TO PERMIT COVER SHEET
. :Jane Watson Residence
is 'hereby authorized to:
1. Enter Into a contract for construction of a wastewater treatment facility, and
2. Make an outlet into Bald Creek, and
3. After receiving an Authorization to Construct from the Division of Environmental
Management, construct and operate a 300 GPD wastewater treatment facility,
located on Hidden Valley Road, Lot No. 55, Haywood County (See Part III
of this 'Permit)', and.
4. Discharge from saidAreatment works into Bald Creek which Is 'classified
Class "C" waters in'the French Broad River Basin'.

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State of North Cad ina
Department of Environment,
Health and Natural ResourcesW.KA4
:
Division of Environmental Management 4 7�
James B. Hunt, Jr., Governor
��
Jonathan B. Howes, Secretary E p
A. Preston Howard, Jr., P.E., Director
November 29, 1993 „
Jane Watson
321 Harvey Street
Punta Gorda FL 33950
Subject:. Certified Operator Requirements.
Single Family Treatment Systems
NPDES Permit No. NCG550381
Haywood County
Dear Ms. Watson:
During February of this year,public hearings were held on proposed changes to modify the
operator certification rules. The proposed rules included a requirement that single-family
discharge systems would be classified wastewater treatment facilities,which would require
an annual inspection by a certified operator. The intent of the rule was to insure that the
systems are being properly operated and maintained. ,
During the public comment period, a significant amount of comments, statements and
additional information was submitted. As a result, the Water Pollution Control System
Operators Certification Commission amended the proposed rules. The rule,as adopted and
effective July 1, 1993,. now requires single-family discharging systems to be classified
.only if they are permitted after July 1, 1993 or if upon inspection by the Division of
Environmental Management (DEM) it is found that the system is not being adequately
operated and maintained. Systems can be inspected by DEM during routine compliance
inspections, permit renewals, or complaint investigations. Once a system is classified, it
will be required to have at a minimum, an annual inspection by a certified operator.
It is important to remember that the NPDES permit is part of a Federal program
administered by the State of North Carolina and that violations of the permit are enforceable
by Federal and State laws. Although your system will not be required to have a certified
operator at this time,proper operation and maintenance is needed for the system to function
satisfactorily. In as much as each.system must be individually designed and sited, special
maintenance requirements may apply to a specific installation. The attached maintenance
schedule should however be applicable to most systems. The frequencies suggested are
considered to be the minimum necessary. More frequent attention may be needed for a
specific system and may be required by conditions of the permit.
RO. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50%recycled/10%post-consumer paper

Certified Operator Requirements
NCG550381
Page 2
In addition to being required by your permit,proper maintenance of your treatment system
is extremely important to the long term serviceability of your wastewater treatment system.
If proper maintenance is not given to. the system, it will fail and will result in major
expenses for repairs.
We would strongly encourage you to take the necessary action to insure that your system is
operating properly. If we can be of any assistance to you or if you have any questions or
comments,please call Dwight Lancaster of our staff at(919) 733-0026.
Lenly,man, ery so
g and 'fi' tion Unit
cc: Asheville Regional Office-Water Quality
Facilities Assessment Unit
Central Files

�r
State of North Carolina
Department of Environment, Health, and Natural Resources
Asheville Regional Office
James G. Martin, Governor Ann B. Off
William W. Colaey,Jr., Secretary Regional Manager
DIVISION OF ENVIRONMENTAL MANAGEMENT
WATER QUALITY SECTION
October 16, 1991
Ms. Jane Watson
321 Harvey Street
Punta Gorda, Florida 33950
Subject: Compliance Evaluation Inspection
Status : In Compliance
r
rmit Number NCO064670
County
Dear Ms. Watson:
A Compliance Evaluation Inspection was conducted September 27,
1991, 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.
I£, in the future, the residence is sold, please inform the new
owners that they will need to apply for a new permit as NPDES Permits
are not transferable.
If you should have any questions, please feel free to contact me
at 7047251-6208.
Sincerely y trs,
Kerr. Becker
Environmental Technician
KSB
Enclosure
xc: Dan Ahern, EPA
Interchange Building, 59 Woodfin Place, Asheville, NC. 28801 •Telephone 1 251L208
An Equal Opponuniry A(firmanvc Action Employer

?33T aecv Form Approved
(1, Washmgmn.0.C,20060
a-®EPA NPDES Com fiance Inspection Re ort OMB No 2040-0003
P p Rep or Expires 7-31-85
Section A: National Data System Coding
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fre Type
1NU 2LJ-5 4 vjok141Eblolit i� & L2191a17117 1C1c I" 201AI
111111II111111111111 ReImIarks IIIIIIIIIIIIIIIIIIIIIIIII
Reserved Facility Evaluation Rating 81 QA - ResJerved----------------- 66
6� 1 1J 69 70J 71J 7�_j 7LIJ 74 . 74 1 1 180
Section B:Facility Data 1y
_ame and Location o Facility Inspected Entry Time AM L'J PM Permit Eff.c ive Date
/i 6nE3s i t�Z-r"`c-C. /Z Z
/t/i✓0%4- (/ ppa" Exit Time/Date ermit Expiration Date
NO✓, 30 /9 l
eme(s)o n-Site Representative(s) Tillers) Phone Nola)
Neme,Address of Responsible Official Title
-JAtvE -
3z/ /�nxv1� Sf, z �crL
/` Phone No. ContaM�ef
rL 'fn- U"O"K�6 /, ur/ r✓�- '� 3 `j SG ❑ Yes LJ No
Section C:Ames Evaluated During Inspection
IS=Satisfactory,M=Marginal,U=Unsatisfactory,N=Not Evaluated)
Permit Flow Measurement /J Pretreaimant j Operations&Maintenance
R,ecerds/Reports /t/ Laboratory Compliance Schedules Sludge Disposal
Facility Site Review Effluent/Receiving Waters Self-Monitoring Program Other:
// Section D:Summery of Findings/Comments(Anach additional sheets i/necessery)
) /7uyxec� EXj/=/*�t�-�v7�./m-- d/tifti /��
NOcf Cv ($C/L A-'V l f dc.(. � YF N •/ iNS c 't J P J U/ /w v rc,/ Y
9 0
Name(s)and Sigtlature(s)of Iy ector(s) Agency/Office/Telephon. Date
74
Ci
Signature of Reviewer Agency/Office out.
Regulatory Office Use only
Action Taken Date Commpliance Status
t_l Noncompliance
®C nn fiance

RECFIVEDf
PUBLIC NOTICE Water Quality SertiGlaj
Yll�✓ STATE OF NORTH CAROLINA U
/ " Il ENVIRONMENTAL MANAGEMENT COMMISSION
POST OFFICE BOX 27687
RALEIGH, NORTH CAROLINA 27611-7687 Asheville Regional Office
pshe Ile North Carolirm
NOTIFICATION OF INTENT TO ISSUE A STATE NPDES MI IY
On the basis of thorough staff review and application of Article 21 of Chapter 143, General Statutes of. -
North Carolina, Public Law 92-500 and other lawful standards and regulations, the North Carolina
Environmental Management Commission proposes to issue a permit to discharge to the persons listed
below effective 8/l/91 and subject to special conditions.
Persons wishing to comment upon or object to the proposed determinations are invited to submit same in
writing to the above address no later than 7/17/91 . All comments received prior to that date will be
considered in the formulation of final determinations regarding the proposed permit A public meeting may
be held where the Director of the Division of Environmental Management finds a significant degree of
public interest in a proposed permit.
A copy of the draft permit is available by writing or calling the Division of Environmental Management,
P.O. Box 27687, Raleigh, North Carolina 27 61 1-7 6 87, [phone],
The application and other information may be inspected at these locations during normal office hours.
Copies of the information on file are available upon request and payment of the costs of reproduction.
All such comments or requests regarding a proposed permit should make reference to the NPDES permit
number listed below. ,J
Date
/ George T. Everett, Director
Division of Environmental Management
N
Public notice of intent to issue a State NPDES permit to the following:
1. NPDES No. NCO024805. North Carolina Department of Transportation, PO Box 25201, Raleigh,
NC 27611 has applied for a permit renewal for a facility located at NCDOT Welcome Center/Rest Area off
I-40, north of Walters Lake, Hayn'ood County. The facility discharges 0.026 MGD of treated domestic
wastewater from one outfall into the Pigeon River, a Class C stream in the French Broad River Basin
which has a 7Q10 flow of 120.00 efs. For some parameters, some of the available load capacity of the
immediate receiving waters will be utilized, and more stringent water quality based effluent limitations may
be established for dischargers downstream.
2. NPDES No. NCO064670. Ms. Jane J. Watsoi , t. 1, Box 291-P, Clyde, NC 28721 has applied for
a permit renewal for a facility loca � theJane Watson Residence, at the intersection of Hidden Valley
Road <& North Fork Road, northeast of Crabtree, Haywood County. The facility discharges 0.0003 MGD
of treated domestic wastewater from one outfall into Bald Creek, a Class C stream in the French Broad
River Basin. None of the available load capacity of the immediate receiving waters will be utilized, and
more stringent water quality based effluent limitations will not be established for dischargers downstream.
t�

3. NPDES No. NCO033511. Baptist Children's Home of North Carolina, Inc., 61 Sneed Drive, Clyde,
NC 28721 has applied for a permit renewal for a facility located at Baptist Childrens Home of N. C.,
adjacent to Jones Cove Road, southeast of Lake Junaluska, Haywood County. The facility discharges
0,010 MGD of treated domestic wastewater from one outfall into an unnamed tributary to Pigeon River, a
Class C stream in the French Broad River Basin which has a 7Q10 flow of 0 cfs and a 30Q2 flow of 0.08
cfs. Dissolved oxygen is water quality limited. For some parameters, the available load capacity of the
immediate receiving waters will be utilized, and more stringent water quality based effluent limitations may
be established for dischargers downstream.
i
8'.

Permit No. NCO064670
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH,AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
PERMIT
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE IMINATION 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,
Ms. Jane J. Watson
is hereby authorized to discharge wastewater from a facility located at
Jane J.Watson Residence
at Hidden Valley Road&North Fork Road
northeast of Crabtree
Haywood County
to receiving waters designated as Bald Creek in the French Broad River Basin
in accordance with effluent limitations,monitoring requirements, and other conditions set forth in
Parts I, H, and III hereof.
This permit shall become effective bl-� 4
This permit and the authorization to discharge shall expire at midnight on em er
Signed this day NJJ 30)14a1(o
tY m IF� wA
ftltli
George T.Everett,Director
Division of Environmental Management
By Authority of the Environmental Management Commission

( Permit No. NC0064670
SUPPLEMENT TO PERMIT COVER SHEET
Ms. Jane J. Watson
is hereby authorized to:
1. Continue to operate an existing wastewater treatment system consisting of a septic tank, and a
subsurface sand filter trench located at Jane J.Watson Residence, at Hidden Valley Road&
North Fork Road, northeast of Crabtree ,Haywood County (See Part III of this Permit), and
2. Discharge from said treatment works at the location specified on the attached map into Bald
Creek which is classified Class C waters in the French Broad River Basin.

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?ENNESSEE �;NL. ern+;l
MISS oty-
QUADRANGLE LOCATION FINES CREEK.
N3537 5-V10212.5/].
196]
AMS H55 III NW SERIFS
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Part III Permit No. NCO064670
D. In the event that violations of the fecal coliform requirements of the North Carolina water
quality standards occur as a result of this discharge, disinfection will immediately be required and
the permit amended to establish a coliform effluent limitation.

MEMO
A/ TO: �✓�`S e- "'wl' SUBJECT:
eer.5lA1[y
ONorth Carolina Department of Environment,
. Health, and Natural Resources

A- � }
aopwr
��• / /.C- e o O (� Appt RATION unable
racy
[ at, 9ttt Ruin
� - `I✓ C[- S r 'lU",er Quali?Y SectirmAr
Do nee alt"pt to cowlete this fore adtheut reaeenp .._ -
:tent (� r��
pleatt print or type rA?�V 0 iGO10
1, hear. addres,. and telephone hpebar Of facility producing disehbrge
A MareAsheville Rvioosl Office
PRO
I.
Street address Rg' / /3 o_k a9,(-P Afid ie . i/n/i e. / •�•.
C, my (^.L J-I
t. County ./ferry Wn dam/ 9°Au.✓'7"t f, Sip 2..97 d—/
6. telephone NO.' Coo 'P
area a77r .L. 7 -8'I'3-- �39-a-bGo
7. SIC S'e>vPLYM/T.ta �"•� . et�(c�te.a�
(lesve blani) (,//�K •L- 'U, �/✓/�'�SON
3 a-1 14 Pr-S—✓may s/T•
3. MNnber of mloyees -. — .Du r/TR
a. hature of NSIress R e .-O/In oi.• Ad „
S. (a) Check here if discharge occurs all yeare)! Or
(b) Check the Mrth(S) dltChai'ge OCCUR:
1,0January 2.04bryary S.ONIrch 6.t7bril 6.a Nay
6,0 June 7.9)July B.t7 August 9.0 September 10.0 October
11. 0 hovenoer 17,0 Decimeter
(c) No✓ many days per Beak;
1.01 7.02-3 3.04-5 4.06.7
6. Types of easle .Ste, discharged to surface eaters only (Check at appliCable)
rla, pliant per operating day Vail tressed afore
Discharge per discharging (cement)
operating day 0.1.999 1000.6999 St100.9999 10.000. S0,o00 Np 0.1-
30- 65-
69.!!9 or egre 69.9 6443 94,9 ROC
(1) (y) (3) (4) (6) (6) (1) (a) (9) (10)
A. Sanitary, daily D
average Epp�e
S. Cooling eater, etc. . Y
daily average
C. other dttCharge(tJ,
daily average:
Specify
0. hatihur per, Cge'ab
1.9 day for co .,c ,c
d1sch,.rge (all trDrs1

2. treaateG in dliccmrw waste
ether tto"surface "to".eeeaaakt beta,
of applicable.
IYss, eater It d/sekarged to: 0.I-vel 100041/1 UN-"" 10,0004/.0" $0.000 W ae't
(11 . ttl tit (Q (61
A. Nunlsipal tnrr cysts
n, tln.b up,+um ..I I .
C. Septlr tank
U. Evaporation lagw or pond
[. Other. specify:
6, auAer o�f/stoante dtfcbargt Points:
A.P1 6.02.3 C.O 4.5 0.06 or soft //��
9. Maae of receiving water or waters tt:naI zu sin
.10. Does Your drseh,rps contain or Is It Posfiblt for your discharge to certain
One or Pon Of tIN following fYhatanGf �tj of a result Of your Operations.
activities. or processes: ataoale. Clem 1,, Slub gue. beryl""' eersae,
MrMtua, C""r, lead, WIMMUT nickel. selanha, list. pawls. oil a"
Ines,, and chlertne��(residual).
A.nYes 1.prn0
certify
I contained
IN the
that to the best of ytnooloap and ad,iff SUAN lorforral lsM . compatil ioR�wd
accurate. .y
Printed Mate of /trfm 51pn1n9
ti __
Tide
W4 Applluifon bit'"? /') 2z/�
�1 /gi 'Pon 01 1c /y'/"1 .
North Carolina General Statute 143-215.6(b) (2) 0revid,a tlut: A¢7 Wean who Imwi¢Fly ear
nny false etacenmt repreunut en, or east eat on ay, app,."em,'reCard, report, pl<
or other doetmant filasor required to be maintained tmdar Article 21 or rala gutions of tie
em,trantxatal MSS gammt Commission implamantijaA that Artialau r srho or method raigaii,damper to s u, •
or knovly renders inaccurate any recording or moniteria �i
,perated or mingained under AFtiale. 21:•or regulations of the Envircwntal 1lteagammt Ciy �
:ap lene¢c in9 that Article, sthali'be'•fuiity of a jkiederanor punishable by a -fine not to eac<
ao,nqn, or by imprisonment not to exceed six months, or by both. (1S C.S.C. Section 10:11 p- Y
punishment, by a fine of'aot more then $10,000 or }ap es riaant not more than S years, cT br
`..r a sinllar offense.)

C
GENE OR JANE WATSON -19
PHONE [phone] 1859
321 HARVEY STREET
PUNTA GOROA FL 33950
Pay to[he
order oP �/ C r11r - � ..1�O1urw�.....Q� � —6i ad.. _
/oa o rs
® 4f'x 1RSTON
Memo L859
i: 267086702C25L000Op8557

l
March 19, 1990
FRED WOODALL
---)S WATSON RESIDENCE (JANE)
ROUTE 2, BOX215.0
WAYNESVILLE, NC 28786
Subject: NPDES PERMIT NO. NCO064670
HAYWOOD COUNTY
Dear Permittee:
Our files indicate that the subject permit issued on 1/16/86 expires on
12/31/90. GS 143-215. 1(c) requires that an application for renewal must be filed 180
days prior to the expiration date. We have not received an application for renewal
from you as of this date.
A renewal application shall consist of a letter requesting renewal along with the
appropriate completed and signed application form, submitted in triplicate, referenced
in Title 15 of the North Carolina Administrative Code, Subchapter 2H .0105(a).
Primary industries listed in Appendix A of Title 40 of the Code of Federal
Regulations, Part 122 (40 CFR Part 122), shall submit a priority pollutant analysis
that is performed in accordance with 40 CFR Part 122.21. A processing fee must be
submitted with the application. Please find attached a copy of the 15 NCAC 2B.0105(b)
regulations. The processing fee for your facility is based on the design or permitted
flow, whichever is appropriate, listed in the first five categories of facilities. No
facility is allowed to submit a fee for the general permits listed in the fee schedule
at this time since EPA has not approved our general permit. If the facility covered
by this permit contains some type of treatment works, a narrative description of the
sludge management plan that is in effect at the facility must be submitted with the
application for renewal.
The Environmental Management Commission adopted rules on August 1, 1988,
requiring the payment of an annual fee for most permitted facilities (see attached 15
NCAC 2H .0105(b) regulations). You will be billed separately for that fee (if
applicable), after your permit is approved.
Please be advised that this permit must not be allowed to expire. If the renewal
request is not received within 180 days prior to the permit's expiration date as
required by 15 NCAC 2H .0106, you will be assessed an automatic civil penalty. This
civil penalty by North Carolina General Statute may be as much as $10,000 per day. If
a permit renewal request is not received 180 days before permit expiration, a civil
penalty of at least $300 will be assessed. Larger penalties may be assessed depending
�1

b
on how late the request is made. In addition, any permit renewal request received
after the permits expiration date will be considered as a new application and will be
required to pay the higher permit application fee.
The letter requesting renewal, along with a completed NPDES Permit application
and appropriate standard fee, should be sent to:
Permits and Engineering Unit
Division of Environmental Management
Post Office Box 27687
Raleigh, North Carolina 27611-7687
The check should be made payable to the North Carolina Department of Environment,
Health, and Natural Resources (DEHNR).'
If you have any questions or need any additional information regarding this
matter, please contact me at (919) 733-5083.
Sincerely,
Original Signed By
M. Dale Overcash
M. Dale Overcash, P.E.
Supervisor, NPDES Permits Group
cc: Asheville Regional Office
Permits and Engineering Unit
Central Files

yet,
4 , �
Permit No. NC0064670
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT F?E �. .f.P ti r I)
PERMIT Wafer Quali'iy.iecL;�n
TO DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM AN 1Clu
,Asheville Legionat office
Aslieville, North Carolina
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,
Ms. Jane J. Watson
is hereby authorized to discharge wastewater from a facility located at
Jane J.Watson Residence
at Hidden Valley Road&North Fork Road
northeast of Crabtree
Haywood County
to receiving waters designated as Bald Creek in the French Broad River Basin
in accordance with effluent limitations,monitoring requirements,and other conditions set forth in
Parts I, H, and III hereof.
This permit shall become effective
This permit and the authorization to discharge shall expire at midnight on November 30, 1991
Signed this day
D sir
George T.Everett,Director
Division of Environmental Management
By Authority of the Environmental Management Commission

r)
Permit No. NC0064670
SUPPLEMENT TO PERMIT COVER SHEET
Ms. Jane J. Watson
is hereby authorized to:
1. Continue to operate an existing wastewater treatment system consisting of a septic tank, and a
subsurface sand filter trench located at Jane J.Watson Residence, at Hidden Valley Road&
North Fork Road, northeast of Crabtree ,Haywood County (See Part III of this Permit), and
2. Discharge from said treatment works at the location specified on the attached map into Bald
Creek which is classified Class C waters in the French Broad River Basin.

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;'2] 't8 • ..¢a:e.—� .�...E.w.....:o.o„ _g 35"3]'30'
�i30o^en^m{ 82°52'30"
(TVA 183 NW) *Pr,
ROAD CLASSIFICATION v
Heavy duty ..... Poor motor road
-- r
ILL.' Medium duty .. .. a Wagon and jeep track --
RENTUCNY Light duty .......... Fool trail _. .... .......
M0. ....VA. � ' Interstate Route C3 e U. S. Route Q Slate Route \l,_
- �YENNESSEE •.:NC. '„r@,l:C
M155� "ALn. GA S.C. H4aRC-.
QUADRANGLE LOCATION FINES CREEK,
N3537.5 Wf252.5/].
1967
AMS 4455111 NW SERIES
t '7 NC
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Part III Permit No. NCO064670
D. In the event that violations of the fecal coliform requirements of the North Carolina water
quality standards occur as a result of this discharge, disinfection will immediately be required and
the permit amended to establish a colifomt effluent limitation.

TO: PERMITS AND ENG` .;ERING UNIT �
WATER QUALITY SECTION
DATE: June 4, 1990
NPDES STAFF REPORT AND RECOMMENDATION
COUNTY Haywood
PERMIT NUMBER NC0064670
PART I - GENERAL INFORMATION
1. Facility and Address: Jane Watson Residence
Hidden Valley Road
Crabtree, North Carolina
2. Date of Investigation: October 18, 1988
3 . Report Prepared By: Kerry S. Becker
4. Persons -Contacted and Telephone Number:
5. Directions to Site: From the intersection of NCSR 1503
and1505, travel 3 . 1 miles on NCSR 1505 to Hidden Valley Rd.
Travel east on Hidden Valley Rd. 0. 5 miles to North Fork.
Property is located at junction of Hidden Valley Road and
North Fork Road.
6. Discharge Point(s) , List- for all discharge points:
Latitude: 35 deg. 39 min. 28 sec.
Longitude:82 deg. 52 min. 42 sec.
Attach a USGS map extract and indicate treatment facility site
and discharge point on map.
U. S.G. S. Quad No. F7 NE U. S.C. S. Quad Name Fines Creek,
NC
7. Size (land available for expansion and upgrading) : 1/8 acre
8. Topography (relationship to flood plain included) : Flat
9. Location of nearest dwelling: 1.00 yards
d WA

16. Receiving stream or affected surface waters: Bald Creek
a. Classification: C
b. River Basin and Subbasi.n No. : 04-03-05
C. Describe receiving stream features and pertinent downstream
uses: Bald Creek serves as habitat for the propagation
and maintenance of wildlife.
PART II - DESCRIPTION OF DISCHARGF. AND TREATMENT WORKS
1. Type of wastewater: 1.00 % Domestic
Industrial.
a. Volume of Wastewater: .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 septic tank/ subsurface sand
filter trench.
S. Sludge handling and disposal. scheme: 1i ,Pnsed commercial septic
tank cleaning firm.
6. Treatment plant classification: Less than 5 points; no rating
(include rating sheet, iif appropriate ) . N,'A
7. SIC Codes(s) : 4952
Wastewater Code( s) : Primary 01 Secondary

� n
PART III - OTHER PERTINENT INFORMATION
1. Is this facility being constructed with Construction Grant funds
(municipals only)?
2 . Special monitoring requests:
3 . Additional effluent limits requests:
4. Other:
PART IV - EVALUATION AND RECOMMENDATIONS
The Asheville Regional Office recommends the renewal of NPDES
permit 64670.
S.J,guatlof Report�Prep�arer
'N pater Ou a. i ty (`R gi_onal Supervisor
Date

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327 1 1328 35-37'30' �,.E,
Wou-E, 82-52'30'
(TVA 183-NW) 'c'
ROAD CLASSIFICATION
Heavy duty — Poor motor road
ILL Medium duty — Watmo and jeep track———— aide,
MO KENiUCNT __VA. L,htduty Foot trail
Interstate Route U. S, Route
0 Soo, R.TLA
QUADRANGLE LOCANON FINES CREEK
N3537.5 W82
1967
AMS 4455 1]NW SERIES
E r7 n

State of North Carolina
Department of Environment,Health, and Natural Resources
Division of Environmental Management
512 North SalisburyStreet• Raleigh, North Carolina 27611
James G. Martin,Governor George T.Everett,Ph.D.
William W. Cobey,Jr.,Secretary Director
May 15, 1990
Ms. Jane J. Watson
321 Harvey Street
Punta Gorda, FL 33950
Subject: NPDES Permit Application
NPDES Permit No. NC0064670
Watson Residence
Haywood County
Dear Ms. Watson:
On May 14, 1990, the Division of Environmental Management received a NPDES
Permit Application for the subject facility. The application is considered incomplete. Therefore,
the Division of Environmental Management is returning the application.
The returned information must be resubmitted with the following to complete the
application:
1 . A check for $60.00 made payable to the NC Department of EHNR. Since the permit
has not expired, the renewal fee of $60.00 is appropriate. Your check for
$120.00 is enclosed.
The Division of Environmental Management will initiate the permit review process
upon receipt of the above requested information. The receipt of the above information does not
preclude this Division from requesting additional information at a future date.
If you have any questions, please contact me at [phone].
Ise Overcash, PE
Supervisor, NPDES Permits
cc: Asheville Regional Office
RFf' EIVED
Water Quality 5ertion
MAY 16 1990
Pollution Prevention Pays
, s h viIle Regional-Office
E.O.Box27687,Raleigh,North Carolina27611-7687 Telephone919-733-jY e'ville, North Carolina
An Equal Oppeounity Affirmative Action Employer

(11
f �� eNaral
szEcEivEo,
r �) Water Quality Section
State of North CarMAY 3 11090
Department of Environment, Health, rces
Division of Environmental Management ,Asheville Regiona60ffice
512 North Salisbury Street • Raleigh, North Carolina 27611 ,Asheville, North Carolina
James G.Martin,Governor George T. Everett,Ph.D.
Wiliam W.Cobey,Jr.,Secretary Director
5/30/90
Ms. Jane J. Watson
Rt. 1, Box 291-P Subject : NPDES Permit Application
Clyde, NC 28721 NPDES Permit No.NC0066670
Jane J. Watson Residence
Dear Ms. Watson Haywood County
This is to acknowledge receipt of the following documents on May 30, 1990:
Application Form
Engineering Proposal (for proposed control facilities) ,
Request for permit renewal,
Application Processing Fee of $60.00,
_ Other—,
The items checked below are needed before review can begin:
Application Form ,
Engineering proposal (see attachment) ,
Application Processing Fee of
_ Delegation of Authority (see attached)
Biocide Sheet (see attached)
Other
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. You will 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 OverCa6h, P .E.
CC: ,Aslae will e Regional Office
/ PoI1Won Prnenflon Pays
�JINI�IvyI'I/or
I 'I�% P.O.Box 27687,Raleigh,North Carolina 27611-7687 Telephone 9I9-733-7015
IUI'I�,V�O An Equal Opportunity Affirmative Action Employer

Leh 72o / �ro-)
B/vO.D�
NORTH CAROLINA DEPT. OF NATURAL RESOURCES AND COMMUNITY DEYELOPIffNT
ENVIRONMENTAL MANAGEMENT COMMISSION 99
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM APPLICATION IOWA
APPLICATION FOR PERMIT TO DISCHARGE - SHORT FORM D too
Afd11Cr
to be titre wily by services, veolesalI era retail trade, OSC 0411 91(tielp
and other cauercial establishrnts including vessels O 1) a S 3
r :. A.
Water Quality cockiest
by net attaept to complete this form adthWt reading the &ac~ying teaefloctims
plus[ print or type MAY 1 J 1$SO
1, far. address, and telemme framer of facility producing discharge
A, far T%GHD TT W.g7seA • Asheville Region,,[-Office
I.
Street address . /._L3ak �.91-P Ajjd l a v
C. City
_C.LS.J.o 0. State TL• �;
t. County„UAQ ;).� Nnuv'7"y� e. itpu� S''Jd-/
G. Telephere fo. ' $C1L .� (�> —,(n�..7-7 3t- Q
Arealba7l _ a
Sk cl Rev v iY:f� �� . udcP� o, MAY 2 3 )990
2, sic ® _..- �/ �
(Leave blank) �t//"3N 2. "[� �/-7'�5D/✓
3a( I }AY✓ ry 5 T kNR7IiSF r-am,P`JrpnlNr,
]. hunter of ew,lo,ees Pe/N TA Yd
I. Nature of business —a-_Q >2.rfAn aM 14 LAe n L
5. (a) Check here if discharge occurs all yeare or
(b) Check the enth(s) Eischuge eccun: -
1.0Janwry 2,0fabrvary ],OWrch 4.0 Aprl1 6.0 Nay _ -
6.0June 7,O Ju I 9.0 watt 9.0 S"teowr 10.O Octeb
Il,ohove.notr 12.0 becomer k� 1T= +' "'•"�''�s
(c) Nbr wily days ber rook: MAY 1 4 '11990
1.01 2,02•] ],01.5 1.06.7 _
6, Types or vast[ .peter discharged to surface rater rely (check pee apellualt)
PERMITS & F.NGINEF11mc,
flow, Sellers per operating day V.I. treated load"
Discharge per discharging (Present)
Writing day 0.1.999 1000.1999 sm-t99 19,9f9 mm 9 10,100. f0,000 f 0.1. 3D-
65• 1cc
or care 21,9 M,9 91,9 10<
(11 12) (]) (1) (S) (Q (7) (6) lot (IC,
A. Sanitary, daily
average 3aa�Fp
9. Cooling rrtr, etc„
daily average
C. Other dlseharpelsl,
daily average
Specify
D. ftwnua br DDe-eb
Ing day for cbm:,nrc
anena.ge late tyorst

7. treaated I+rMi1{W Gtplac % saw, tWn Wrfiaterton.eadock be,"
at apelicable.
WSG raker 1t 01fcMrgad to: 0.1.1p9
1000-NM f000•Mf3 10,00041.SM 50,000 a eor.
pl It) III N) 151
A. Nlnlclpol %w'r tyttap
11• IIIYa•, II'IYllld M'il
C. Se011 tank
V. irapOratlan legion or pond.
C. other, 1peclfyk
S. ii rcer of separate discharge points:
A.MK 8.02-7 C.a C-S o.06 Brian
9. Mare o/ recttrtnq water or raters
.10. Our your dl scMrpe Contain or Is It possible for your discharge to Contain
one or son of t1% following Substo"2 J00c4 as A result Of your Operations.
actlrlt Gs, or processes: ~16, cy" a binge,
enratu 1, Copper, load, MMUl. nickel, Glanlu. chef, gaaplls, all and
gn6se, and chlorin ��
e (residual).
Cores p.pne
1 certify that 1 a faailta G
r with the WOMMItlon CCoGed In the application and
that to the best of A' knowledge and MIIM Such IsferrtiM Is tide, CM'*t*' aad
accurate.
Jl� u G r/ W/) / S D/✓
Printed Kapp Of persm Slgntng.
Title
- � Cn M6\Y 7 A ig�ll
aG Application Npp1d
I/C2'.1 �i�'.. ��/ /7 S r1re� e+Elli�ltS l:cutlhTV' nni;
tare of Appltc
North Carol ioa General Statute 143-215.6(b) (2) p_ravides tbatt Any person Who knowingly ma'.:
nny false statmant repreeentat on, or certification any applieatienr'reeosd, report, p::
or other doctmant files 'or required to be maintained tender Article 21 or regulations of the
Environmeatal *IeaaSemeot Cotenisaion implempatlta5 that Article, or who
falsifhod ies,
campers u, •
cr knovly renders inaccurate any recording or mpnitoritig /�i
d to be
rpereted or Taintained under Article 21•et regulations of the Environalental Mmagesest Cow_
:❑^r'_etencing that Article, shali 'be�gaiitv'of a tislsdemeanor punishable by a •fiae tut to tau
clO,nnn, or by imprisonm►nt not to exceed six months, or by both. (18 t.S.C. Section 10% p
A punishment by a fine of'sot mare then $10,000 or imprisoe•snt not Tore than 3 years, or bt
f,.r a finilar o!fense.)

{� w �1 I
State of North Carolina f
Department of Natural Resources and Community Development
Asheville Regional Office
James.G. Martin, Governor - David.R. Spam
S. Thomas Rhodes, Secretary Regional Manager
DIVISION OF ENVIRONMENTAL MANAGEMENT 4
WATER. QUALITY :SECTION '
S• October 18, 1-988
Ms. Jane Watson `+
.321 Harvey .Street f
Punta Gorda, Florida 33950 - -
Subject: Compliance Evaluation Inspection
Status: in :Compliance l
-Jane Watson 'Residence S
NPDES Permit Number NCO064670 Haywood County
County
Dear Ms. Watson: L;
r
A Compliance Evaluation Inspection was conducted on September 21,
1988, of the septic . tank/subsurface -sandfilter serving . your
residence. The facility was not discharging at the time :of the
inspection and visa thus-considered in compliance.
-Effluent samples collected October 10, 1986, indicated the
facility was generatingpoor quality effluent. Effluent samples were
:not collected on the two succeeding inspections (:September 21, 1988
inspection inclusive) , since the facility was not discharging�aad Since ,
no response regarding remedial actions taken was received by this
office. asrgq� uired' in the October 23 , 1986, Notice of Non-Compliance
letter] The true performance of this facility cannot be determined
until .effluent samples .are collected..
If you have .any questions, please contactMr. Max Haner or me at
704/251-6208,. extension 225 or 258 respectively. ti
.Sincerely yours,
Kerry S. Becker
Environmental Technician
KSB:ls
Enclosure
`xe: Dan Ahern, EPA
Max L. Haner y
Interchange Building 59 Wrodk Pia a, PO Box 3M, Asheville, NC 2880M0 M•Telephone 70F253 3341

United i tes LaV,r0mumul Protectica Agency —Form APProveQ
wa n'ngwn,D:D 20460 OMS No.2040.0003
PANPDES Compliance Inspection Report ,,prpya,e.p;ras,3,.e5
Section A:National-Date System Coding
-Transa ton Code -NPDES yr/mo/day Inspection Type - inspector ZF Type
e nYCI 010 M{ Is16171()11+ ,a<tl aubl�l/117
R iraIrksl l l l l 1 1 1 1 1 1 1 1 t l l l l l l l l 1 1 1 f
-Reserved - Facility Evaluation Rating SI. CA -- Reserved---------------- 86
eel I 169 TdJ 71W , Z2L T ]74 T so 6
Section D Facility Data
Name entl Locet nof Facility Inspected -Entry Tima❑ AM IGI PM Permit Effective Date k4
ExitTima/Data - Permu Espimtion'Date
/VO k.. Cl .V t 414� / g
eme(s)of On-Site Represenodive(s) Title(s) Phone No(s)
y
4
Name, ddresse flgqsponsble Official - Title
J fiArE G/.a{sail W
S�' Phone 'No. Contacted
N1M .(ic2.r.1 F A. 3 :- s ,, ❑ Yea[!] No
Section C.Areas Evaluated::During Inspection' Il
IS Satisfactory,M=Marginal,U=Unsatisfactory.N=Not Evaluated) C
Permit - Flow Measurement Pretreatment Operations&-Maintenance
Records/Reports n/ Laboratory 'acrid Inca Schedules Sludge Disposal
S Facility Sit.Review .Effluent/Receiving Water. Self.Monitoring Program Other:
Seeti/n D:Summaryof Findings/Comm.�elnts(Affach-add1mano/sheats i/nece/s/sary) /
/T'ILr� TY W/`I S FU� K/3 /i/.(. � �/1I/u/ (L'J D{L-J LOh'l �IG'kn�GCC �'N4/ �L�CP/U/.✓5
/V/ 5.4n._�rer /i/4". .q;Lu.., otl.yi.-,cs.1>.nvu. .At J...s✓(.,...zLr.a«s.. Si��ucXin- �t
N
i
Name(s)and Sig"ratulre(s)of Inspectors) Agency/Office/Telephone Date .
t
J 7. V-as6 a
Signat of Reviewer Agency/Office " Data 4
d
Nct�ee �l 0415 �zaa
Re ulet� Office Use only
Y
Action Taken Date Compliance Status 1 I,
❑ Noncompliance

i �
�lyUs
,(
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
October 23 , 1986
Mr. Gene Watson
321 Harvey Street
Punta Gorda, Florida 33950
Subject: Compliance Evaluation Inspection
Jane Watson Residence
NPDES Permit Number N00064670
Haywood County, North Carolina
Status: Non-Compliance
Dear Mr. Watson:
L
A Compliance Evaluation Inspection was conducted October 10, 1986,
�. by ,Ms. Kerry Becker for the wastewater facility serving your residence.
Enclosed please find a copy of the laboratory analysis for the effluent
samples taken at the time of the inspection. The laboratory results
indicate the facility to be producing a poor quality effluent causing
the facility to be out of compliance with permit limits.
The most cost effective approach would be to first pump out the
septic tank to see if this would bring the facility into compliance.
Please notify Ms. Becker when the septic tank has been pumped, and a
date for resampling will be scheduled. At such time, if the effluent
quality still indicates non-compliance, further modifications of the
system will be needed.
Should there by any questions, please contact Ms. Becker or myself
at 704/253-3341.
Sincer ly, ���(�
FRW:KB: ls Forrest R. Westall
Frfie Water Quality Regional Supervisor
�/1IC7/j;c: Gil Gil Wallace, EPA
Kerry Becker t/
nrerchanw Building, 59 WoodHn Place, P.O Be.370, Asheville, NC.28802-0370 s Telephone [phone]
An Coual Ounum,nlm Afdnnatloe AcNnn Gnoloco

mf pews n n ger¢y form AlMroved
EPA W."in,ma.o c zoaw°
' NPDES Compliance Inspection Report OMBNa.]D,,..7-3
Approval Expires 7-31-RB
Section A: National Dete System Coding
Tra�nsp<tipn Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 _ 'u e1e)lci& 16Mali, , 86 ( a / Oj ,7 IEU 1'0 xu
IIIIIIII11jIIIIIIII Remarks IIIIIIIIIIIIIIIII_ IIIIIIIII
6tReserved Facility Eveluelion Rating R ......._...._.-Reserved...... fi
_Lij 69 74A 71u 7J T�J Ta 7q 1 BO
Section B:Facility Data
name an oc than of Facility )J¢ry¢peeped Env AM PM giy Time Permit Effeve Date
tse.ue/t/Aa1Eu/ sorJ 7fes/ o/ti A/ce. ❑ IQJ
qqPermit
d l.o Al.C.AKe /NA a?7?e Eslt Time/Dale Permd Expiration Dale
�Q t, on-Sp.
a 30 /0 d-� l O
am s o n- /te epro entative(sl Title(¢) Phone Nds)
GtNF Wgy4sa.)
0W Nti2
/�ame.Address of espo7sible Kiel Title
66,E/J/Ml6Lddl se,J pyVN t-Yf
3a }1�a,cue 5� Phone No. Contacted
YI
PuN-{z (ro V.PAo Floclla 3395D ° - F39-71 /.QA IIC�II
rV Yes❑ No
_ SMion C:Areea Ewluetetl During Inspection
(S=Satisfactory,M=Marginal,U=Unsatisfactory.N=Not Evaluated)
S Permit Flow Measumment Pretreatment Operations&Maintenance
A/ Records/Reperts laboratory Compliance Schedules 7t/ Sludge Disposal
Facility Site Review ERIuanVReoliking Waters Self-Monitoring Fragrant Other:
Section D:Summery of FindinIS/Comments/Attach addition�l sheets ilnecessary)
.Sx4ru files Ca/(ec�ed. Reve4ko C fF,- eACIueA,l A 6e alA,T d7 emu /tiruee.
BOb s4 5/Q
.S'LL — 37 nf..�
/'j'l�� /✓K- e'YV"/ /S Hn°5 A'�"/s �cfaK�/ IRF �Jf�6PKcy� /3 //�/S/GN/�c.e.v/T
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//C9ccs/CP�^ R'/�Sga- Gs /
Namels)an SP9p 11alurels)pl lnspecim(s) eegrtp,/O(j,/T°y�pM1nnC
a,� ENS/ReN nevw .a i/9
-33 /or
siemlm of Reviews Agency/OII¢e one:
// /p- ZZ�BG
Regulatory Office Use Only
Action aken
Oale C.'ri Slelus
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4X�-T''Nencompl ie nee

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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 S. Thomas Rhodes, Secretary
Dear
We acknowledge receipt of the following documents: 19
permit application -APN��1 '�t
engineering plans
specifications
other
Your project has been assigned to fora detailed engineering review.
All project documents will be reviewed with respect to the proposed wastewater facilities.This review will not commit
this Division to approving any expansion of these treatment facilities or increase of flowrate in the future. li
Prior to the issuance of the permit, you will be advised of the recommendations any comments of this Division. Ili
You will also be informed of any matter which needs to be resolved.
}Our reviews are scheduled based on receipt date of complete informations.The items checked below are needed
before your project can be reviewed.
permit application (copies enclosed)
engineering plans (signed and sealed by N.C.P.E.)
specifications (signed and sealed by N.C.P.EJ '1
" other additional information detailed on attachment
The above checked information is needed by . If not received, your application
package will be returned as incomplete. Please be aware that the Division's a Regional Office
must provide RECOMMENDATIONS from the Regional Supervisor or a Procedure Four Evaluation for this project,
prior to final action by the Division.
If you have any questions, please call the review engineer at this telephone number 919/733-5083.
i
Sincerely, C� -I', V 3
Water Quality Division
Nov t 79D5 �I
cc
P.O Box 2]68],Raleigh,North Carolina 27611]68] Telephone 919,7334984
A:hewlle IJ irS Cn ,r.
OAn Equal Opporamity AHinnative Action Employzr

Attachnent
AC0064670
Please be advise of the following infonnatico :
1. An Authorization to Construct cannot be issued until an NPDES Permit
has been issued.
2. The area of the primary subsurface sand filter must be 260 square feet.

/^\ `
( , \/" )
- NON NPDE,, | ACILITY AUD PEXHlT DATA
R6 [RI�VE UP,TI(IN TRXID 6OU |(EY 86�,4676AC
-
PSI%DNAL D&TA FACILIfY APPLYlNG FOR PERMIT APV/PERHIT FEE-$ .88 R&[ION
[6ClLITY NAKE> WATSON |U%lDENCE-NNE 9 C0lNTY> HA�WO()D 81
n 1>6RE%'� ; M All:LIN[ (RE(11UIR[]) oj8NE
NTREEl : kT2, 0)X2i5-C %7K| EiI
CITY , WAYNE%VILLE %T NO ZlF' 23/86 CITy : NONE %T NA IIP 8
TELAPHONE O 8 8 I if PHONE -
%TATE (�ONTAC7 ) IkYIN[ FACIL] TY CONTACT FRED WGOD41,L
P[RKIT fUP|/LICATION IAFOkMATION FOR PERUIT NUKBFR 686467OAC
TyPE OF PRUJECT> AUD1URlZATI()N TO CONSTRUCT PER6I / EXPlKAl ION DATE
DATE APP RCVD 18/21/85 N=NEQ/ il: mODIFICATI MN' R N
DATE AC|(NOWLEDGED I8/36/85
DooflF REVIEWED 18/3OW RETURN DATE / / NPDE% 1-
RE , CUGG KEQ% I8/Z)8/O1�
R8l COMM PC: VD DAHE DENIED / / 16888 MOD
ADD IN|�O REp%
ADD INFO RCVi) 3ATE R[[||RNED / / TRIB DATE-
OT A� CON
OF AG L0M RCVD l)A7E l'S"%UED HERMIT |
END %TAT API, P 6i /12/86
COMMENT% : NEED% NPDEJ INFUK, 16/28/3!� , REC ' D i8/29/8!�5�
H[%WE :

n n r-
0
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 January 23, 1986 R. Paul Wilms
S. Thomas Rhodes, Secretary Director
Ms. Jane Watson
Rt 2, Box 215C
Waynesville, N.C. 28786
SUBJECT: Permit No. NC0064670
Authorization to Construct
Watson Residence
Wastewater Treatment Facility
Haywood County
Dear Ms. Watson:
A letter of request for Authorization to Construct was received October 24,
1985, by the Division and final plans and specifications for the subject
project have been reviewed and found to be satisfactory. Authorization is
hereby granted for the construction of a 300 GPD wastewater treatment facility
consisting of a 1000 gallon capacity septic tank and a 260 square foot subsur-
face sand filler with distribution box to serve the Watson Residence in Haywood
County.
This Authorization to Construct is issued in accordance with Part III
paragraph C of NPDES Pennit No. W0064670 issued January 16, 1986, and shall
be subject to revocation unless the wastewater treatment facilities are
constructed in accordance with the conditions and limitations specified in
Permit No. NC0064670.
The sludge generated from these treatment facilities must be disposed of
in accordance with G.S. 143.215.1 and in a manner approvable by the North
Carolina Division of Environmental Management.
The Asheville Regional Office, telephone number 704/253-3341, shall be
notified at least twenty-four (24) hours in advance of backfilling of the
installed subsurface filter system so that an in-place inspection can be
made of said system prior to backfilling. 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.
In event the facilities fail to perform satisfactorily in meeting its
NPDES permit effluent limits, the Perntittee shall such immediate corrective
action as may be required by this Division, including the construction of
additional wastewater treatment and disposal facilities.
Pollution Prevention Pays
P.O. Box 27697, Raleigh,North Camlina 27611-76U Telephone 919-733Jm5
a4n4 An Equal Opportunity ABirmanve Pcdon Employer

Permit No. NC0064670
Page 2
The sand media of the subsurface filter must comply with the Division's
sand specifications and must be analyzed and approved by this Division either
by direct sampling or by acquisition of filter sand from a dealer who is
currently certified by the Division as an acceptable source.
The septic tank must be pumped once a year and the filters must be rehabili-
tated as needed but should be inspected no less than once every three years of
operation.
If you have any,questions or need additional information, please contact
Ms. Cyretha Irving, telephone number 919/733-5083, ext. 119.
Sincerely yours,
Original Signed By
ARTHUR MOUSERRY
For.
R. Paul Wilms
cc: Haywood County Health Department
Mr. Dennis R. Ramsey
Asheville Regional Supervisor
Cl/ad

uate-Torwarded 1 , Lo, rl I
to :Raleigh: >p s-/ate f
;. .. .. Permit No. N000 4670 r
STAFF REPORT AND RECOMMENDATIONS aywoo u
i
PART I —INSPECTION OF FACILITY
1 . Place Visited: Jane .Watson Residence S
)
(` 2. Date Visited: : September 4,-1985 - C
3. By: Max L. Haner
4. Persons Contacted: Fred::Woodall , .Contractor
-
5. Directions to :Site: From intersection of NCSR 1503 and 1505, travel
north on NCSR .1505 3.1 miles to Hidden Valley Road. Travel east on
Hidden Valley Road 0.5mile to North Fork. Travel approximately r
0.5- mile to property on south side of road in.valley. (Haywood County)
i
6. ,Latitude and :Longitude of the':.Discharge: !
;Latitude: 350.-39' 28" N
L
..Longitude: 820 52' 42" W - - -
_7. _Size.: ..Adequate.
8. Topography: Slopes southward.
9. Location of Nearest...Dwelling: N/A '
10. .._Receiving Stream: Bald Creek
(a) Classification: C
(b) Sub-basin: 04-03-05
(c) Attach map indicating location of discharge point.
I
PART II _ .DESCRIPTION OF DISCHARGE
1 . Type Of Wastewater: Residential/Domestic j

-.2_ (i
2. Volume of Discharge: 300;,gpd (2-bedroom residence)
3. Production Rates and Major Processes. (If industrial , guidelines '..
are based on production.) 1 N/A
4. Description of Treatment Facility/Class: Septic tank/subsurface sand-
filter. - �
5. Sample Locations: N/A
O _ _ .. .
D -
I. _
6. 4-Digit SIC Code : -- -
PART III - OTHER PERTINENT INFORMATION:

-3-
PART IV - RECOMMENDATIONS
Recommend Permit:: be issued.:, r .i
4,
j
i
I
1

11 Name: UAAM4�6..`ik� eQ.A� P e r m i t .
Rece ivl nA Stream: IAY Class ;_ — '/:�Sv D-B as in;.AQ'63�ot r
Co 1.r ; . _. _ �SCI
�./A '-/p F.c_c o r a O' f.. c: . FSQ.C)
r; tc . enc- ii Suja 6,.{:l�y�i.LIJO __ �C t> Is; i na - cposeG '�
Cr eJ. Je5 0 m : ufc �
r�a &.ee Z�—qUi VMUMV— -C /Kje{ 0Tu6� Zeuy ( 11 oueae,�)
3S4or a 1 ( 000
3440' a. C 8� ar
3 aao ' o . e B 00 fW74133d'
3 Geaf
FECCMMENDED EFF i UEIN '. . MITE
( pyd7i
EODS Cmg /.I
( SU
Fecal. Coli i / 100ml ) :
TSS
PI—COMMENDED BY :� IIIfVY t .V Uete.:
A PPROV-eD BY : �1 ' /
P- tonal Engineer :. D<.t ?:
PC'I:TE to TachnIaF. . S.p6or '. ' .z.r.. _. .. .err: : r _ Bring Uni ;
i r:c. 1 es c. cep. of US"S t epos: rn;: . . ^se 1,[ 'wi oc ,. f .discharger )
CIE

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26 A55' 121 18 r =o bo 35°3J 30
P2p� e3poim�E 82°52'80
r ' (TVA 83 N )
t [E � t rr r } t�`+k° RFONU CCASSIFIGATIOM' v
tcrl� r
}e ( dNe Yd tY Fa nt to d �.ryqz
'i x
VAN dum°duty e W a a,nMeaptrack _ ' 2
rM'fiV,. ILL 1TtiCN M D "L f L Fhl tl tY -L mt l 1 a Y"
l' i t "Y
� y r t c 1 o siete Rovre �,J U +$ h to r, r r St to Ro to ae r
F
tag�ga`,rAxlU°`i / i.rn s�� t,c arlr t r t It �4 "s }
"4 h t= tr p yw5y^5 t a ?
" nttx _atq S G � ��_ ! �ti«�. t4
rtrra �f
A4 D"RINGL LOCI Or, t�' ' ` .r FINES ,CREEK.'N:C
,oan, 3 rt -

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4r� t "'.�l ✓iAf �Y.1�t�J�!U �'y��,(JJJ� �����/j{p� rk+.'/ i ' ! j')�'// " � r��� ��l �t.
tL�� � l/ ''E.,
i •� ���Ee 5>rs'" 1. % `�� 7 `Carle"-'+�`-�p, /
�l
326 55' I127 1128 . .... 35r37'30"
330wor, 82'52'30"
: . (TVA lae-NW)
I MILE - ROAD CLASSIFICATION v
1T
NeavY-act y._......-1®, Poor motor road :6—__.
marinate duty Wagon and jeep track
r�YllFNTKY , L Rht duty — Foot tra I Inlarstale R to 11 U S. RouteStata Route
SSEEA `GA s
VUADRANGE., E(OATtON FINES:CREEK. N.C.
N3537.3.W8259.5;7.5

State of North Carolina
Department of Natural Resources and Community Development
Asheville Regional Office
James G. Martin, Governor S. Thomas Rhodes, Secretary
October 15 , .1985
- Mr. Fred Woodall
Route 2 , Box 215C
Waynesville, North Carolina 28786
SUBJECT: NPDES Permit Application and
Plans andSpecifications
Jane Watson Residence
Haywood County, North Carolina
Dear Mr. Woodall:
Receipt of the following documents is hereby acknowledged:
X Application Form
_Engineering Proposal (for proposed control facilities)
Request for Permit Renewal
--T--Permit Processing Fee
x Other Plans, specifications and letter for authorization to
construct.
This application has been forwarded to the Permits and Engineer-
ing Unit in the Raleigh Office for review and preparation of a draft
permit. You will be advised of any comments, recommendations,
questions, or other information necessary for the review of the
application.
A Staff Report and Recommendations regarding this discharge will
be prepared by the Asheville Regional Office. If you have any
questions regarding this application, please contact the Permits and
Engineering Unit, Water Quality Section, Posh Office Box 27687 ,
Raleigh, North Carolina 27611.
Sincerely
cc: Roy M. Davis
Permits and Engineering
Administrative Services
Asheville Regional Office
Inrerchange 1301ding,5911'oodU Place P,O Box 3N, Asheville, N_C 28802-0370•Telephone [phone]
An Equal Opporcuntry Affinrcrmc Aalo� F.mplmer

-- `
JLA . �der�c�sh
- �ssuED
%Ilater Quality Division
acy F t l 8S
wsoe o kFe&,ml Office!
._
� y - --

FNED C. WOODALL 1171
JO ANN'-WOODALL -SPECIAL ACCOUNT
ROUTE 2, BOX 215 C 66210
WAYNESVILLE, NO 28786 —// 19�1 531 N
PAY TO THE 7�
: ORDER OHF ���J] /��QJ-d C {
`�- DOLLARS
F p First Union National.Bank
W1aynes/vllle North Carolina 28786
FOR Nf✓r-2 /Ld-Y�1Nl . 1/dl,//�/�1�2�-�-5-
.. 4

i
NORTH':CAROL TNA-DEPT. .OF`NATURAL '&-ECOHOMIC 'RESOURCES
":ENVIRONMENTAL:'?ANAGEHiENT"tO,%MISSION -
NATIONAL .P.OLLUT'AIdT DISCHARGE"ELIMINATION SYSTEM ....iPPGI CAT I DN-NIIRR(R
APPi:.ICAT,ION' FOR -PERMIT TO':_DISCHARGE--= SHORT!i FORM D
- ... AGPNCY
. .:
USE naDATE.-RECE i eED
To be hil.O only iby el-emblis ,dlesale.and retail trade,
and oEheE dmtrerct el-establ5shnenYS; incluCS r:g-vessels -'
. - .1. .-- •- :--. r, YEAR M. DAY
Do noY zttempt tol o lete'th[s form rt thout .reading tbe.accmwanying instructions
ease'-vrint ortype
7. Name,dcress;..aod-ttelephwe^nuvtmr of"an9i-y producing^discharge
�✓E�� s. Arso v 3V r14XvE r y reCF7-
j' S. Street address,&7- # raX 9,15 PuIVTJ4 06k0A
- :C, city„ rJ ANhJG`rtt,/t"SGIpI� D. stau V� cry/ 33sso-
00
G:.:Telephone No-,..,'�7a 9'�11° 'f0SP
.!.area
Coda
i. ;ietve blank)
1 3 N,,er cf e.;icyees,
Nature of auslnas5,
S. (a) C,.et v,.nere if discharge.occurs all _Ye.r , cr
Ip) CheCk the rt4n ih15)-d.Sch?roe ocevrs' I ``
'.❑JanazrY i:2.ClFebroary _3.0 Nz rch - 4',0 Avril
G.v:vne 7. Jvly a-0 August goseptemer Mo octoder
i'.. ohvvmber i2:rJ Decm'.,er
in,: sa ny day., per-weak:
O -,'ne'. 2 -e eater dii oarped i. Svr'zte wate,s boly (LheCk ai..appliCabie�
1'o:wv trpo ced be t.re
pal ions cer pceracinv .day dtrche . p. in Ipe rec:''
I - .
.a,!.-", aay 50n .coo 10 000 50,0D' N" -
r I I a9 nv nr.imre Y' c I lOD
t
i I I
c i

-7 If any of the types of,waste ,dsnti f.i etlatn 7Tem fi, __et ther treatedaoc.vm- r ib � "�`
treated,_are discharged to-places other than Surface atera,^•nth .�I
V =as.appll cable wa
caste^wa[er is discharged to' -0 1-999 _1000-4999 `'SDDO=9999 19,=-49,999 .50.,000,or more
. A. Munivi Val e—' 'Y'icn
n.
I
C. suptic tank -.
0. Evaporations lagoon or pond
E. Other, specify:
o_ N,nber of S,paratP discharge p0ints:
0..11-6- B.02.-3 C.o=-5 J:o Enor rare
9. Name of receiving water or waters:,�3a.�� LG.
10..Does your discharge contain or is its possible for your discharge to con ain:
one or mire of the following substances added as a,result-of-your-operations,
activities, or processes' ammonia, cyanide, aluminum, beryllium, cadmium,
=chromium, copper, lead, mercuryp, nickel, selenium, Zinc, phenols, oil and ,
grease, and chlorine (residual). )-T
A.Clres 9.° io . Sf�))��a) j3
e . y n 1 am familiar wizii ;he information contained , ^the"'application and �$
tnat to ine pest of my knowledge and:belief such a.information=is 'true, Complete,:and l F
i
i"
Printed Nave o' Gerson Signing
Title
..Date Application Signetl
ri mine ri5 � C2di2-At, /5� a)��cQ�
T
Sl gnature.of App7ican C:-:. v ,:.
1 I
Nor- . 'Cz ec Stator e 14 1-2115 6(o) r_j..nro, des that
ply oerscn -1hc I'noui i• , rcaeo
amy false s_ace-er_ __nresentz__on, -.Cr cer _fication in cay acold-cation, recce rencrt'
or e_ser. 6cccraezi= -Ties or reeu^__ed:`to be.[1La_nt _ned:.uclder Article' i or togs at=ems a'_`
_(:_=� _rent COG 551 an.,J=- 1u ntj-c, SZLCCia or A00 2 x-S 5, Lc 9rs "t
c. c_v_'lc race ers _ cce_arc or, -e'ca.c_.:g or de:vice or:'Method rec_ et to
:c..e_atec z �cde_ .,r iegu a__o o .: ..ne ..=_o•-ie tz,.. -Cn=-ssr
4sileneanc on'4shab e etice=c
_.._
- . - Se�-s no-

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I, "TM1Ki T-o JB= Con15'V2UCT2D or Cpa7G¢ETE MIN TS O
Oops ��.
fzEINL'OQCE ALL. 1:,IQEC('10lJe5 W/ '` ,-Q, n4vzS . IV' O'C' OR
QPP;9- D' +MUAL , ALL . INTG9jo2 . SQR.FpGES To 69 C04TSD . ',..
j N/IT44 vJA7ERTI&AT SEza L.PnlT.
2. 6AFFi..E C6`NSTZL4CTEd? Cr S21C.K c12 CONGZETE
(QeINFCRCE-p: A5 DESe.R18E.a ASovEZ WITP k. CLU�6
R2ovIDEA �IM(Lgr,� •{-o TF4OSE S}lo�rJrt,
3 TAt4Ke 6MI ,4 e)z FLpeCD ON, UNDTSTURSesD X'APTA BASE
6F caMPACTLD TU.ITA6LF FILL /qA-l-cfRrlAL/ To ';00/0 STp, F7e'61-- ,6

I
� ..TY.FI'CAL SOND FILTER " .TTzZNCFIES-
'TREN CH OYERFIIIED
EX IST' 4 � TO 6� TO ALLO�\/
CiRnaND Fr>Q s - LE 'I
//-/% Uf+TRE6TEO IIID�=�// .n=/o'�J 4NT2En'TED
10
OF
� �� BLDG PnPER. � q� /8° 8�4• PV PE2.
s
INLET
AND OL nm
III FILTERD. 1
0 III �..PlLTE1z/sLV�a•. i t
0 Il .
Of
f I 7E MGX.
1
FI LTEFZ TREK C�
1 1 I.
SNOT. TO FILTER BE D I:
SCALE . (TWO OR AAME ]D I6T L)NES)
IrE_%15T_Gfz04ry D1EVEL
slq
`� VNTRHATED t
SLDla. .PdPEiz J
dua.':F1tJE-." r W2 VE, 't
FILTER "5&Nt, FILTER SAND
TO SE APPKOVED
m lc BOAR FILTER ME.a14 SPE Cs. _
GRhVEL 9.35-O.S mm EFF, 61
U LlIFORIY� C�RpDE . < 3. 0 VNIFOP^M-i(
3n / IPD'' COE FI CIENT
�aTN LINE-S, O.S Ie DLLST CONTEN
A YST2i.8 j
4TloN .L,I LIES S{�dLL SE VG. DQAaN TILE (.oPEN 46)NT
PERFO2pTED VG ( TI C�FlT �C)INT � r oR ��., PER✓=O<pTED` PVG . ?
'- FILT72pTE COLLECT ION. L1IJ25 .. 5HLLL. ,E' VC JCINT� V C FF - BELL MID.; SPI CiOT ofzN DKdILI TILE (OPEN
FOFZpTe.D PVC. JOINT) OR PER-
{{
p 15T�1�Lh-ICN LINES- MIn FILTC'n,T E. . CA.LLEGTION LINES S 1
SE 4 -INCN ,�14M E:TBf2 I{pll 3

oivisiONor
Y;r ar r
North Carolina Department of 'Natural "NhNA�=M1'Nr
Robert F. N irm,
'
Resources &Community Development_ er
1?r James.e Hunt Jr Governor - Joseph W Grir3fc y . o
�. Secretary
T on �e 0,0 733 1015
)44
C,� rv�
F1VrD
c>� SC.
� I
yes . ` , , ,I
j
l 4 1
N I r'rt yyµNNN���' Al I5
SUBJECT:, Prlter Sand Analysis Program
Approved Sand Source
, ziH 7p73 .j
Plant
�f
cix�5 Dear FS. � a�,t�4 � j
-
, q, North Carolina Dvisron f Cnpironmen tal Management adaiewledge5 receipt
r(- IL \ur R �h� ;'. Plait of a
k5x is amp le ,of sand thatdias been approved to be used as s,*id media for a sand filter.
bed or'sludge dryingf,bed As per your request,.
r,,, �„ is;hereby cert7.fa.ed as an approved sand source per the Division's Filter Sand
Analysis Program for UJthe . t ,i' quarter of 198=1 L• n
d " The .Division"}isElcoking !fo rward Q working with you for the mutual benefit: ,
o£ xall parties ChaCzTcans beachieved with the success of this program: You are'reminded Fth at this jce;cti fication is� andy valid so long as you comply :with the
ai4 r�.r.requirements aof the I73vrsian�s Palter. $end Analysis Program. If you have any 4
xf {xy i questions please corttact me at telephone number:919/733 5083, extension 104 or:
ka �g }xs. the address stated+yb,e�&lyow
7 rGFdvim6 .7+k,'.h 't,
raS,IN 11
a
a _ ( llo-h"'F%s9 z1-p iu
y Z' 2ussel L.: Talley;'J-c. , CET, Coordinator
� FMen Sand Anal s s. Fro ram,, ,
a Y E
��A^i t L♦ "� S t � � 4 yp
¢J
f Yr 9 t,1 ......
9yf n ,x
.vvyy, t1Rx 1 t + A Y r ,
POG`L UTION PREYENTlON PAYS
f f
P 0 Be.27687 Fala gh N.C.27511 7687, ,
8 t 71A An E9toe70,,,,n 11,A//Ir �Na A¢tlon.fmployer

F .. SEm F _
jl
NOR,TN CAROLINA DIVISION OF-;, ENVIRONMENTAL MANAGEMENT Lab -� S— � fi 3
SAND ANALYSIS CHART
s �x
t �
T � r
i7
.y1 x9r'S e
A4 r
c'++y'djdR 3
m
k if co
¢ ,
El;'FE"CfIVE STYE 0.44 m
z Ii*CdF MIITY. CLEF 2.44
w
i V
1 Er
vn a. � �,e.� Irtaa tMam' limits.)
e
�� '' 9• ISO 1Id9 435 40 r 35 28 20 14 R 0 4
.� �SIEVE NUMBER TYLER SERIES �
Tyler Opening Weight 'Source Sample
Sieve Size Retain site Sample E
C
Number-' �n ' " S1Sludge Drying, Bed
Fi a 5 nd FilterIIed �LJ
G ' 4 699 FOR
6 ' 3 7 8
14 -- 21.316682 C by U� r/yDro e>m��(7ClA•
ERMITS.LENGINEERIN 28 0,58911, CE w.0. 8'W -h°l'u„"SG aq
q.�0 - By
35 0.417 ' Received .�—
Y � 48 0.295 " � E Analyzed 4—�— ly -�-
65 0. 208 I. _
v 100 '. 0. 147 alculations S-Z- 'sR By -�twT-�—
150 0. 104 C i Sample is' Sat' r
..£act nsatij actor
1 PAN. : C, I
SAND CRITERIA �
Effective Size
Sludge Drying Bed 0. 30 0. 50 mm Rus'se1 L. T ley, Jt. , EI
„ed : 0. 35,,— 0. 50 mm Environmental Engineeda.g Tecb. II
Sand. Filter "

,11�
mw
State of North Carolina
Department of Natural Resources and Community Development
Asheville Regional Office
James G. Marcin, Governor S. Thomas Rhodes, Secretary
October 15, 1985
Mr. Fred Woodall
Route 2 , Box 215C
Waynesville, North Carolina 28786
SUBJECT: NPDES Permit Application and
- Plans and Specifications
Jane Watson Residence
Haywood County, North Carolina
Dear Mr. Woodall:
Receipt of the following documents is hereby .acknowledged:
R Application Form
__Engineering Proposal (for proposed control facilities)
Request for Permit Renewal
— Permit Processing Fee
X Other Plans , specifications and letter for authorization to
construct.
This application has been forwarded to the Permits and Engineer-
ing Unit in the Raleigh Office for review and preparation of a draft
permit. You will be advised of any comments, recommendations,
questions, or other information necessary for the review of the
application.
A Staff Report and Recommendations regarding this discharge will
be prepared by the Asheville Regional Office. If you have any
questions regarding this application, please contact the .Permits and
Engineering Unit, Water Quality Section, Post Office Box 27687 ,
Raleigh, North Carolina 27611.
S cc: Roy M. Davis incerel�///qqq
Permits and Engineering
Administrative Services (/Asheville Regional Office
Inve¢h�ngc 1ild,,, 59 W,OAH. Place, P_Q 6ox 390, Asheville, N.C. 26802M370•Telephone Al 253-3341
Ao Equal Opportunlw Afiimiadvc Actlon N,,1,cr

sr � �
'85NAUW
State of North Carolina
Department of Natural Resources and Community Development
Asheville Regional Office
James G. Martin, Governor S. Thomas Rhodes, Secretary
October 15, 1985
Mr. Fred Woodall
Route 2 , Box 215C
Waynesville, North Carolina 28786
SUBJECT: NPDES Permit Application and
Plans and Specifications
Jane Watson Residence
Haywood County, North Carolina
Dear Mr. Woodall:
Receipt of the following documents is hereby acknowledged:
X_Application Form -
__Engineering Proposal (for proposed control facilities)
Request for Permit Renewal
--r—Permit Processing Fee
X Other Plans , specifications and letter for authorization to
construct.
This application has been forwarded to the Permits and Engineer-
ing Unit in the Raleigh Office for review and preparation of a draft
permit. You will be advised of any comments , recommendations,
questions, or other information necessary for the review of the
application.
A Staff Report and Recommendations regarding this discharge will
be prepared by the Asheville Regional Office. If you have any
questions regarding this application, please . contact ..the Permits and _. .
Engineering Unit , water Quality Section, Post Office Box 27687 ,
Raleigh, North Carolina 27611.
Sincerely/
cc: Roy M. Davis
Permits and Engineering
Administrative Services // l
Asheville Regional Office
Inverchange Building, 59 Wnod4in Place, P,0 alo 370, Asheville, N C. ]880]UM •TeleOhone 70 253 3311
An Equal Opportusa•AfFrmsive Flccion f-mplova

State of North Carolina
Department of Natural Resources and Community Development
Asheville Regional Office
James G. Martin, Governor S. Thomas Rhodes, Secretary
October 15 , 1985
Mr. Fred Woodall
Route 2, Box 215C
Waynesville, North Carolina 28786
SUBJECT: NPDES Permit Application and
Plans and Specifications
Jane Watson Residence
Haywood County, North Carolina
Dear Mr. Woodall:
Receipt of the following documents is hereby acknowledged:
X Application Form
__Engineering Proposal (for proposed control facilities)
Request for Permit Renewal
Permit Processing Fee
X Other Plans , specifications and letter for authorization to
construct.
This application has been forwarded to the Permits and Engineer-
ing Unit in the Raleigh Office for review and preparation of a draft
permit. You will be advised of any comments, recommendations,
questions, or other information necessary for the review of the
application.
A Staff Report and Recommendations regarding this discharge will
be prepared by the Asheville Regional Office. If you have any
questions regarding this application, please contact the Permits and
Engineering Unit, Water Quality Section, Post Office Box 27687 ,
Raleigh, North Carolina 27611.
Sincerely,
cc: Roy M. Davis -7
Permits and Engineering
Administrative Services
Asheville Regional Office
In,erchange BWldii, 59 Woodhn Place, RO, Ilox 370, Asheville, N.C. 28802-0370•lelephone 7042B 3341
An [yual Oppammiry A(H,n.aave Amon Ernpfovcr

swf s
State of North Carolina
Department of Natural Resources and Community Development
Asheville Regional Office
James G. Martin, Governor S. Thomas Rhodes, Secretary
October 15, 1985
Mr. Fred Woodall
Route 2 , Box 215C
Waynesville, North Carolina 28786
SUBJECT: NPDES Permit Application and
Plans andSpecifications
Jane Watson Residence
Haywood County, North Carolina
Dear Mr. Woodall:
Receipt of the following documents is hereby acknowledged:
X Application Form ='
_Engineering Proposal (for proposed control facilities)
Request for Permit Renewal
-- Permit Processing Fee
X Other Plans, specifications and letter for authorization to
construct.
This application has been forwarded to the Permits and Engineer-
ing Unit in the Raleigh Office for review and preparation of a draft
permit. You will be advised of any comments , recommendations ,
questions, or other information necessary for the review of the
application.
A Staff Report and Recommendations regarding this discharge will
be prepared by the Asheville Regional Office.. If you have any
- questions regarding this application, please contact the Permits and
Engineering Unit, Water Quality Section, Post Office Box 27687 ,
Raleigh, North Carolina 27611.
Sincerer
cc: Roy M. Davis � ,
Permits and Engineering
Administrative Services
Asheville Regional Office
Inrerchange BulldinF, 59 Woodfin Place, PO Box 370, Asheolle, N.C.288024B70 •_Idephor 704253-334I
An Equal Opportunity AHirmadve Acfian Dn,Io,,,

ce( ksr
//AiG ��GPZ �GGC2 $ Wlc�t T.iu Siu�rr6 .
*��f17Z ��ikTUJ 44 ✓�ic /✓t P
14ddmu
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Z �<<LS n,U.CEay�
Cs:

14}J r,\ 9l x�Ifs . 3s47
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IOU
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' (��trA'={ ��+, r• l .,( �1l � �� I A'� �! � w � I x t � � 7 45 -
'o���ry
gg
�roo'� - a4 m
I)
��� .) ��a )./lt�„_ �ll r—"� ,7 ��,i�— 1 j l f / !�� —•A 35"37'30"
r2b 55' 17 irpg • „.,,o,.—�ro�.,��...,.�".. ,. ,..,<.."..e —,,, -
vyq � ajp000,.{ 82"52'30"
� WLf ROAO.CLAS5I CLASSIFICATION (NA 183-NW)
ti T
Heavy-duty .. .... Poor motor road .
---- s q.
*so
m
M dwm-duty Wagon and jeep track ___ a, a
MQ LL KENTUCNY ,YA Lght duty ... l Foot trail L___ e.SF
Interstate Route C� U S. Route (,) Stale Route
:TENN�SSEE eNL
MI55� "'ALA GA. S.0
QUADRANGLE LOCATION FINES CREEK. N.C.
.., N3537.5.bV825O.5.7.5

_ASV." '��e, '• �
�P
V
",J�� U(V]� '+•..•i �`!a i lash Ce�roli��cL
y,1 10 State of North Carolina
Department of Natural Resources and Community Development
Sll North SilMxuySum•RaIeWi,North Gtolim Y76n
lama G.Mawry Governor (jc fd6er S.Thomu Rhoda,SmetNy
fir. FreaL 6dem�Q,��,
�awLt, a �./sue
f�v• G b.Su ect.
/ . 4ppliratton for ! ES Pertdt
Coumty
..��.•.•:: :" _.. _:>teoefPr tf the f .. . d17,ouLe6 docmeab� L hereby
ndPplicattm Pots - -
nwinearbw Proposal (for proposed eoetrol facilities)Request for "
PC= t rewal
�J
e.
Or r/ [v-ilk ���J!
RL4 tf ary of tie Sp Are aPP>sa+ C, Is io co aed tie fedteiLd3 re
tsC+) tmtar be received before. review .ata begin:
!PPdie+tlaa rocs (iypj. see, .. ) -
Pmposal{See (b) 1-5 on at .
ts-aetTce ms*�,ete C3O1 �7e. '�be� �f',,�[ r6 .
• tb ion asd any 6gt+ Wbitt d ebm eiomg r..
(919f 1JJ- �Pltueian bees ssstped m x '
_ soul) of oto•Peadrs Deft for.testev d daft permit.
prior to ti the p t is dcaft". Public rob a es qt be -Ussed for fort,-f#�e (4S) days
ad or stile.on the tswrsaoe.er dental of the Penh. you trill be advised
�ex's. lwtttoes
Merle. or etLer tafoaeeiaa aeessezt fur tie
14016 b espl of ttda let4t. tegaestins tbst oar a.,, ni Office Strpestdsee rcermaMa staff
ta r d ro nda �
oe0wabe this df4disrde. tf you be
above. �s this diOu• pie contact the orvi.person listed
(�
t 1AN' AU thta Mouberry. P.H.
I v Supervisor. Permits and Huttneeriva
regional Supervisor

Lk_ l ; 11 —10✓ 1
1
_1il,U
tees I vet: err-
NORTH CAROLINA DEPT.,WJNATURAL .&''ECONDMIC:;RESOURCES
,
':ENVIRONMENTAL'MANAGEMENT-MMISSIDN
'NATIONAL POLLUTANT`DISCHARGE`zELIMINATION:_SYST£M ...
„, r .•'"APPLI CAT ION-NUMBER -.,.
AP_P.LICATION`fOR PERMIT TO DISCHARGE =SHORT FORM D FOR7f p
AGENCY
USE ': DATE RECEIVED
To be filed only by services, wholesale and retail trade,
-land other rcoreerciel-establishments includiN Vessels _
.. . ..-_._ .. .. . YEAR ._._ ,. MO.. . DAY
Do not attempt to cosylete this form without reeding the.accompanying instructions
Please print or-type
`1. Name, add ess `and'telephdne+number f-taci ii:y-producin9-discharge —A. Ram �HNEs�•cJATSoIiJ 32/ f7f�FRl'&r .ST.F6KT
B, Street +ddreea„�T#- a 01X AIS. 0 - Pa MWTA GOR n4 FLP-
C. city, ff) D. State //.0 33T'
_ E'7-:County:_.9RN6#) OD f. ZIP 200
G. Telephone No. .
Area
2. s1c
Lode
- (Leave blank) OCT I ,?
15tln '
T . v
3. Mlxn6er cf employees, ,-. r •., . _
NEERING
v. Ile tUre of ppS SnaSS
5. (t) Eheck mere if discharge occurs all year
ib) Check the manth(s) Discha;ye occurs:
1.0 January 2.0 February 3.0 March 4.0 April 5.0 May
6,0 June 7.0 July 8,0 August 9.0 September 10.0 October
11.0 November 12.a December
1c! now many days Der week:
1.01 2.0.2-3 3.04-5 4.06-7
6. -rpes o` waste water discharged to surface waters only -(check-as.applicable)
Flow, gallons per operating day Volume treatea before
discharging (Dercen:`
Wschtrpe de,
oreraCng Day 0.1-999 1000-4999 5DOC-9999 10,000- . 50,00 None 0.1- K. -
;: p6.
49,9g9 or no no S I =.9 Sa.S Ma(I) .(2) _ (3, (4) - (5! I fFi O .:) 51 Ili)
average call, f l
.. evertor 1 1
Coolln . ate-...etc.. . _I
tlai 1. -age i
C:ner to cna reelsi. ! I
_ anil. avertne; i �
1
i

,- '-�-
7 If any of the types of-waste' idanttfiedsan�Sem 6 retzher ateeateOaoP.un-c Kf'{a�� r
II tree ted,_uc dtschar d to- laces other than'�surfett+mtt
9e D •e qy q°b�, ++Ra°iaiY 5^ :v �'a �.,e
.cos aPDl icable »• -•.�'rs
-$.a?caraa`a: .r
.Waste:-water is discharged to: 0.1-999 IODO-4999 ''-SDD0=9999 10,D00-49,999 ' 50,000 or.Wore
A. Mun i ci Wl %,-., sy.tom
h. �h.Irr'q,,xnid wril
C. Suptic tank
➢, Evaporation lagoon or pond
E. -Other, specify:
8 Number of separate discharge points:
.A. B.❑.2 3 `, C.0 c-` 0,o6 or more
9. Mahe Of receiving water-or wa ter,
10. Does your discharge,contain or is it possible for your discharge to contain
we,or more Of the'fdllowing substances added as a-result of your-Operations,.-
eftiJi[les, or Processes: ammonia, cyanide, aluminum, beryllium, cadmium, -
chromium, copper, lead,'-mercurp, .nickel, selenium, zinc, phenols, oil end -I
grease, and chlorine (residual). ! 5 A J F
A-oyes D:?ip r AA n
) certify :hat 1 am familiar with the infca ertion contained in the aopiication and
tna: to the best of my knowledge and belief such information is true, complete, and
accurate. 0 C T t'
CP0 t.
Printed Name of Person Signing I 5 "' t)
Title
9 - ib- 8S`
- -Date Application Signed
-r dm4_ o��
Signature of Applicant
North Caralina Genera'_ Statute 143-215.6(b) (2) trotides that: Any verso. iinc knoviag'_r-makes
an; False staterett representation, or certification in any application, record, report, Diaz-
or other dccontenr '_ties or required to be lcaiatained under Article 21 or regulations o` t^e
Fnvir- e tz-' Y:- geneat Ca,ission 1.-oiementing that Article, or who-`.alsi`_ies, tzoirners v_
or lcnow-ly renders inaccurate =v record'_ng or -,. n-:Cring device or method 'reeu'_ee2 to S,
overated cr = --_ ta-rec --der ._-tic'_, '_ or reguatiots Cf tie Eavirorntental Ya29e-eat C0--
_�ent'_-:g , _.-.a_= _ __ . eE c _isceeeacor nutisnable nv z Pine not o ez-e`-
cr __son=•_=_nt c-__ ._'c;t=e' iz ❑_ns Crby :.a_:. (i` r.S.C- Settior __..___ _
-.n. _ ,nn� __ se�rt..zc ___ _ t....r. 5 years, ._ -c

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