WQ0009772_LPP DISPOSAL FIELD TRANSFER TO NEW PERMIT_20200707

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Burgin Engineering Inc.
July 7, 2020
Mr. Robert Tankard
Assistant Regional Supervisor
Division of Water Resources
Water Quality Regional Operations Section
943 Washington Square Mall
Washington, NC 27889
Reference:
Corolla Light WWTF #1, 40,000 GPD Subsurface Capacity transfer to Monteray Shores
Permit
Carolina Water Service, Inc. of N.C.
Minor Modification Major Facility Permit Application
W00035411 (partial 40,000 GPD) to W00009772
Currituck County
Dear Robert,
Please find attached, the minor modification application to transfer the existing 40,000
GPD subsurface disposal facility located at the Whalehead Club from the Corolla Light
WWTP #1 permit WQ0035411, upon closure of the Corolla Light facility #1, to the
Monterey Shores Wastewater Treatment Plant Facility permit WQ0009772 as we have
previously discussed.
The abbreviated application is attached. I thought this to be a minor modification that
would not have an application fee. If this is not correct, just let me know. If anything,
else needs to be added to the application please let me know. Your assistance in the
review of this matter would be greatly appreciated by all parties.
If you have any questions concerning this matter, please feel free to call upon me at any time at
[phone].
Sincerely,
Burgin Engineering, Inc
Robert G. Burgin, Jr., PE \
Attachments
cc: Carolina Water Service, Inc. of NC
Outer Banks Ventures, Inc.
Burgin Engineering, Inc. • PO Box 1804, Irmo, SC 29
Phone [phone]

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
15A NCAC 02T .0700 — HIGH -RATE INFILTRATION SYSTEMS
Division of Water Resources INSTRUCTIONS FOR FORM: HRIS 06-16 & SUPPORTING DOCUMENTATION
Plans, specifications and supporting documents shall be prepared in accordance with 15A NCAC 02H .0400 (if necessary), 15A
NCAC 02L .01009 15A NCAC 02T .0100, 15A NCAC 02T .0700, Division Policies and good engineering practices. Failure to
submit all required items will necessitate additional processing and review time.
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit website
General — When submitting an application to the Water Quality Permitting Section's Non -Discharge Permitting Unit, please use the
following instructions as a checklist in order to ensure all required items are submitted. Adherence to these instructions and checking
the provided boxes will help produce a quicker review time and reduce the amount of requested additional information.
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation.
A. Cover Letter (All Application Packages):
® List all items included in the application package, as well as a brief description of the requested permitting action.
B. Application Fee (All New and Major Modification Application Packages):
® Submit a check, money order or electronic funds transfer made payable to: North Carolina Department of Environmental
Quality (NCDEQ). The appropriate fee amount for new and major modification applications may be found at: Standard Review
Project Fees.
C. High -Rate Infiltration Systems (FORM: HRIS 06-16) Application (All Application Packages):
® Submit the completed and appropriately executed High -Rate Infiltration Systems (FORM: HRIS 06-16) application. Any
unauthorized content changes to this form shall result in the application package being returned. If necessary for clarity or due
to space restrictions, attachments to the application may be made, as long as the attachments are numbered to correspond to the
section and item to which they refer.
❑ If the Applicant Type in Item I.2. is a corporation or company, provide documentation it is registered for business with the
North Carolina Secretary of State.
❑ If the Applicant Type in Item I.2. is a partnership or d/b/a, enclose a copy of the certificate filed with the Register of Deeds in
the county of business.
❑ The facility name in Item II.1. shall be consistent with the facility name on the plans, specifications, agreements, etc.
❑ The Professional Engineer's Certification on Page 13 of the application shall be signed, sealed and dated by a North Carolina
licensed Professional Engineer.
❑ The Applicant's Certification on Page 13 of the application shall be signed in accordance with 15A NCAC 02T .0106(b). Per
15A NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation letter is provided from
a person who meets the criteria in 15A NCAC 02T .0106(b).
❑ If this project is for a renewal without modification, use the Non -Discharge System Renewal (FORM: NDSR) application.
D. Property Ownership Documentation (All Application Packages):
➢ Per 15A NCAC 02T .0704(fl, the Applicant shall demonstrate they are the owner of all property containing the wastewater
treatment and high -rate infiltration facilities:
❑ Legal documentation of ownership (i.e., GIS, deed or article of incorporation), or
❑ Written notarized intent to purchase agreement signed by both parties with a plat or survey map, or
❑ Written notarized lease agreement that specifically indicates the intended use of the property and has been signed by both
parties, as well as a plat or survey map. Lease agreements shall adhere to the requirements of 15A NCAC 02L .0107.
❑ Provide all agreements, easements, setback waivers, etc. that have a direct impact on the wastewater treatment, conveyance,
storage and high -rate infiltration facilities.
INSTRUCTIONS FOR FORM: HRIS 06-16 & SUPPORTING DOCUMENTATION Page 1 of 6

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
15A NCAC 02T .0700 — HIGH -RATE INFILTRATION SYSTEMS
Division of Water Resources FORM: HRIS 06-16
I. APPLICANT INFORMATION:
l . Applicant's name: Carolina Water Service, Inc. of NC
2. Applicant type: ❑ Individual
® Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal
❑ State ❑ Municipal ❑ County
3. Signature authority's name: J Bryce
Mendenhall per 15A NCAC 02T .0106(b) Title: Vice President of Operations
4. Applicant's mailing address: 4944 Parkway Plaza
City: Charlotte State: NC
Zip: 28217-1983
5. Applicant's contact information:
Phone number: [phone]
Email Address: bryce.mendenhall(a)carolinawaterservicenc.com
II. FACILITY INFORMATION:
1. Facility name: Monterey Shores
2. Facility status: Existing
3. Facility type: Major (> 10,000 GPD or > 300 disposal acres)
4. Facility's physical address: 824 Malia Drive
City: Corolla State: NC Zip: 27927- County: Currituck
5. Wastewater Treatment Facility Coordinates (Decimal Degrees): Latitude: 36.3294' Longitude:-75.8211 °
Datum: NAD83 Level of accuracy: Nearest minute Method of measurement: Geodetic quality GPS surveX
6. USGS Map Name: Mossey Islands
III. CONSULTANT INFORMATION:
1. Professional Engineer: Robert G. Burgin, Jr.
Mailing address: PO Box 1804
License Number: 10184 Firm: Bur ig n En ing eerine Inc.
City: Irmo State: SC
Zip: 29063-
Phone number: [phone]
Email Address: rjzb(a,bur ig nen ing eeringinc.com
2. Soil Scientist:
License Number: Firm:
Mailing address:
City: State:
Zip: -
Phone number: (_) _-
Email Address:
3. Geologist:
License Number: Firm:
Mailing address:
City: State:
Zip: -
Phone number: (_) _-
Email Address:
4. Agronomist:
Firm:
Mailing address:
City: State:
Zip: -
Phone number: () -
Email Address:
FORM: HRIS 06-16 Page 1 of 13

IV. GENERAL REQUIREMENTS —15A NCAC 02T .0100:
1. Application type: ❑ New ❑ Major Modification ❑ Minor Modification
If a modification, provide the existing permit number: WQ0009772 and most recent issuance date: 2014
2. Application fee: $0 - Standard - Minor Modification
3. Does this project utilize public monies or lands? ❑ Yes or ® No
If yes, was an Environmental Assessment required under 15A NCAC 01 C? ❑ Yes or ❑ No
If yes, which final environmental document is submitted? ❑ Finding of No Significant Impact or ❑ Record of Decision
Briefly describe any mitigating factors from the Environmental Assessment that may impact this facility:
4. What is the status of the following permits/certifications applicable to the subject facility?
Permit/Certification
Date
Submitted
Date
Approved
Permit/Certification
Number
Agency Reviewer
Collection System (Q > 200,000 GPD)
Dam Safety
Erosion & Sedimentation Control Plan
Nationwide 12 / Section 404
Pretreatment
Sewer System
Stormwater Management Plan
Wetlands 401
Other:
5. What is the wastewater type? ® Domestic or Industrial (See 15A NCAC 02T .0I03(20))
Is there a Pretreatment Program in effect? ❑ Yes or ❑ No
Has a wastewater chemical analysis been submitted? ❑ Yes or ❑ No
6. Wastewater flow: 40,000 GPD
Limited by: ❑ Treatment, ❑ Storage, ® Field/Basin Hydraulics, ❑ Field Agronomics or ❑ Groundwater Mounding
7. Explain how the wastewater flow was determined: ❑ 15A NCAC 02T .0114 or ❑ Representative Data
Has a flow reduction been approved under 15A NCAC 02T .0114(f)? ❑ Yes or ® No
Establishment Type
Daily Design Flow a
No. of Units
Flow
Residential
120 gal/bedroom
333
40,000 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
GPD
a See 15A NCAC 02T .0114(b), (d), (e)(1) and (e)(2) for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-4).
FORM: HRIS 06-16 Page 2 of 13

Professional Engineer's Certification:
Robert G. Burgin, Jr.
I, attest that this application for
(Professional Engineer's name from Application Item IILL)
Monetary Shores
(Facility name from Application Item 11.1.)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications, engineering
calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best of my knowledge the
proposed design has been prepared in accordance with this application package and its instructions, as well as all applicable regulations
and statutes. Although other professionals may have developed certain portions of this submittal package, inclusion of these materials
under my signature and seal signifies that I have reviewed this material and have judged it to be consistent with the proposed design.
NOTE --- In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement,
representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may include a fine not to
exceed $10,000, as well as civil penalties up to $25,000 per violation. `
North Carolina Professional Engineer's seal, signature, and date:
. e
Applicant's Certification per 15A NCAC 02T .0106(b):
I J Bryce Mendenhall ) I attest that this application for
(Signature Authority's name & title from Application item I.3.)
Monteray Shores
(Facility name from Application Item H.1.)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that any discharge of wastewater
from this non -discharge system to surface waters or the land will result in an immediate enforcement action that may include civil
penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition
ofthis permit be violated. I also understand that if all required parts of this application package are not completed and that if all required
supporting information and attachments are not included, this application package will be returned to me as incomplete_ I further certify
that the Applicant or any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility without
proper closure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are compliant with any
active compliance schedule, and do not have any overdue annual fees per 15A NCAC 02T .0105(e).
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any Use statement,
representation, or certification in any aEplication package all be guilty of a Class 2 misdemeanor, which may include a fine not to
exceed $10,00q as wtkas civil penaly up to �25,000 pet olAion.
Signature: f Date: July S, 2020
FORM: HRIS 06-16 Page 13 of 13