NCG550342_Regional Office Historical File Pre 2018

Fitt:OPER Governor
MICHAEL S. REGAN
Secretary
Environmental S. JAY ZIMMERMAN
Quality Director
August 3, 2017
Mr. Edward Stokes
164 Kaywood Lane
Statesville,NC 28625
Subject: Compliance Evaluation Inspection
164 Kaywood Lane
Certificate of Coverage No. NCG550342
Iredell County
Dear Mr. Stokes:
Enclosed is a copy of the Compliance Evaluation Inspection Report for the inspection conducted
at the subject facility on August 2, 2017,by Mr. Wes Bell of this Office.
Should you have any questions concerning this report,please do not hesitate to contact Mr. Bell
at(704)235-2192, or via email at [e-mail].
Sincerely,
W. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources,NCDEQ
Enclosure:
Inspection Report
cc: Iredell County Health Department
MSC-1617 Central-Basement
WB
Mooresville Regional Office
Location:610 East Center Ave.,Suite 301 Mooresville,NC 28115
Phone:[phone] Fax:[phone] Customer Service:1-877-623-6748
Internet www.ncwaterquality.org

United States Environmental Protection Agency Form Approved.
EPA Washington,D.C.20460 OMB No.2040-0057
Water Compliance Inspection Report Approval expires 8-31-98
Section A:National Data System Coding(i.e.,PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 1 u 1 2 I5 I 3 I NCG550342 111 12 1 17/08/02 117 18 i,.i 19 i G I 2011
21111I 11 I I I III I I I I I I I I I I I I I I I I I I I I I I III I I I I I I6
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA --- Reserved------
6711.0 1 70 1, I 71 L 1ti 1 72 1 �, 1 731 I I74 75J I I I 1 1 1 180
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
POTW name and NPDES permit Number) 09:53AM 17/08/02 13/08/01
164 Kaywood Lane
164 Ka pod Ln Exit Time/Date Permit Expiration Date
yw
Statesville NC 28677 10:15AM 17/08/02 18/07/31
Name(s)of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s) Other Facility Data
///
Edward B Stokes///
Name,Address of Responsible OfficialTitle/Phone and Fax Number
Contacted
Edward B Stokes,164 Kaywood Ln Statesville NC 28677///
Yes
Section C:Areas Evaluated During Inspection(Check only those areas evaluated)
11. Permit Flow Measurement El Operations&Maintenance II Records/Reports
111 Self-Monitoring Program II Sludge Handling Disposal Facility Site Review 111 Effluent/Receiving Waters
• Laboratory
Section D:Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s)and Signature(s) f Insper (s) Agency/Office/Phone and Fax Numbers Date
Wes Bell 7. / MRO WQ//704-663-1699 Ext.2192/ /37/ 7
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
W. Corey Basinger MRO WQ//704-235-2194/
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.....000460.400004 4 A 3
, `Z • NF•Q
Page# 1

NPDES yr/mo/day Inspection Type 1
31 NCG550342 I11 121 17/08/02 117 18 U
Section D:Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
Page# 2

Permit: NCG550342 Owner-Facility: 164 Kaywood Lane
Inspection Date: 08/02/2017 Inspection Type: Compliance Evaluation
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new 0 0 • 0
application?
Is the facility as described in the permit? • 0 0 0
#Are there any special conditions for the permit? 0 0 • ❑
Is access to the plant site restricted to the general public? 0 0 • 0
Is the inspector granted access to all areas for inspection? • 0 0 0
Comment: The last compliance evaluation inspection was performed on 10/16/15 by DWR staff.
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ❑ 0 • 0
Does the facility analyze process control parameters,for ex: MLSS,MCRT, Settleable ❑ ❑ • 0
Solids, pH, DO, Sludge Judge,and other that are applicable?
Comment: There is currently one resident(permittee) in the house; therefore, very little wastewater is
generated for the treatment system. The permittee performs periodic inspections and
indicated that no discharges have been observed from the treatment system.
Septic Tank Yes No NA NE
(If pumps are used)Is an audible and visual alarm operational? • 0 0 ❑
Is septic tank pumped on a schedule? ❑ 0 ❑ •
Are pumps or syphons operating properly? ❑ 0 0 •
Are high and low water alarms operating properly? ❑ ❑ ❑
Comment: The wastewater facility includes a septic tank and a pump tank. The pump tank is equipped
with a high water alarm. The permittee must ensure that the high water alarm system stays
powered via plugged into the electrical outlet.
The permittee must also ensure that the septic tank is pumped according to the
requirements of the Permit(Operation &Maintenance Permit Condition#3).
Sand Filters (Low rate) Yes No NA NE
(If pumps are used) Is an audible and visible alarm Present and operational? ❑ ❑ ❑
Is the distribution box level and watertight? ❑ ❑ Elli
Is sand filter free of ponding? 0 ❑ 0 •
Is the sand filter effluent re-circulated at a valid ratio? ❑ 0 • 0
#Is the sand filter surface free of algae or excessive vegetation? 0 • 0 0
#Is the sand filter effluent re-circulated at a valid ratio?(Approximately 3 to 1) 0 0 • 0
Page# 3

Permit: NCG550342 Owner-Facility: 164 Kaywood Lane
Inspection Date: 08/02/2017 Inspection Type: Compliance Evaluation
Sand Filters (Low rate) Yes No NA NE
Comment: The general area of the sand filter bed (subsurface)contained an abundant amount of
vegetation. The permittee must ensure that the vegetation is properly maintained including
the removal of any woody vegetation with significant root systems(trees, etc.). Improper
vegetation maintenance can lead to operational issues with the sand filter bed including
ponding, surface runoff, etc.
Disinfection-Tablet Yes No NA NE
Are tablet chlorinators operational? • 0 0 0
Are the tablets the proper size and type? • ❑ 0 0
Number of tubes in use? 2
Is the level of chlorine residual acceptable? 0 0 • 0
Is the contact chamber free of growth, or sludge buildup? 0 0 • 0
Is there chlorine residual prior to de-chlorination? 0 0 • 0
Comment: No evidence of wastewater flowing through this treatment unit was observed during the
inspection.
De-chlorination Yes No NA NE
Type of system? Tablet
Is the feed ratio proportional to chlorine amount(1 to 1)? 0 0 III 0
Is storage appropriate for cylinders? 0 0 IN 0
#Is de-chlorination substance stored away from chlorine containers? 0 0 • 0
Comment:
Are the tablets the proper size and type? • ❑ 0 0
Are tablet de-chlorinators operational? • 0 0 ❑
Number of tubes in use? 1
Comment: Powder was observed in the tablet dechlorination unit's sleeve. The permittee was using
the previous Owner's Norweco container and tablets/powder. The dechlorination tablets
had been previously crushed into powder. The permittee must remove the powder from the
treatment unit and initiate the usage of dechlorination tablets as soon as possible. No
evidence of the dechlorination powder was observed in the receiving stream.
Effluent Pipe Yes No NA NE
Is right of way to the outfall properly maintained? • 0 0 0
Are the receiving water free of foam other than trace amounts and other debris? • 0 0 0
If effluent (diffuser pipes are required) are they operating properly? 0 0 IN 0
Comment: No effluent discharges were observed at the time of the inspection.
Page# 4

hgc,„.
MICHAEL S. REGAN
Secretary
Environmental S. JAY ZIMMERMAN
Quality Director
July 17, 2017
Mr. Edward Stokes or current tenant
164 Kaywood Lane
Statesville,NC 28625
Subject: Compliance Evaluation Inspection
164 Kaywood Lane
Certificate of Coverage No.NCG550342
Iredell County
Dear Mr. Stokes or current tenant:
Please be advised that Division of Water Resources (DWR) personnel from the
Mooresville Regional Office need to conduct an inspection of your permitted wastewater
treatment system (Permit#: NCG550342). The proposed inspection date has been tentatively
scheduled for August 2, 2017 at 10:00 am. If this date and/or time are not convenient for you,
please contact me at(704) 235-2192 within 48 hours of receipt of this letter so that an alternate
date and/or time can be established.
Should you have any questions or concerns regarding this inspection,please contact me
at the above-mentioned telephone number or via email at [e-mail].
Sincerely,
(Z-(7 "/
Wes Bell, Sr. Environmental Specialist
Mooresville Regional Office
Division of Water Resources,NCDEQ
Mooresville Regional Office
Location:610 East Center Ave.,Suite 301 Mooresville,NC 28115
Phone:[phone] Fax:[phone]\Customer Service:1-877-623-6748
Internet:www.ncwaterguality,org

ROY COOPER
Governor
S. JAY ZIMMERMAN
RECEIVEDINCDENR/DWFP're"°`
Water Resources
ENVIRONMENTAL QUALITY FEB - 2 2017
January 31, 2017 WQROS
MOORESVILLE REGIONAL OFFICE
Mr. Edward Stokes
164 Kaywood Lane
Statesville, NC 28625
Subject: General Permit NCG550000
164 Kaywood Lane
Certificate of Coverage NCG550342
Iredell County
Dear Permittee:
The Division has received and approved your request to transfer ownership of the subject Certificate
of Coverage (CoC) under General Permit NCG550000. As a result, the Division hereby reissues NCG550342.
This CoC is issued pursuant to the requirements of North Carolina General Statue 143-215.1 and the
Memorandum of Agreement between North Carolina and the US Environmental Protection agency dated
October 15, 2007 [or as subsequently amended].
If any parts, measurement frequencies or sampling requirements contained in this General Permit
are unacceptable to you, you have the right to request an individual permit by submitting an individual
permit application. Unless such demand is made, the certificate of coverage shall be final and binding.
Please take notice that this Certificate of Coverage is not transferable except after notice to the
Division. The Division may require modification or revocation and reissuance of the certificate of coverage.
Contact the Mooresville 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 any other State, Federal, or Local
governmental permit that may be required. If you have any questions concerning the requirements of the
General Permit, please contact Brianna Young of the NPDES staff[919-807-6388 or
[e-mail]].
i
Sincer ly,
/QP1
r S.Jay Zimmerman, P.G.
Director, Division of Water Resources
cc:
NPDES File
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
https://deq.nc.gov/about/divisions/water-resources/water-resources-permits/wastewater-branch/npdes-wastewater-permits

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG550342
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,
Edward Stokes
is hereby authorized to discharge <1000 gallons per day of domestic wastewater from a
facility located at
164 Kaywood Lane
Statesville
Iredell County
to receiving waters designated as an unnamed tributary to Fourth Creek, a class C stream in
subbasin 03-07-06 of the Yadkin Pee-Dee River Basin in accordance with the effluent limitations,
monitoring requirements, and other conditions set forth in Parts I, II, and III hereof.
This certificate of coverage takes effect January 31, 2017.
This Certificate of Coverage shall remain valid for the duration of the General Permit.
Signed this day January 31, 2017.
le L._ /
for :'. ay Zimmerman, P.G.
1 irector, Division of Water Resources
By Authority of the Environmental Management Commission

PAT MCCRORY
Governor
DONALD R. VAN DER VAART
Secretary
Water Resources S.JAY ZIMMERMAN
ENVIRONMENTAL QUALITY
Director
November 30, 2016 RECEIVED/NCDENR/DWR
CERTIFIED MAIL 7013 2630 0001 8998 2212 DEC - 6 2016
RETURN RECEIPT REQUESTED
WQROS
MOORESVILLE REGIONAL OFFICE
Mr. Edward Stokes
164 Kaywood Lane
Statesville,NC 28677
Subject: Notice of Violation NOV-2016-PC-0558
Wastewater Disposal at
164 Kaywood Lane, Statesville
Certificate of Coverage(CoC)NCG550342
Iredell County
Dear Mr. Stokes:
Iredell County tax records list Mr. Edward Stokes as the current owner of the subject property. We are
contacting you to determine the status of a wastewater disposal system on your property that was covered by General
Permit NCG550000 under CoC NCG550342. The Division needs information from you to renew coverage under
NCG550000. Please respond by January 16, 2017 with one the following:
➢ If you are the current owner of this property and it still has a wastewater system like the ones described in the
enclosed Technical Bulletin, you must submit a change in ownership form. Please complete the enclosed form
and submit it to Charles Weaver at the address on the form. In addition, a$120 in overdue annual fees is
required to maintain this permit. Please send payment for the enclosed invoice(s):
2014PR010286, 2015PR010891.
(Payment instructions are provided on the invoice.)
➢ If you know that your property no longer discharges wastewater and the treatment system has been replaced
with a different treatment system or connected to a city sewer,please contact me at the address or phone
number listed below to request rescission of the CoC.
If you have questions concerning this matter,please do not hesitate to contact Meredith Wojcik at 919-807-6479
or [e-mail].
nicer ly,
John E. Hennessy
Division of Water Resources, DEQ
cc: Mooresville Regional Office,DWR WQRO
NPDES General Permit Files NOV-2016-PC-0558
Teresa Revis,DWR Budget Office
State of North Carolina I Environmental Quality I Water Resources
1611 Mail service Center j Raleigh,North Carolina 27699-1611
919 707 9000

PAT MCCRORY
Governor
DONALD R. VAN DER VAART
Secretary
Water Resources S.JAY ZIMMERMAN
ENVIRONMENTAL QUALITY
Director
October 10, 2016 RECEIVED/NCDENR/DWR
Mr. Edward Stokes O C T 12 2016
164 Kaywood Lane
Statesville,NC 28677 WQROS
MOORESVILLE REGIONAL OFFICE
Subject: Wastewater Disposal at
164 Kaywood Lane, Statesville
Certificate of Coverage(CoC)NCG550342
Iredell County
Dear Mr. Stokes:
Iredell County tax records list Mr. Edward Stokes as the current owner of the subject property. We are
contacting you to determine the status of a wastewater disposal system on your property that was covered by General
Permit NCG550000 under CoC NCG550342.The last CoC was issued to Michael J. Cox on 8/1/2013. The Division
needs information from you to determine if coverage under NCG550000 is still necessary. Please respond by
November 28, 2016 with one the following:
➢ If you are the current owner of this property and it still has a wastewater system like the ones described in the
enclosed Technical Bulletin, you must submit a change in ownership form. Please complete the enclosed form
and submit it to Charles Weaver at the address on the form. In addition, a$120 in overdue annual fees is
required to maintain this permit. Please send payment for the enclosed invoice(s):
2014PR010286, 2015PR010891.
(Payment instructions are provided on the invoice.)
➢ If you know that your property no longer discharges wastewater and the treatment system has been replaced
with a different treatment system or connected to a city sewer,please contact me at the address or phone
number listed below to request rescission of the CoC.
➢ If you are not sure what type of system your property has, contact Ori Tuvia in the NC DEQ Mooresville
Regional Office at 704-663-1699. This contact [or other staff members] can help you determine if you should
maintain your CoC.
If you have questions concerning this matter,please do not hesitate to contact me at 919-807-6479 or
[e-mail].
Sincerely,
fAhiAL
Meredith Wojcik
Division of Water Resources, DEQ
cc: W .•O
NPDES General Permit Files
Teresa Revis,DWR Budget Office
State of North Carolina I Environmental Quality I Water Resources
1611 Mail service Center I Raleigh,North Carolina 27699-1611
919 707 9000

PAT MCC
DONALD R. VAN DER VAART
Secretors
Water Resources S. JAY ZIMMERMAN
ENVIRONMENTAL QUALITY
Director
S NPDES Certificate of Coverage (CoC) � wJ { _�
'� ,= r ` ` " OWNERSHIP CHANGE FORM = *�
I. Please enter the CoC number for which the change is requested.
Certificate of Coverage
N C 5 5
II. Please provide the following for the requested change(revised permit).
a. Request for change is a result of: ❑ Change in ownership of the residence/property
❑ Name change of the facility or owner
If other please explain:
b. Permit will be issued to(company
name, if applicable):
c. Person legally responsible for permit:
First MI Last
Title
Permit Holder Mailing Address
City State Zip
( )
Phone E-mail Address
d. Facility name(discharge):
e. Facility address:
Address
City State Zip
f. Facility contact person:
First MI Last
( )
Phone E-mail Address
III. Permit contact information(if different from the person legally responsible for the permit)
Permit contact:
First MI Last
Title
Mailing Address
4 0
City State Zip
( )
Phone E-mail Address
N Will this permitted facility continue to discharge the same volume and type of wastewater as
prior to this ownership or name change?
❑ Yes
❑ No(please explain)
Revised 9/2016

IPPIFF
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENTAL QUALITY 11111111 liii 11111111111 11111
INVOICE * 2014PR010286 *
Annual Permit Fee Overdue
This annual fee is required by the North Carolina Administrative Code.It covers the administrative costs associated with
your permit. It is required of any person holding a permit for any time during the annual fee period, regardless of the facility's
operating status.Failure to pay the fee by the due date will subject the permit to revocation.Operating without a valid
permit is a violation and is subject to a$10,000 per day fine.If the permit is revoked and you later decide a permit is
needed,you must reapply,with the understanding the permit request may be denied due to changes in environmental,
regulatory,or modeling conditions.
Invoice Number: 2014PR010286 Annual Fee Period: 2014-12-01 to 2015-11-30
Permit Number: NCG550342 Invoice Date: 11/06/2014
Iredell County
164 Kaywood Lane Due Date: 12/06/2014
Michael J.Cox Annual Fee: $60.00
164 Kaywood Ln
Statesville,NC 28677
Notes:
1. You may pay either by mall with check/money order OR by electronic payment(eCheck or Credit Card).
2. If payment is by check/money order,please remit payment to:
NCDEQ-Division of Water Resources
Attn: Animal/Discharge/Non-Discharge Billing
1617 Mall Service Center
Raleigh,NC 27699-1617
3. If payment is electronic,please see htta:/ldeo.nc.00vlwq-eaavments to pay electronically. Payments by eCheck will debit your
checking account. Credit card transactions will incur a convenience fee.
4. Please Include your Permit Number and Invoice Number on all correspondence.
5. A$25.00 processing fee will be charged for returned checks in accordance with North Carolina General Statute 25-3-512.
6. Non-Payment of this fee by the payment due date will initiate the permit revocation process.
7. Should you have any questions regarding this invoice,please contact the Annual Administering and Compliance Fee
Coordinator at 919-807-6316.
(Return This Portion With Check)
liii III 11111 I 1
* 2 0 1 4 P R 0 1 0 2 8 6
ANNUAL PERMIT INVOICE
Overdue
Invoice Number: 2014PR010286 Annual Fee Period: 2014-12-01 to 2015-11-30
Permit Number: NCG550342
Iredell County Invoice Date: 11/6/2014
164 Kaywood Lane Due Date: 12/6/2014
Annual Fee: $60.00
Michael J.Cox
164 Kaywood Ln
Statesville,NC 28677 Check Number:

NORTH CAROLINA DEPARTMENT OF
ENVIRONMENTAL QUALITY 1111111111 II II
11111111111
I II
INVOICE * 2 0 1 5 P R 0 1 0 8 9 1 *
Annual Permit Fee Overdue
This annual fee is required by the North Carolina Administrative Code.It covers the administrative costs associated with
your permit. It is required of any person holding a permit for any time during the annual fee period,regardless of the facility's
operating status.Failure to pay the fee by the due date will subject the permit to revocation.Operating without a valid
permit is a violation and is subject to a$10,000 per day fine.If the permit is revoked and you later decide a permit is
needed,you must reapply,with the understanding the permit request may be denied due to changes in environmental,
regulatory,or modeling conditions.
Invoice Number: 2015PR010891 Annual Fee Period: 2015-12-01 to 2016-11-30
Permit Number: NCG550342
Invoice Date: 11/06/2015
Iredell County
164 Kaywood Lane Due Date: 12/06/2015
Michael J.Cox Annual Fee: $60.00
164 Kaywood Ln
Statesville,NC 28677
Notes:
1. You may pay either by mall with check/money order OR by electronic payment(eCheck or Credit Card).
2. If payment is by check/money order,please remit payment to:
NCDEQ-Division of Water Resources
Attn: AnimaUDischarge/Non-Discharge Billing
1617 Mail Service Center
Raleigh,NC 27699-1617
3. If payment is electronic,please see htta://dep.nc.gov/wa-eoavments to pay electronically. Payments by eCheck will debit your
checking account. Credit card transactions will incur a convenience fee.
4. Please include your Permit Number and invoice Number on all correspondence.
5. A$25.00 processing fee will be charged for returned checks in accordance with North Carolina General Statute 25-3-512.
6. Non-Payment of this fee by the payment due date will initiate the permit revocation process.
7. Should you have any questions regarding this invoice,please contact the Annual Administering and Compliance Fee
Coordinator at 919-807-6316.
(Return This Portion With Check)
1111111 IIIIIII III 11111111111
* 2 0 1 5 P R 0 1 0 8 9 1 *
ANNUAL PERMIT INVOICE
Overdue
invoice Number: 2015PR010891 Annual Fee Period: 2015-12-01 to 2016-11-30
Permit Number: NCG550342
Iredell County invoice Date: 11/6/2015
164 Kaywood Lane Due Date: 12/6/2015
Annual Fee: $60.00
Michael J.Cox
164 Kaywood Ln
Statesville,NC 28677 Check Number:

Technical Bulletin ©wi
For General Permit NCGS50000 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 chlorination/dechlorination (or equivalent means of
domestic wastewater may be covered under this permit disinfection)and post-aeration apparatus.
with the approval of the Division.
Operation and Maintenance
Changes in Reissued General Permit
In order to protect water quality and to ensure proper
The previous General Permit expired July 31, 2007. The operation of domestic wastewater systems,the following
permit has been reissued for an additional five years. The measures should be taken:
new permit contains the following significant changes • Check the septic tank every year to see if solids
from the previous version: should be removed.
• Dechlorination is now required for all facilities • Have the septic tank pumped out every three to five
installing chlorination after the effective date of the years. Contact a local septic service/repair company
final permit. from the yellow pages.
• Risers will be required on all new septic tanks • Inspect disinfection and dechlorination equipment
making them easier to locate. (if applicable)weekly to confirm proper operation.
• If a chlorinator and/or dechlorinator is installed,
There were also changes made to the Notice of Intent replace tablets whenever necessary.
(NOI) which is filed to gain coverage under this permit.
The NOI requires updated buffer requirements aligning Tips for 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 drainfield. 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 your septic system are:
can be obtained by calling the Division.
• All samples should be collected before the effluent • Do not put too much water into the septic system.
joins or is diluted by any other wastestream,water or Try to conserve water wherever possible.
substance. (Part II,Section 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 your garbage disposal.
system that could significantly increase the quantity • Do not pour grease or cooking oils down the drain.
of pollutants discharged or introduce new pollutants • Have the solids pumped out of the septic tank every
to the discharge. These alterations include any types 3-5 years.
of residence/facility expansions. (Part II, Section • Keep automobiles and heavy equipment off of the
E:3) septic tank and drain field.
• Submission of monitoring reports is not required. All
monitoring information must be retained on site for a Chlorination and Dechlorination Tablets
period of 3 years. (Part II,Section E:1)
If the treatment system has a chlorinator or dechlorinator,
Minimum Treatment System Requirements it is important that there is an adequate supply of tablets
to ensure proper operation. There will usually be a white
System requirements for existing (previously PVC pipe sticking up from the chlorinator/dechlorinator
constructed) systems are a septic tank, sand filter and where the tablets should be inserted. Tablets can be

. ,
,„0 ,
PAT MCCRORY
DONALD R. VAN DER VAART
- S.' rera .al
Envirvr rrzentul 1 6 .da Lain
Quality
October 28, 2015
Mr. Edward Stokes, Owner
164 Kaywood Lane
Statesville,NC 28677
Subject: Compliance Evaluation Inspection
164 Kaywood Lane
Certificate of Coverage No. NCG550342
Iredell County
Dear Mr. Stokes:
Enclosed is a copy of the Compliance Evaluation Inspection for the inspection conducted
at the subject facility on October 16, 2015 by Mr. Ori Tuvia. Your cooperation during the site
visit was much appreciated.
As was discussed during the inspection and as described in the permit,the following
issues are needed to be addressed:
a. Annual fees in the sum of 60$ are due in December.
b. Septic tanks shall be inspected at least yearly, and shall be pumped out every five
years.
c. Flow, Biological Oxygen Demand(BOD) ,Total Suspended Solids (TSS), Fecal
Coliform and Total Residual Chlorine need to be sampled annually.
d. All sample data and results need to be kept on site for at least five years.
e. Chlorine tablets approved for wastewater disinfection,need to be used in the chlorine
tube. Weekly inspections need to be performed to ensure there is an adequate supply
of chlorine tablets used.
The attached report, should be self-explanatory; however, should you have any questions,
please do not hesitate to contact Mr. Tuvia at(704) 235-2190, or via email at [e-mail].
S. erely, ii.„\),
-t.Michael Parker, Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional Office, DWR
Enclosure: Inspection Report
CC: MSC 1617- Central files/Basement
Iredell County Health Department

United States Environmental Protection Agency Form Approved.
EPA Washington,D.C.20460 OMB No.2040-0057
Water Compliance Inspection Report Approval expires 8-31-98
Section A:National Data System Coding(i.e.,PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 N 2 IS I 3 [ NCG550342 I11 12 I 15/10/16 117 18( I 19 I s I 201 1
21I I I I I I I I I I II l 1 1 i l l l l l l l l l l l l l l l l l l l � � � ( � 166
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA ---- Reserved--
67110 I 70 1, I 71 I,. l 72 N I 73[ � 174 75j 1 1 1 1 1 1 180
LJ Section B:Facility Data
Name and Location of Facility Inspected(For Industrial Users discharging to POTW,also include Entry Time/Date Permit Effective Date
POTW name and NPDES permit Number)
02:15PM 15/10/16 13/08/01
164 Kaywood Lane
164 Kaywood Ln Exit Time/Date Permit Expiration Date
Statesville NC 28677 03:OOPM 15/10/16 18/07/31
Name(s)of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s) Other Facility Data
///
Edward B Stokes///
Name,Address of Responsible Official/Title/Phone and Fax Number
Contacted
Michael J Cox,164 Kay
wood Ln Statesville NC 28677//704-682-1609/
No
Section C:Areas Evaluated During Inspection(Check only those areas evaluated)
▪ Permit Flow Measurement 1111 Operations&Maintenance Records/Reports
▪ Self-Monitoring Program 1. Facility Site Review III Effluent/Receiving Waters 11111 Laboratory
Section D:Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s)and Signature(s)of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Ori A Tuvia MRO WQ//704-663-1699/
là!2
Signatu of anage ent Q A Reviewer Agency/Office/Phone and Fax Numbers Date
(C3. -cS
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.
Page# 1

NPDES yr/mo/day Inspection Type 1
31 NCG550342 111 121 15/10/16 11 7 18 I c I
Section D:Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
Page# 2

Permit: NCG550342 Owner-Facility: 164 Kaywood Lane
Inspection Date: 10/16/2015 Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? 1111 0 0 0
Does the facility analyze process control parameters,for ex: MLSS,MCRT,Settleable 0 0 U 0
Solids, pH,DO,Sludge Judge,and other that are applicable?
Comment: The Facility did not appear to be well maintained at the time of the inspection.There were no
chlorine tablets at the chlorine tubes.
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new 0 0 11 0
application?
Is the facility as described in the permit? • 0 0 0
#Are there any special conditions for the permit? 0 • 0 0
Is access to the plant site restricted to the general public? CI. ❑ • 0
Is the inspector granted access to all areas for inspection? 0 0 0
Comment: There has been change of ownership. new owner name is Ed Stokes
Record Keeping Yes No NA NE
Are records kept and maintained as required by the permit? 0 11 0 0
Is all required information readily available,complete and current? 0 II 0 0
Are all records maintained for 3 years(lab. reg.required 5 years)? ❑ • ❑ 0
Are analytical results consistent with data reported on DMRs? 0 • 0 ❑
Is the chain-of-custody complete? 0 0 11 ❑
Dates,times and location of sampling 0
Name of individual performing the sampling ❑
Results of analysis and calibration ❑
Dates of analysis ❑
Name of person performing analyses ❑
Transported COCs ❑
Are DMRs complete:do they include all permit parameters? 0 0 • 0
Has the facility submitted its annual compliance report to users and DWQ? 0 0 • 0
(If the facility is=or>5 MGD permitted flow)Do they operate 24/7 with a certified operator ❑ 0 • ❑
on each shift?
Is the ORC visitation log available and current? 0010
Is the ORC certified at grade equal to or higher than the facility classification? ❑ 0 0
Is the backup operator certified at one grade less or greater than the facility classification? ❑ ❑ • 0
Is a copy of the current NPDES permit available on site? 0 0 II 0
Page# 3

Permit: NCG550342 Owner-Facility: 164 Kaywood Lane
Inspection Date: 10/16/2015 Inspection Type: Compliance Evaluation
Record Keeping Yes No NA NE
Facility has copy of previous year's Annual Report on file for review? ❑ 0 11 0
Comment: No records are kept, no sampling has been done since change of ownership.
Effluent Pipe Yes No NA NE
Is right of way to the outfall properly maintained? • 111 0 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? ❑ 0 • 0
Comment: At the time of the inspection no discharge was visible.
Septic Tank Yes No NA NE
(If pumps are used)Is an audible and visual alarm operational? 0 • 0 0
Is septic tank pumped on a schedule? • 0 ❑ ❑
Are pumps or syphons operating properly? • ❑ 0 0
Are high and low water alarms operating properly? 0 0 • 0
Comment: Since change of ownership the septic tank had not been pumped.
Sand Filters (Low rate) Yes No NA NE
(If pumps are used)Is an audible and visible alarm Present and operational? 0 ❑ • 0
Is the distribution box level and watertight? U 0 0 0
Is sand filter free of ponding? • 0 0 0
Is the sand filter effluent re-circulated at a valid ratio? 0 0 11 0
#Is the sand filter surface free of algae or excessive vegetation? 0 ❑ • 0
#Is the sand filter effluent re-circulated at a valid ratio?(Approximately 3 to 1) 0 0 11 0
Comment: No ponding was obseved near the sand filters.
Laboratory Yes No NA NE
Are field parameters performed by certified personnel or laboratory? ❑ U ❑ ❑
Are all other parameters(excluding field parameters)performed by a certified lab? 0 111 0 ❑
#Is the facility using a contract lab? 0 0 0 U
#Is proper temperature set for sample storage(kept at less than or equal to 6.0 degrees 0 ❑ I ❑
Celsius)?
Incubator(Fecal Coliform)set to 44.5 degrees Celsius+/-0.2 degrees? 0 0 MI 0
Incubator(BOD)set to 20.0 degrees Celsius+/-1.0 degrees? ❑ • ❑ 0
Page# 4

Permit: NCG550342 Owner-Facility: 164 Kaywood Lane
Inspection Date: 10/16/2015 Inspection Type: Compliance Evaluation
Laboratory Yes No NA NE
Comment: No lab has been contracted to sample the site.
Disinfection-Tablet Yes No NA NE
Are tablet chlorinators operational? • ❑ ❑ 0
Are the tablets the proper size and type? 0 0 11 0
Number of tubes in use? 0
Is the level of chlorine residual acceptable? 0 0 MI ❑
Is the contact chamber free of growth,or sludge buildup? 0 0 • 0
Is there chlorine residual prior to de-chlorination? 0 0 IN ❑
Comment: No evidence of Chlorine tablets being used.
Effluent Semolina Yes No NA NE
Is composite sampling flow proportional? 0 0 • 0
Is sample collected below all treatment units? ❑ ❑ 11 0
Is proper volume collected? 0 0 111 0
Is the tubing clean? IN 0 0 ❑
#Is proper temperature set for sample storage(kept at less than or equal to 6.0 degrees ❑ ❑ DI
Celsius)?
Is the facility sampling performed as required by the permit(frequency,sampling type 0 0 0
representative)?
Comment: No effluent sampling had been done.
Page# 5

r .
•
A . .4,,A ii FILE
,�.A��.
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
August 4, 2011
Mr. Michael Cox
164 Kaywood Lane
• Statesville,NC 28677
Subject: Compliance Evaluation Inspection
Michael Cox Residence/single family discharge
NPDES General Permit NCG550342
Iredell County,North Carolina
Dear Mr. Cox:
Enclosed please find a copy of the Compliance Evaluation Inspection Report for the inspection conducted at the
subject facility on August 3, 2011, by Ms. Donna Hood of this Office.
This report should be self-explanatory; however, should you have any questions concerning the report, please
do not hesitate to contact Ms. Hood or me at(704) 663-1699.
Sincerely, q
‘,. ....ly—) _ _ - ./______.-t- ----'--- --"C--)
gcfr Robert B. Krebs
Surface Water Protection Regional Supervisor
Enclosure
DH
Mooresville Regional Office
Location:610 East Center Ave.,Suite 301 Mooresville,NC 28115I:,
Dlltie
Phone:[phone] Fax:[phone] Customer Service:1-877-623-674$ N th Cc`1 C01111�
Internet:www.ncwaterquality.org /��/1� K�!/�����
An Equal Opportunity 1 Affirmative Action Employer-50%Recycled/10%Post Consumer paper f� ,
ME

r 1
Jniteu ;'a:es=nvironmentai?rctec:on Agency
rcrn reproved.
EPA 'Nashington,J.C.2C460
OMB No.2040-0057
Water Compliance Inspection Report Approval expires 8-31-98 •
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/nmmo/day Inspection Type Inspector Far.Type
1 I NI 2 15I 31 NCG550342 111 121 11/08/02 117 18I CI 191 SI 20�II
Remarks
21 III 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I I IIII I I I I IIII 1 1 1 1 1 1 1 1 I 1 166
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA -------------Reserved---
67I 1.0 169 70I I 711 I 721 I 731 I 174 751 I I I I I I 1 "
Section B: Facility Data
Name and Location of Facility Inspected(For Industrial Users discharging to POTW,also indude Entry Time/Date Permit Effective Date
POTW name and NPDES permit Number)
03:30 PM 11/08/02 07/08/01
164 Kaywood Lane
—
164 Kaywood Ln Exit Time/Date Permit Expiration Date
Statesville NC 28677 04:05 PM 11/08/02 12/07/31
Name(s)of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s) Other Facility Data
///
Name,Address of Responsible Official/Title/Phone and Fax Number
Contacted
Michael J Cox,164 Kaywood Ln Statesville NC 28677//704682109/ Yes
Section C: Areas Evaluated During Inspection(Check only those areas evaluated)
®Permit ®Flow Measurement ®Operations&Maintenance ®Records/Reports
li Self-Monitoring Program ®Sludge Handling Disposal ®Facility Site Review ®Effluent/Receiving Waters
®Laboratory
Section D: Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s)and Signature(s)of Inspector(s) Agency/Office/Phone and Fax Numbers . Date
77
Donn H od MRO WQ//709 663 1699 Ext.2193/ 1.4
_-4.,. /IX/1/61 .. ,_.,
tur of Management Q A er ""-1Agency/Office/Phone and Fax Numbers Date
Marcia 'Allocco MRO WQ//704-663-1699 Ext.2204/ (014.
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.
Page it 1

NPDES yr/mo/day Inspection Type 1
3I NCC550342 I11 12I 11/08/02 I17 18ICI
. Section D: Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
•
Page# 2

Permit: NG3550342 Owner-Facility: 164 Kayweoe Lane
Inspection Cate: 08102/2011 Inspection Type: Compliance Evaluation
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application? ❑ o El LI
Is the facility as described in the permit? Ninon
#Are there any special conditions for the permit? n ■ n n
Is access to the plant site restricted to the general public? ❑ ❑ ■ ❑
Is the inspector granted access to all areas for inspection? ■ n n n
Comment: The permit is in effect from 08/01/2007-07/31/2012. Annual fees for the
associated Certificate of Coverage, NGG550342, have been paid and are up to date.
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ■ n n ❑
Does the facility analyze process control parameters,for ex: MLSS, MCRT,Settleable Solids,pH, DO,Sludge 0 0 ■ n
Judge, and other that are applicable?
Comment: The facility appeared very well maintained and operated at the time of the •
inspection.
Record Keeping Yes No NA NE
• Are records kept and maintained as required by the permit? ® n n n
Is all required information readily available,complete and current? ® n n n
Are all records maintained for 3 years(lab. reg. required 5 years)? ® n n n
Are analytical results consistent with data reported on DMRs? ® n n n
Is the chain-of-custody complete? ® n n n
Dates,times and location of sampling ■
Name of individual performing the sampling
Results of analysis and calibration
Dates of analysis
Name of person performing analyses
Transported COCs
Are DMRs complete: do they include all permit parameters? n n ■ n
Has the facility submitted its annual compliance report to users and DWQ? n n ® 171
(If the facility is=or>5 MGD permitted flow) Do they operate 24/7 with a certified operator on each shift? ❑ n ® ❑
Is the ORC visitation log available and current? n n U ❑
Is the ORC certified at grade equal to or higher than the facility classification? n n e n
Is the backup operator certified at one grade less or greater than the facility classification? ❑ 0 ® ❑
Page# 3

Permit: NCG5�J342 Owner-Facility: 164 Ka,, vocd Lane
Inspection Date: 08/02/2011 Inspection Type: Compliance Evaluation
Record Keeping Yes No NA NE
Is a copy of the current NPDES permit available on site? ❑ n
Cl
Facility has copy of previous year's Annual Report on file for review'? n n ® n
Comment: All records were maintained and readily available at the time of the
inspection.
Laboratory Yes No NA NE
Are field parameters performed by certified personnel or laboratory? ■ n n n
Are all other parameters(excluding field parameters) performed by a certified lab? ■ n n n
#Is the facility using a contract lab? ® n n n
#Is proper temperature set for sample storage(kept at less than or equal to 6.0 degrees Celsius)? n n n ■
Incubator(Fecal Coliform)set to 44.5 degrees Celsius+/-0.2 degrees? ' n n ® n.
Incubator(BOD)set to 20.0 degrees Celsius+/-1.0 degrees? n n U ❑
Comment: Statesville Analytical (#440) performs required annual sampling as well as
the laboratory analyses for Mr. Cox. The last sampling event was on 02/08/2011.
Septic Tank Yes No NA NE
(If pumps are used) Is an audible and visual alarm operational? n n n
Is septic tank pumped on a schedule? ® n n n
Are pumps or syphons operating properly? ® n n n
Are high and low water alarms operating properly? n n ® n
Comment: The septic tank is pumped annually by Lentz Septic. No ponding was
observed near the septic tank. Lentz Septic performed pump repair in
November/December 2010.
Sand Filters (Low rate) Yes No NA NE
(If pumps are used) Is an audible and visible alarm Present and operational? n n ® n
Is the distribution box level and watertight? ® n n n
Is sand filter free of ponding? ® n n n
Is the sand filter effluent re-circulated at a valid ratio? n n ® n
#Is the sand filter surface free of algae or excessive vegetation? n n ® ❑
#Is the sand filter effluent re-circulated at a valid ratio?(Approximately 3 to 1) 11
nia
Comment: No ponding was observed near the sand filters.
Disinfection-Tablet Yes No NA NE
Are tablet chlorinators operational? ® n n n
Page# 4

Permit: NCC550342 Owner-Facility: 154 Kaywood Lane
Inspection Date: 08/02/2011 Inspection Type: Compliance Evaluation
Disinfection-Tablet Yes No NA NE
Are the tablets the proper size and type? tri ❑ ❑ (U1
Number of tubes in use? 1
•
Is the level of chlorine residual acceptable? n n n i
Is the contact chamber free of growth,or sludge buildup? inn n
Is there chlorine residual prior to de-chlorination? n n n i
Comment:
De-chlorination Yes No NA NE
Type of system? Tablet
Is the feed ratio proportional to chlorine amount(1 to 1)? ■ n n n
Is storage appropriate for cylinders? n n i n
#Is de-chlorination substance stored away from chlorine containers? n n i n
Comment:
•
Are the tablets the proper size and type? inn n
Are tablet de-chlorinators operational? 0n n n
Number of tubes in use? 1
Comment:
Effluent Pipe Yes No NA NE
Is right of way to the outfall properly maintained? inn n
Are the receiving water free of foam other than trace amounts and other debris? inn n
If effluent (diffuser pipes are required) are they operating properly? n n i n
Comment: The receiving stream appeared unaffected by the discharge on the day of
the inspection.
Effluent Sampling Yes No NA NE
Is composite sampling flow proportional? n n i n
Is sample collected below all treatment units? ® n n n
Is proper volume collected? n n n
Is the tubing clean? n n i
#Is proper temperature set for sample storage(kept at less than or equal to 6.0 degrees Celsius)? 0n n n
Is the facility sampling performed as required by the permit(frequency, sampling type representative)? i n n n
Page# 5

Permit: NC3550342 Owner-Facility: 164 Kaywcod Lane
• Inspection Date: 0 8102/2 01 1 Inspection Type: Compliance Evaluation
Effluent Sampling Yes No NA NE
Comment: Sampling results from 02/0E3/2011 are as follows:
BOD: <2 mg/L
Fecal coliform: <1 cfu/100 mis
TSS: <2.5 mg/L
Chlorine: 20 ug/L
•
•
•
•
Page# 6

•
COMPLIANCE EVALUATION INSPECTION CHECKLIST
DATE: ORC:
ENTRY TIME: 2 ' I NPDES PERMIT NO:NCO°
EXIT TIME: 2/`1 S FACILITY NAME: •
COUNTY: •
MET WITH ON-SITE:
PERMIT: EFFECTIVE DATE: EXPIRATION DATE:
•
•
FLOW MEASUREMENT: INSTANTANEOUS/CONTINUOUS-RECORDING/TOTALIZER(IN PERMIT) .•
•
•
EFFLUENT/RECEIVING STREAM: STREAM NAME: U c/ti C G P
SLUDGE DISPOSAL:NON-DISCHARGE PERMIT#:(If Applicable)
•
•
RECORD KEEPING:
1 10 17do
LABORATORY: CERTIFICATION(FIELD)#. • (pH,TRC,DO,Temp.,SS, COnd.)
(ten V SC-t . Uryy 35 • Or ;ScA-td riA/4_
OPERATION& INTENANCE/FACILITY SITE REVIEW •
. iV0 A I Y �().'t c� i; S Lip P .a CP
Q Pi- ( d J
�--� �v d e-L-� U o �c of fc(, L r 016 4 M-I0 *Cci o1 Fie 44,,.4 Y

•
SELF-MONITORING PROGRAM:
Sample Type (Composite or Grab)
•
•
DMR REVIEW:TIME PERIOD through

/d/o
//? 4)1_
•
December 9, 2007
Response to
Notice of Deficiency
NCG550342
Dear Mr. Krebs:
Since receiving your notification,my wife and I have contacted a testing lab and
set up a testing date for all the tests required by our permit. These tests will take place on
December 18 and be performed by Statesville Analytical Laboratories.
We have also been gathering bids for the construction of the declorinization unit
and will schedule construction after a bidder is selected.
If you have any questions,you may contact me at 704-682-1609.
Sincerely,
- 4,4;./1,...A.P)• 64
Michael J. Cox
164 Kaywood Ln.
Statesville,NC
RECEIVED
DEC 1 1
NC DENR MRO
DWQ-Surface Water Pry

\f J A 1 F Michael F.Easley,Governs
R
O��
pG GWilliam G.Ross Jr.,Secretary
2� pillar_ North Carolina Department of Environment and Natural Resources
a*
>_
-71 Colleen Sullins,Director
- 'c Division of Water Quality
November 13, 2007
Mr. Michael Cox
164 Kaywood Lane
Statesville ,NC 28625
Subject: NOTICE OF DEFICIENCY
Compliance Evaluation Inspection
Cox Residence
NPDES Permit NCG550342
Iredell County,North Carolina
Dear Mr. Cox:
Enclosed please find a copy of the Compliance Evaluation Inspection Report for the inspection
conducted at the subject facility on October 22, 2007, by Ms. Donna Hood of this Office.
It is requested that a written response be submitted to this Office by December 13,2007,
addressing the deficiency noted in the Effluent Sampling Sections of the report. In responding,
please address your comments to the attention of Ms. Marcia Allocco.
This report should be self-explanatory; however, should you have any questions concerning the
report, please do not hesitate to contact Ms. Hood or Ms. Marcia Allocco at(704) 663-1699.
Sincerely, �I —
&(- Robert B. Krebs
Regional Supervisor
Surface Water Protection Section
Enclosure
cc: Shelton Sullivan, NPS-ACO Unit
DH
AVA
R bENR
N.C.Division of Water Quality,Mooresville Regional Office,610 East Center Avenue,Suite 301,Mooresville NC 28115 [phone] Customer Service
1-877-623-6748

United States Environmental Protection Agency Form Approved.
111
EPA Washington,D.C.20460 OMB No.2040-0057
Water Compliance Inspection Report Approval expires 8-31-98
Section A: National Data System Coding(i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 lI NJI 2 11ILJ 31 NCG550342 1 11 121 07/10/22 1 17 18U1 19' G' 20I I
Remarks U !J
21111111II IIII1111IIII IIII IIII IIII IIIIIIII1111II166
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA Reserved
671 1 69 "Li I 7111
' t_!
72 N 731 1 1 74 751 11 1 1 1 1 1 80
Section B: Facilityt Data
Name and Location of Facility Inspected(For Industrial Users discharging to POTW,also include Entry Time/Date Permit Effective Date
POTW name and NPDES permit Number)
02:30 PM 07/10/22 07/08/01
164 Kaywood Lane
164 Kaywood Ln Exit Time/Date Permit Expiration Date
Statesville NC 28677 03:20 PM 07/10/22 12/07/31
Name(s)of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s) Other Facility Data
///
Michael J Cox//704-872-5185 /
Name,Address of Responsible Official/Title/Phone and Fax Number
Contacted
Michael J Cox,164 Kaywood Ln Statesville NC 28677//704-872-5185/ No
Section C: Areas Evaluated During Inspection(Check only those areas evaluated)
III Permit ■Flow Measurement III Operations&Maintenance 111 Records/Reports
Self-Monitoring Program "'Sludge Handling Disposal II Facility Site Review •Effluent/Receiving Waters
11 Laboratory
Section D: Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s)and Signature(s)of Inspector(s) Agency/Office/Phone and Fax Numbers Date
_ 1
Donna Hoo ! MRO WQ/// /
/ / I
/
Signature of Management Q A Revieyer. �^ Agency/Office/Phone and Fax Numbers Date
Marcia A Y6 'co - xJ MRO WQ//704 235 2209/ tt t CR-
l!
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.
Page# 1

NPDES yr/mo/day Inspection Type (cont.) 1
31 NCG550342 I" 12L_ 07/10/23 17 18ICI
Section D: Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
Permit:
Mr. Michael Cox has owned 164 Kaywood Lane since 2000.
Operations and Maintenance:
The system looked well maintained and operated.
Record Keeping:
Some records were available at the time of the inspection. North Carolina law requires lab and sludge
records to be retained for 5 years. Other associated permit records are to be retained for 3 years.
Laboratory:
No sampling has been performed therefore no lab has been retained.
Septic Tank:
One septic tank has been pumped every two years since Mr. Cox has owned the property.
Sand Filters:
Sand filters are subsurface and appear to be operating correctly.
Disinfection:
Chlorine tablets are used for disinfection. These tablets have been supplied by the companies that have
pumped the septic tank.
Dechlorination:
Dechlorination facilities are required to be added with the issuance of the new permit.
Effluent Flow:
Effluent flow has not been measured at the facility.
Effluent Sampling:
No sampling has been performed at the facility.
Additional Observations:
Page# 2

Permit: NCG550342 Owner-Facility: 164 Kaywood Lane
Inspection Date: 10/23/2007 Inspection Type: Compliance Evaluation
Mr. Cox did not have the complete text of the permit on site, nor was he aware of any required sampling.
Mr. Cox was given the complete text of his permit during the inspection. Mr. Cox has already had
conversations with a contract lab that can help him become compliant with his permit. The facility has been
well maintained during Mr. Cox's ownership and the effluent was very clear on the day of the inspection. No
accumulated solids were seen in the stream bed even though the stream contained no base flow because
of the exceptional drought.
Permitting in Raleigh has Mr. Cox's name as the permittee, although nothing has been reissued in his
name.
Page# 3

Pr
Permit: NCG550342 Owner-Facility: 164 Kaywood Lane
Inspection Date: 10/23/2007 Inspection Type: Compliance Evaluation
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application? 0 0 • ❑
Is the facility as described in the permit? ■ ❑ ❑ ❑
#Are there any special conditions for the permit? 0 ■ 0 0
Is access to the plant site restricted to the general public? 0 0 ■ 0
Is the inspector granted access to all areas for inspection? ■ ❑ ❑ ❑
Comment: Please see attached summary. •
Operations& Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ■ ❑ ❑ ❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge 0 0 ■ 0
Judge, and other that are applicable?
Comment: Please see attached summary.
Record Keeping Yes No NA NE
Are records kept and maintained as required by the permit? ■ ❑ ❑ ❑
Is all required information readily available, complete and current? 0 .100
Are all records maintained for 3 years(lab. reg. required 5 years)? ■ ❑ ❑ ❑
Are analytical results consistent with data reported on DMRs? 0 0 ■ 0
Is the chain-of-custody complete? 0 0 ■ 0
Dates,times and location of sampling 0
Name of individual performing the sampling 0
Results of analysis and calibration 0
Dates of analysis 0
Name of person performing analyses 0
Transported COCs 0
Are DMRs complete: do they include all permit parameters? 01100
Has the facility submitted its annual compliance report to users and DWQ? 0 0 ■ 0
(If the facility is=or>5 MGD permitted flow)Do they operate 24/7 with a certified operator on each shift? 0 0 ■ 0
Is the ORC visitation log available and current? 0 0 ■ 0
Is the ORC certified at grade equal to or higher than the facility classification? 0 0 • 0
Is the backup operator certified at one grade less or greater than the facility classification? 0 0 ■ 0
Is a copy of the current NPDES permit available on site? ■ ❑ ❑ ❑
Page# 4

Permit: NCG550342 Owner-Facility: 164 Kaywood Lane
Inspection Date: 10/23/2007 Inspection Type: Compliance Evaluation
Record Keeping Yes No NA NE
Facility has copy of previous year's Annual Report on file for review? 0 0 ■ 0
Comment: Please see attached summary.
Laboratory Yes No NA NE
Are field parameters performed by certified personnel or laboratory? 0 0 • 0
Are all other parameters(excluding field parameters)performed by a certified lab? 0 0 ■ 0
#Is the facility using a contract lab? 0 0 ■ 0
Is proper temperature set for sample storage(kept at 1.0 to 4.4 degrees Celsius)? ❑ 0 ■ 0
Incubator(Fecal Coliform)set to 44.5 degrees Celsius+/-0.2 degrees? 0 0 ■ 0
Incubator(BOD)set to 20.0 degrees Celsius+/- 1.0 degrees? 0 0 ■ 0
Comment: Please see attached summary.
Septic Tank Yes No NA NE
(If pumps are used)Is an audible and visual alarm operational? 0 0 ■ 0
Is septic tank pumped on a schedule? ■ ❑ ❑ ❑
Are pumps or syphons operating properly? ■ ❑ ❑ ❑
Are high and low water alarms operating properly? ■ ❑ ❑ ❑
Comment: Please see attached summary.
Disinfection-Tablet Yes No NA NE
Are tablet chlorinators operational? ■ ❑ ❑ ❑
Are the tablets the proper size and type? ■ ❑ ❑ ❑
Number of tubes in use? 1
Is the level of chlorine residual acceptable? 0 0 0 ■
Is the contact chamber free of growth, or sludge buildup? ■ ❑ ❑ ❑
Is there chlorine residual prior to de-chlorination? 0 0 ■ 0
Comment: Please see attached summary.
Sand Filters (Low rate) Yes No NA NE
(If pumps are used)Is an audible and visible alarm Present and operational? 0 0 ■ 0
Is the distribution box level and watertight? ■ ❑ ❑ ❑
Is sand filter free of ponding? ❑ ❑ ❑ ■
Is the sand filter effluent re-circulated at a valid ratio? 0 0 ■ ❑
#Is the sand filter surface free of algae or excessive vegetation? 0 0 ■ 0
Page# 5

Fir
Permit: NCG550342 Owner-Facility: 164 Kaywood Lane
Inspection Date: 10/23/2007 Inspection Type: Compliance Evaluation
Sand Filters (Low rate) Yes No NA NE
#Is the sand filter effluent re-circulated at a valid ratio?(Approximately 3 to 1) 0 0 • 0
Comment: Please see attached summary.
Flow Measurement-Effluent Yes No NA NE
#Is flow meter used for reporting? 001. 0
Is flow meter calibrated annually? 0 0 • 0
Is the flow meter operational? 0 0 • 0
(If units are separated) Does the chart recorder match the flow meter? 0 0 • 0
Comment: Please see attached summary.
Effluent Pipe Yes No NA NE
Is right of way to the outfall properly maintained? ■ ❑ ❑ ❑
Are the receiving water free of foam other than trace amounts and other debris? ■ ❑ ❑ ❑
If effluent (diffuser pipes are required) are they operating properly? 0 ❑.■ 0
Comment:
Effluent Sampling Yes No NA NE
Is composite sampling flow proportional? 0 0 ■ 0
Is sample collected below all treatment units? 0 0 ■ 0
Is proper volume collected? 0 0 ■ 0
Is the tubing clean? 0 0 ■ 0
Is proper temperature set for sample storage(kept at 1.0 to 4.4 degrees Celsius)? 0 0 • 0
Is the facility sampling performed as required by the permit(frequency, sampling type representative)? 0 ■ 0 0
Comment: Please see attached summary.
Page# 6

TT;FAii
AI;
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
Michael& Sandra Cox
164 Kaywood Ln
Statesville,NC 28677
Subject: Renewal of coverage/General Permit NCG550000
164 Kaywood Lane
Certificate of Coverage NCG550342
Iredell County
Dear Permittee:
In accordance with your renewal application [received on January 25, 2007],the Division is renewing
Certificate of Coverage(CoC)NCG550342 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 Mooresville 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 Toya
Fields [919 733-5083,extension 551 or [e-mail]] or Susan Wilson [919 733-5083,extension 510
or [e-mail]].
Sincerely, AND NATURAL ROOM
MOORESVILLE REGIONAL
for Coleen H. Sullins JU
cc: Central Files •
NPDES file .t
WATER QUALITY SECTIO,
1617 Mail Service Center,Raleigh,North Carolina 27699-1617 One
512 North Salisbury Street,Raleigh,North Carolina 27604 NorthCarolina
Phone: [phone]/FAX [phone]/Internet:www.ncwaterquality.org Naturally
An Equal Opportunity/Affirmative Action Employer—50%Recycled/10%Post Consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG550342
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,
Michael & Sandra Cox
is hereby authorized to discharge domestic wastewater [1000 GPD] from a facility located
at
164 Kaywood Lane
Statesville
Iredell County
to receiving waters designated as an unnamed tributary to Fourth Creek in subbasin 03-07-
06 of the Yadkin River Basin in accordance with the effluent limitations, monitoring
requirements, and other conditions set forth in Parts I, II, III and IV hereof.
This certificate of coverage shall become effective August 1, 2007.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 27, 2007.
for Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

•
Collection System SSO 24-Hour Notification
Collection System: Number and Name WQCS#
Incident Number from BIMS
Incident Reviewed (Date):
Incident Action Taken: BPJ
NOV-2008-DV
Cji/Akfc) O (( Gins tin AD 00a �
Spill Date Time am/ pm
Reported Date Time am/ /MA
Reported To SWP Staff or EM Staff maid 067/1(6-11/4-)
Reported By FE — /Lepa-6u-e- Phone .
Address of Spill / & O91A)Od'(/j2i4 act/e)Z
I • , 241_j___..467
County City C�� �0,
Cause of Spill
Total Estimated Gallons Est. Gal to Stream
Stream Fish Kill: Yes No Number Species
Non Required Information and other comments relating to SSO incident:
Response time minutes Zone Map Quad 4pLed/c/Zni
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NPDE% FACILITY AND PERMIT DATA
RETRIEVE OPTION TRXTD 6NU KEY NCO062332
PERSONAL DATA FACILITY APPLYING FOR PERMIT REGION
FACILITY NAME> GARY WAYNE EDWARD% COUNTY) IREDELL O3
ADDRESS : MAILING (REQUIRED ) LOCATION (REQUIRED)
STREET : RT i . , BOX 364-A STREET :
CITY : HARMONY %T NC ZIP 28634 CITY : HARMONY %T NC ZIP 28634
TELEPHONE 704 876 iiii DATE FEE PAID : ii /i6/88 AMOUNT : 25 .0O
STATE CONTACT > WIGGIN% PERSON IN CHARGE GARY WAYNE EDWARD%
i =PROPO%ED, 2=EXI%T, 3=CLO%ED 2 i =MAJOR, 2=MINOR 2 1 =MUN, 2=NON-MUN 2
LAT : 3546190 LONG : 08048040 N=NEW , M=MODIFICATION, R=REI%%UE> M
DATE APP RCVD 11 /17/88 WA%TELOAD REQ% ii /0 /88
DATE STAFF REP REQ% 11 /22/88 WA%TELOAD RCVD 11 /30/88
DATE STAFF REP RCVD 11 /30/88 %CH TO ISSUE 12/22/89
DATE TO P NOTICE / / DATE DRAFT PREPARED ii /3O/88
DATE OT AG COM REQ% / / DATE DENIED
DATE OT AG COM RCVD / / DATE RETURNED
DATE TO EPA / / DATE ISSUED 12/22/88 ASSIGN/CHANGE PERMIT
DATE FROM EPA / / EXPIRATION DATE 11 /30/90
FEE CODE ( 5 ) i =( )iOMGD) , 2=( >iMCD) , 3=( >O. iMGD) , 4=( <O. iMGD) , 5=%F, 6= (GP25 , 64 , 79) '
7=(GP49 , 73)8=(GP76)9=(GPi3 , 34, 30, 52)0=(NOFEE) DI%/C 04 CONBILL ( )
COMMENTS :
MESSAGE :

STAFF REPORT AND RECOMMENDATIONS
PART I - INSPECTION OF PROPOSED WASTEWATER TREATMENT PLANT SITE
1. a. Place Visited: Charles G. Moore Residence
b. Mailing Address: 126 Kaywood Drive
Statesville, N. C. 28677
2. Date of Investigation: 5/13/85 Date of Report: 5/21/85
VY3. By: Michael L. Parker, Environmental Engineering Technician II -"
4. a. Persons Contacted: Mr. Henry C. Moore, Owner's Father �
b. Phone No. : (704) 872-2667 (Mr. Charles Moore)
5. Directions to Site: From the City of Statesville, travel east on Highway
70 approximately 2.0 miles and turn left on SR 2316 (Bell Road) . Travel
approximately 1.1 miles and turn left onto SR 2514 (Bellwood Road) . Travel
0.3 miles on SR 2514 and turn right on SR 2515 (Kaywood Drive) . The Moore
residence is the 4th house on the right side of Kaywood Drive.
6. a. The coordinates to the proposed/existing point of effluent discharge
are: Latitude: 35°46'19" Longitude: 80°48'04"
b. USGS Quad No. : D15SE (see attached map)
7. Size (land available for expansion and upgrading) : There is ample area
available for the construction of the proposed wastewater treatment plant.
8. Topography: Hilly, 6-15% slopes
9. Location of Nearest Dwelling: There is two other dwellings within 800 feet
of the proposed wastewater treatment facility.
10. Receiving Stream: U.T. to Fourth Creek
a. Classification: C
b. Minimum 7-Day, 10-Year Discharge at Site: Unknown
c. River Basin and Sub-Basin No. : Yadkin 030706
PART II - DESCRIPTION OF PROPOSED/EXISTING TREATMENT FACILITIES
1. Existing Facilities: Applicant currently operates a septic tank/
nitrification field which has been repaired once and continues to fail.
Site appears to have groundwater flooding the drain field area and preventing
proper operation of system.
2. Proposed Modifications: Applicant will attempt to divert the groundwater
infiltration by constructing a french drain above the nitrification field.
If this measure fails, a sand filter bed followed by chlorination is proposed.
The sand filter bed should be lined to prevent groundwater infiltration.
From DEM guidelines, a wasteload allocation was developed for this proposed
discharge and the limits are as follows:

-2-
Flow 0.001 MGD
BODS 30 mg/1
TSS 30 mg/1
Fecal Coliform 1000/100 ml
Dissolved Oxygen 6.0 mg/1
pH 6-8.5 S.U.
PART III - EVALUATION AND RECOMMENDATIONS
1. Performance Evaluation: N/A.
2. 0 & M Evaluation: N/A.
3. Recommendations and/or Special Conditions: Pending review and approval
of plans and specifications, it is recommended that an NPDES Permit be
issued.

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`5 (SHEPHERDS) 518 4(30" I9
16 4855 /ll NE
SCALE 1:24000 C'�kd ��0eke •Msiale�c�
1 7 —
a Z O 1000�� L� y_ t_ 1
WOO4000 5000 6000 7000 FEET
MOO 3000-r -� �4Z-
a T�- 5 0 1 KILOMETER
1

Date : 7- _ 85
_Facility Name : `1 MOO/Le ►l1Es- Permit : MCOO6,233L
Receiving Stream: U•T--t6 Ft;u.k41.1n ?It€€k Class : O. Sub-Basin : 03O70l0
County : �R1e(I Regional Office : rYI R Q
Reference USGS Ouad : D11J SE Existing : L� Q Proposed :
Elevation : iQoO1 L Drainage Area : L• -_.)C
" t,. Z
^'O
Hydrologic Group : Design Temperature : 2�1
Slope : g7d. � 57o�E : Comments :
�+
644)4 411 7$o
770' .03M;. 333,5-tem:
7100 . o 4M:. 2,5o -re
750 , Nom:. I fo(o . p
1
4 54i'E; .23/ , n
RECOMMENDED EFFLUENT LIMITS
Wastetlow (gpd) : 0.00/
BOD5 (mg/ I ) : 3c71
NH3-N (mg/ I ) :
D .O. (mg/ I ) :
PH (SU) : to"8•S
Fecal Coli ( / 100m1 ) : /000
TSS (mg/ 1 ) : 3 O
RECOMMENDED BY : "CL C• Data : 7 9-SS
APPROVED BY:
Regional Engineer : Date :
.`Regional Supervisor : - 11P Date'
•
ROUTE to Technical Support Group and Permits & Engineering Unit
(Enclose copy of USGS topographical map showing location of discharger )

•
81(./. . , ,
II
•
• > 1 r, . .i_ ?,�a �+.ICE::; .. ._ .
APett_
M . c�ecL�s G. M ea Q� • N. C. DEPT. OF NATURAL
RE OUJRCES AND
124 Ka`iHtcoJ oRws_ COMMUNITY DEVELOP xENT s • J /
Z � 11
APR 201985 -
•
vi DIVISION Of r VI ;t!?'Er TA1 1 A3AtElMEtf c:ri%.,:7-'- Ga;� Mc—t_• o , :e r :
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r '°
ORTH CAROLINA DEPT. OF NATURAL RESOURCES AND COMMUNITY DEVELOPMENT
NVIRONMENTAL MANAGEMENT COMMISSION
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM APPLICATION NUMBER
APPLICATION FOR PERMIT TO DISCHARGE - SHORT FORM D FOR 1 1 1 1 I I 1 1
AGENCY
USE DATE RECEIVED
To be filed only by services, wholesale and retail trade,
and other commercial establishments including vessels IIII l
YEAR MO. DAY
'1�
UP
Do not attempt to complete this form without reading the accompanying instructions .
Please print or type It 7
1. Name, address, and telephoonf number of�faaci l ii producingdischarge
A. Name C/%j �� c� ('''', !1,/(4? i�`1,ep ?
B. Street address '',1Diefle — S2-
C. City— D. State i
E. County,Z—ie F.F. ZIP ,i
G. Telephone No' , c7 2 — 47
Area N c. DEPT.
Code RESOURCESND
CO1VmuNITy D Pst
2. SIC M
(Leave blank) f//� APR �$ 1985
3. Number of employees �/ ` `5/�e,i /V1/4
Y /� J :'/131 OF F. .4—
/ Ac5/e/0 / R "ITAl MAIIACEMENT
4. Nature of business ��/^' �`' .e6I0,7
AL Oita
5. (a) Check here if discharge occurs all year o, or
(b) Check the month(s) discharge occurs:
1.❑January 2.0 February 3.0 March 4.❑April 5.0 May
6.❑June 7.o July 8.o August 9.0 September l0.❑October
11.o November 12.o December
(c) How many days per week:
1.01 2.0 2-3 3.0 4-5 4.0 6-7
6. Types of waste water discharged to surface waters only (check as applicable)
Flow, gallons per operating day Volume treated before
discharging (percent)
Discharge per
operating day 0.1-999 1000-4999 5000- 999 10,000- 50,000 None 0.1- 30- 65- 95-
49,999 or more 29.9 64.9 94.9 100
(1) - (2) {3) (4) (5) (6) (7) (8) (9) (10)
A. Sanitary, daily V
average
B. Cooling water, etc.,
daily average
C. Other discharge(s),
daily average; � , . ^�
Specify V 0
D. Maximum per operat-
ing day for combined APR i 1 '�
discharge (all types) WATERc95
1117°NS 8-ANCOa

7, If any of the types of waste identified in item 6, either treated or un-
4.4‘
treated, are discharged to places other than surface waters, check below
as applicable.
Waste water is discharged to: 0.1-999 1000-4999 5000-9999 10,000-49,999 50,000 or more
(1) (2) (3) (4) (5)
A. Municipal ;ewer system
•
P. IInileryrnund we l l
C. Septic tank
D. Evaporation lagoon or pond
E. Other, specify:
8. Number of s crate discharge points:
A. 1 B,0 2-3 C.0 4-5 D.0 6 or more
9. Name of receiving water or waters /
10. Does your discharge contain or is it possible for your discharge to contain
one or more of the following substances ,added as a result of your operations.
activities, or processes: ammonia, cyanide, aluminum, beryllium, cadmium,
chromium. copper, lead,,mercury, nickel , selenium, zinc, phenols, oil and
grease, and chlorine esidual).
A.0 yes B, no
I certify that I am familiar with the information contained in the application and
that to the best of my knowledge and belief such information is true, complete, and
accurate.
1-/-E-4/0
Printed Name o Pers '
Person Signing
/44,44)
Title
T�•
�'1
Date Application Sig
ignature o pp icant
North Carolina General Statute 143-215.6(b) (2) provides that: Any person who knowingly makes
any false statement representation, or certification in any application, 'record, report, plan,
or other document files or required to be maintained under Article 21 or regulations of the
Environmental Management Commission implementing that Article, or who falsifies, tampers with,
or knowly renders inaccurate any recording or monitoring device or method required to be
operated or maintained under Article 21,•ot regulations •of the Environmental Management Commissior
• implementing that Article, shallbe''gu .itY•of a misdemeanor punishable by a fine not to exceed
$10,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section 1001 provide
a punishment by a fine of-not more than $10,000 or imprisonment not more than 5 years, or both,
for a similar offense.)

DIVISION OF ENVIRONMENTAL MANAGEMENT
c,24 /-4e-a /975
MEMORANDUM
TO: Regional Supervisor
FROM: Arthur Mouberry
SUBJECT: Waste Load Allocation for Single Family Residences
Because this is a single family residence the Regional Office is also
requested to complete the waste load allocation.
AM/km

- oasUrEq;-
4
Mnv i�
I; 4
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 N. C. DrpT. of NA> ltll Wilms
S. Thomas Rhodes, Secretary December 21, 1988 RESOURCES AND I?irector
CQ`" 1TY DZVELOPMEN
Mr. Gary Wayne Edwards
9
126 Raywood Drive JAN 198
Statesville, N.C. 28677
MANASEIRIg
Subject: Modification to `NPDES ! ER WlU1. OffICE/
Permit No. NC0062332
Mr. & Mrs. Gary Wayne Edwards
formerly issued to Mr. Charles G. Moore
Iredell County
Dear Mr. Edwards:
In accordance with your request received November 17, 1988, we are forwarding
herewith the subject permit now issued to Mr. & Mrs. Gary Wayne Edwards. The only
change in this Permit are in name and ownership.
This permit is issued pursuant to the requirements of North Carolina General
Statutes 143-215. 1, and the Memorandum of Agreement between North Carolina and the
U.S. Environmental Protection Agency dated December 6, 1983.
If any parts, measurement frequencies, or sampling requirements contained in
this permit are unacceptable to you, you may request a 1+aiver or modification
pursuant to Regulation 15 NCAC 2B .0508(b) by written r,,quest to the Director
identifying the specific issues to be contended. Unles such request is made within
30 days following receipt of this permit, this permit s'.all be final and binding.
Should your request be denied, you will have the right to request an adjudicatory
hearing.
Please take notice that this permit is not transferable. Part II, D.3.
addresses the requirements to be followed in case of ch.=.nge 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 Mangement Act, or any other Federal or
Local governmental permit that may be required.
Pollution Prevention Pays
P.O. Box 27687, Raleigh, North Carolina 27611-7687 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

If you have any questions concerning these permit modifications, please contact
Mr. Mack Wiggins at telephone no. 919/733-5083.
Sincerely,
Original Sighed $y
ARTHUR MOUBERRY
R. Fl ul Wilms
AM/ads
cc: Mr. Jim Patrick, EPA
°1Ue Re i..,office
Central Files

Permit No. NC0062332
STATE OF NORTH CAROLINA
DEPARTMENT OF NATURAL RESOURCES AND COMMUNITY DEVELOPMENT
DIVISION OF ENVIRONMENTAL MANAGEMENT
PERMIT
To DISCHARGE WASTEWATER UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provisions of North Carolina General Statute 143-215. 1,
other lawful standards and regulations promulgated and adopted by the North Carolina
Environmental Management Commission, and the Federal Water Pollution Control Act, as
amended,
Mr. & Mrs. Gary Wayne Edwar,-s
is hereby authorized to discharge wastewater from a facility located at
Mr. & Mrs. Gary Wayne Edwards Reidence
on NCSR 2515
Iredell County
to receiving waters designated as an unnamed tributary to Fourth Creek in the
Yadkin-Pee Dee 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 December 22, 1988
This permit and the authorization to discharge shall expire at midnight on November
30, 1990
Signed this the 22nd day of December, 1988.
U►►O": Sip*d By
ARIfHUR MERRY
For
R. Paul Wilms, Director
Division of Environmental Management
By Authority of the Environmental Management Commission

•
Permit No. NC0062332
SUPPLEMENT TO PERMIT COVER SHEET
Mr. & Mrs. Gary Wayne Edwards
is hereby authorized to:
1. Enter into a contract for construction of a wastewater treatment facility,
and
2. Make an outlet into an unnamed tributary to Fourth Creek, and
3. After receiving an Authorization to Construct from the Division of
Environmental Management, construct and operate a 0.001 MGD wastewater
treatment facility located on NCSR 2515 in Iredell County (See Part III of
this permit), and
4. Discharge from said treatment works at the location specified on the
attached map into an unnamed tributary to fourth Creek which is classified
Class "C" waters in the Yadkin-Pee Dee River Basin.

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A. (1). EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS Final NPDES It NC0062332
During the period beginning on the effective date of the Permit and lasting until expiration, the
Permittee is authorized to discharge from outfall(s) serial number(s) 001. Such discharges shall be limited
and monitored by the Permittee as specified below:
Effluent Characteristics Discharge Limitations Monitoring Requirements
Lbs/day Other Units (Specify) Measurement Sample *S
ample
Monthly Avg. Weekly Avg. Monthly Avg. Weekly Avg. Frequency Type Location
Flow 0.001 MGD Weekly Instanteneous I or E
BOD, 5Day, 20 Dogrees C 30,0 mn/l 45. 0 mg/1 2/Month Grab E
Total Suspended Residue 30.0 mg/1 45.0 mg/1 2/Month Grab E
NH3 as N 2/Month Grab E
Dissolved Oxygen (minimum) 6.0 mg/1 6.0 mg/1 Weekly Grab E
Fecal Coliform (geometric mean) 1000.0/100 ml 2000. 0/100 ml 2/month Grab E
Total Residual Choline Daily Grab E
Temperature Weekly Grab E
The Chlorinator shall be inspected weekly to ensure there is an ample supply of Chlorine tablets for continuous
disinfection of the effluent.
* Sample locations: E - Effluent, I - Influent.
The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units and shall be
monitored 2/month at the effluent by grab sample.
There shall be no discharge of floating solids or visible foam in other than trace amounts.
M3

•
Part I
B. Schedule of Compliance
1. The permittee shall comply with Final Effluent Limitations specified for
discharges in accordance with the following schedule.:
Permittee shall comply with Final Effluent Limitations by the effective
date of the permit.
2. Permittee shall at all times provide the operation and maintenance
necessary to operate the existing facilities at optimwu efficiency.
3. No later than 14 calendar days following a date identified in the above
schedule of compliance, the permittee shall submit either a report of
progress or, in the case of specific actions being required by identified
dates, a written notice of compliance or noncompliance. In the latter
case, the notice shall include the cause of noncompliance, any remedial
actions taken, and the probability of meeting the next schedule
requirements.

Part li
Page 1 of 14
PART II
STANDARD CONDITIONS FOR NPDES PERMITS
SECTION A. GENERAL CONDITIONS
1. Duty to Comply
The permittee must comply with all conditions of this permit. Any permit
noncompliance constitutes a violation of. the Clean Water.. Act and is grounds
for enforcement action; for permit termination, revocation and reissuance,
or modification; or for denial of a permit renewei application.
2. Penalties for Violations of Permit Conditions
Any person who violates a permit condition is subject to a civil penalty not
to exceed $10,000 per day of such violation. Any person who willfully or
negligently violates a permit condition is guilty of a misdemeanor punishable
by a fine not to exceed $15,000 per day of violation, or by imprisonment
not to exceed six months or both.
3. Duty to_Mitigate
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 accelerated or additional monitoring as
necessary to determine the nature and impact of the noncomplying discharge.
4. 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 modified, suspended,
or revoked in whole or in part during its term for cause including, but not
limited to, the following:
a. Violation of any terms or conditions of th.i.s permit;
b. Obtaining this permit by misrepresentation or failure to disclose fully
all relevant facts;
c. A change in any condition that requires either a temporary or permanent
reduction or elimination of the authorized discharge; or
d. Information newly acquired by the Division indicating the discharge poses
a threat to human health or welfare.
If the permittee believes that any past or planned activity would be cause for
modification or revocation and reissuance, the permittee must report such
information to the Permit Issuing Authority. The submittal of a new application

Part II
Page 2 of 14
may be required of the permittee. The filing of a request by the permittee for
a permit modification, revocation and reissuance, or termination, or a
notification of planned changes or anticipated noncompl.i.ances, does not stay
any permit condition.
5. Toxic Pollutants
Notwithstanding Part II, A-4 above, if a toxic effluent standard or prohibition
(including any schedule of compliance specified in such effluent standard or
prohibition) is established under Section 307(a) of the Act for a toxic
pollutant which is present in the discharge, if such standard or prohibition
is more stringent than any limitation for such pollutant in this permit., this
permit shall be revised or modified in accordance with the toxic effluent
standard prohibition and the permittee so notified.
The permittee shall comply with effluent standards or prohibitions established
under Section 307(a) of the Clean Water Act for toxic pollutants within the
time provided in the regulations that establish those standards or prohibitions,
even if the permit has not yet been modified to incorporate the requirement.
6. Civil and Criminal Liability
Except as provided in permit conditions on "Bypassing" (Part t1 , B-3) and
"Power Failures" (Part II, B-6), nothing in this permit shall be construed
to relieve the permittee from any responsibilities, liabilities, or penalties
for noncompliance pursuant to NCGS 143-215.3, 143-215.6 or Section 309 of the
Federal Act, 33 USC 1319. Furthermore, the permittee is responsible for
consequential damages, such as fish kills, even though the responsibility
for effective compliance may be temporarily suspended.
7. 011 and Hazardous Substance Liability
Nothing in Ohs permit shall be r.o;istrucd to preclude the institution of any
legal action or relieve the permittee from any responsibilities, liabilities,
or penalties to which the permittee is or may be subject to under NCGS
143-215. 75 et seq. or Section 311 of the Federal Act, 33 USC 1321 . Furthermore,
the permittee is responsible for consequential damages, such as fish kills,
even though the responsibility for effective compliance may be temporarily
suspended.
8. 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.

•
Part II
Page 3 of 14
9. Onshore of Offshore Construction
This permit does not authorize or approve the construction of any onshore or.
offshore physical structures or facilities or the undertaking of any work
in any navigable waters.
10. Severability
The provisions of this permit are severable, and if any provision of this
permit, or the application of any provision of this permit to any circumstances,
is held invalid, the application of such provision to other circumstances, and
the remainder of this permit, shall not be affected thereby.
11. Duty to Provide Information
The permittee shall furnish to the Permit Issuing Authority, within a reason-
able time, any information which the Permit Issuing Authority may request
to determine whether cause exists for modifying, revoking and reissuing,
or terminating this permit or to determine compliance with this permit. The
permittee shall also furnish to the Permit Issuing Authority upon request,
copies of records required to be kept by this permit.
SECTION B. OPERATION AND MAINTENANCE OF POLLUTION CONTROLS
1. Proper Operation and Maintenance
The permittee shall at all times maintain in good working order and operate
as efficiently as possible all treatment or control facilities or systems
installed or used by the permittee to achieve compliance with the terms
and conditions of this permit.
2. Need to Halt or Reduce not a Defense
It shall not be a defense for a permittee in an enforcement action that it
would have been necessary to halt or reduce the permitted activity in
order to maintain compliance with the condition of this permit.
3. Aypassing
Any diversion from or bypass of facilities is prohibited, except (i) where
unavoidable to prevent loss of life or severe property damage, or (ii)
where excessive storm drainage or runoff would damage any facilities
necessary for compliance with the effluent limitations And prohibitions of this
permit. All permittees who have such sewer bypasses or overflows of this
discharge shall submit, not later than six months from the date of issuance
of this permit, detailed data or engineering estimates which identify:
a. The location of each sewer system bypass or overflow;
b. The frequency, duration and quantity of flow from each sewer system
bypass or overflow.

Part II
Page 4 of 14
This requirement is waived where infiltration/inflow analyses are scheduled
to be performed as part of an Environmental Protection Agency facilities
planning project.
The permittee shall report by telephone to either the central office or
appropriate regional office of the Division as soon as possible, but in
no case more than 24 hours or on the next working day following the
occurrence or first knowledge of the occurrence of any division from or
bypass of facilities.
4. Upsets
"Upset" means an exceptional incident in which there is unintentional and
temporary noncompliance with technology based permit effluent limitations
because of factors beyond the reasonable control of the permittee. An upset
does not include noncompliance to the extent caused by operational error,
improperly designed treatment facilities, inadequate treatment facilities,
lack of preventive maintenance, or careless or improper operation. An upset
constitutes an affirmative defense to an action brought for noncompliance
with such technology based permit limitation if the requirements of 40 CFR S
122.41(n)(3) are met.
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 accordance with
NCGS 143-215. 1 and in a manner such as to prevent any pollutant from such
materials from entering waters of the State or navigable waters of the United
States.
6. Power Failures
The permittee is responsible for maintaining adequate safeguards as required
by DEM Regulation, Title 15, North Carolina Administrative Code, Subchapter 2H,
.0124 Reliability, to prevent the discharge of untreated or inadequately treated
wastes during electrical power failures either by means of alternate power
sources, standby generators or retention of inadequately treated effluent.
SECTION C. MONITORING AND RECORDS
1. Representative Sampling
Samples collected and measurements taken, as required herein, shall be
characteristic of the volume and nature of the permitted discharge. Samples
collected at a frequency less than daily shall be taken on a day and time that
is characteristic of the discharge over the entire period which the sample
represents. All samples shall be taken at the monitoring points specified in
this permit and, unless otherwise specified , before the effluent joins or is
diluted by any other wastestream, body of water, or substance. Monitoring points
shall not be changed without notification to and the approval of the Permit
Issuing Authority.

Part II
Page 5 of 14
2. Reporting
Monitoring results obtained during the previous month(s) shall be summarized for
each month and reported on a monthly Discharge Monitoring Report (DMR) Form
(DEM No. MR 1, 1. 1, 2, 3) or alternative forms approved by the Director, DEM,
postmarked no later than the 30th day following the completed reporting period.
The first DMR is due on the last day of the month following the issuance of the
permit or in the case of a new facility, on the last day of the month following
the commencement of discharge. Duplicate signed copies of these, and all other
reports required herein, shall be submitted to the following address:
Division of Environmental Management
Water. Quality Section
ATTENTION: Central Files
Post Office Box 27687
Raleigh, North Carolina 27611
3 Flow Measurements
Appropriate flow measurement devices and methods consistent with accepted
scientific practices shall be selected and used to insure the accuracy and
reliability of measurements of the volume of monitored discharges. The
devices shall be installed, calibrated and maintained to insure that the
accuracy of the measurements are consistent with the accepted capability of
that type of device. Devices selected shall be capable of measuring flows
with a maximum deviation of less than + 10% from the true discharge rates
throughout the range of expected discharge volumes. Once-through condenser
cooling water flow which is monitored by pump logs, or pump hour meters as
specified in Part I of this permit and based on the manufacturer's pump
curves shall not be subject to this requirement.
4. Test Procedures
Test procedures for the analysis of pollutants shall conform to the EMC
regulations published pursuant to NCGS 143-215.63 et seq, the Water and Air
Quality Reporting Acts, and to regulations published pursuant to Section 304(g),
33 USC 1314, of the Federal Water Pollution Control Act, as Amended, and
Regulation 40 CFR 136.
5. Penalties for Tampering
The Clean Water Act provides that any person who falsifies, tampers with, or
knowingly renders inaccurate, any monitoring device or method required to be
maintained under this permit shall, upon conviction, by punished by a fine of
not more than $10,000 per violation, or by imprisonment for not more than
six months per violation, or by both.

Part II
Page 6 of 14
6. Records Retention
All records and information resulting from the monitoring activities required by
this permit including all records of analyses performed and calibration and
maintenance of instrumentation and recordings from continuous monitoring
instrumentation shall be retained for a minimum of three (3) years by the
permittee. Thisperiod of retention shall be extended during the course
of any unresolved litigation or if requested by the Division of Environmental
Management or the Regional Administrator of the Environmental Protection Agency.
7. Recording Results
For each measurement or sample taken pursuant to the requirements of this
permit, the permit Lee shall record the following information:
a. The exact place, date, and time of sampling;
b. The dates the analyses were performed;
c. The person(s) who performed the analyses; and
d. The results of such analyses.
8. Right of Entry
The permittee shall allow the Director of the Division of Environmental
Management, the Regional Administrator, and/or their authorized 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.
SECTION D. REPORTING 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 modifi.:ations which will result

Part II
Page 7 of 14
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. Anticipated Noncompliance
The permittee shall give notice to the Permit Issuing Authority of any planned
change in the permitted facility or activity which may result in noncompliance
with permit requirements. Any maintenance of facilities, which might
necessitate unavoidable interruption of operation and degradation of effluent
quality, shall be scheduled during noncritical water quality periods and carried
out in a manner approved by the Permit Issuing Authority.
3. Transfer of Ownership or Control
This permit is not transferable. In the event of any change in name, control
or ownership of facilities from which the authorized discharge emanates or is
contemplated, the permittee shall notify the prospective 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.
4. Additional Monitoring by Permittee
If the permittee monitors any pollutant at the location(s) designated herein
more frequently than required by this permit, using approved analytical methods
as specified above, the results of such monitoring shall be included in the
calculation and reporting of the values is required in the DMR. Such increased
frequency shall also be indicated. The DEM may require more frequent monitoring
or the monitoring of other pollutants not required in this permit by written
notification.
5. Averaging_of. Measurements
Calculations for limitations which require averaging of measurements shall
utilize an arithmetic mean unless otherwise specified by the Permit Issuing
Authority in the permit.
6. Noncompliance Notification
The permittee shall report by telephone to either the central office or the
appropriate regional office of the Division as soon as possible, but in
no case more than 24 hours or on the next working day following the
occurrence or first knowledge of the occurrence of any of the following:

Part II
Page 8 of 14
a. Any occurrence at the water pollution control facility which results in
the discharge of significant amounts of wastes which are abnormal in
quantity or characteristic, such as the dumping of the contents of a
sludge digester; the known passage of a slug of hazardous substance
through the facility; or any other unusual circumstances.
b. Any process unit failure, due to known or unknown reasons, that render
the facility incapable of adequate wastewater treatment such as mechanical
or electrical failures of pumps, aerators, compressors, etc.
c. Any failure of a pumping station, sewer line, or treatment facility
resulting in a by-pass directly to receiving waters without treatment
of all or any portion of the influent to such station or facility.
d. Any time that self-monitoring information indicates that the facility has
gone out of compliance with its NPDES permit limitations.
Persons reporting such occurrences by telephone shall also file a written
report in letter form within 15 days following first knowledge of the
occurrence.
7. Changes in Discharges of Toxic Substances:
The permittee shall notify the Permit Issuing Authority as soon as it knows or
has reason to believe:
a. That any activity has occurred or will occur which would result in the
discharge, on a routine or frequent basis, of any toxic substance(s) (listed
at 40 CFR S 122, Appendix D, Table II and III) which is not limited in the
permit, if that discharge will exceed the highest of the following
"notification levels".
(1) One hundred micrograms per liter (100 ug/1);
(2) Two hundred micrograms per liter (200 ug/1) for acrole.tn and
acrylonitrile; five hundred micrograms per. liter (500 ug/1)
for 2,4-dinitrophenol and for 2-methyl-4,6-dinitrophenol; and one
milligram per liter (1 mg/1) for antimony; or.
(3) Five (5) times the maximum concentration value reported for that
pollutant(s) in the permit application.
b. That any activity has occurred or will occur which would result in any
discharge, on a non-routine or infrequent basis, of a toxic pollutant
(listed at 40 CFR S 122, Appendix D. Table II and III) which is not
limited in the permit, if that discharge will exceed the highest of the
following "notification levels":

Part II
Page 9 of 14
(1) Five hundred micrograms per liter (500 ug/1) ;
(2) One milligram per liter (1 mg/1) for antimony; or •
{3) Ten (10) times the maximum concentration value reported for that
pollutant(s) in the permit application.
8. 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 enforcement procedures as provided in NCGS 143-215.6 and 33 USC 1251. et seq.
9. Signatory Requirements
All applications, reports, or information submitted to the Permit Issuing
Authority shall be signed and certified.
a. All permit applications shall be signed as follows:
(1) For a corporation: by a responsible corporate officer. For the
purpose of this Section, a responsible corporate officer means:
(a) a president, secretary, treasurer or vice president of the
corporation in charge of a principal business function, or any
other person who performs similar policy or decision making
functions for the corporation, or (b) the manager of one or more
manufacturing production or operating facilities employing more
than 250 persons or having gross annual sales or expenditures
exceeding 25 million (in second quarter 1980 dollars), if authority
to sign documents has been assigned or delegated to the manager in
accordance with corporate procedures.
(2) For a partnership or sole proprietorship: by a general partner or
the proprietor, respectively; or
(3) For a municipality, State, Federal, or other public agency: by either
a principal executive officer or ranking elected official.
b. All reports required by the permit and other information requested by the
Permit Issuing Authority shall be signed by a person described above or by
a duly authorized representative of that person. A person is a duly
authorized representative only if:
(1) The authorization is made in writing by a person described above;
(2) The authorization specified either an individual or a position having
responsibility for the overall operation of the regulated facility or
activity, such as the position of plant manager, operator of a well or

Part II
Page 10 of 14
well field, superintendent, a position of equivalent responsibility,
or an individual or position having overall responsibility for environ-
mental matters for the company. (A duly authorized representative
may thus be either a named individual or any individual occupying a
named position. ); and
(3) The written authorization is submitted to the Permit Issuing Authority.
c. Certification. Any person signing a document under paragraphs a. or b. of
this section shall making the following certification:
"I certify, under penalty of law, that this document and all attachments
were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gather and evaluate the
information submitted. Based on my inquiry of the person or persons who
manage the system, or those persons directly responsible for gathering the
information, the information submitted is, to the best of my knowledge and
believe, true, accurate, and complete. I am aware that there are
significant penalties for submitting false information, including the
possibility of fines and imprisonment for knowing violations."
10. Availability of Reports
Except for data determined to be confidential under NCGS 143-215.3(a) (2) or
Section 308 of the Federal Act, 33 USC 1318, all reports prepared in accordance
with the terms shall be available for public inspection at the offices of the
Division of Environmental Management. As required by the Act, effluent data
shall not be considered confidential. Knowingly making any false statement on
any such report may result in the imposition of criminal penalties as provided
for in NCGS 143-215. 1(b) (2) or in Section 309 of the Federal Act.
11. Penalties for Falsification of Reports
The Clean Water Act provides that any person who knowingly makes any false
statement, representation, or certification in any record or other document
submitted or required to be maintained under this permit, including monitoring
reports or reports of compliance or noncompliance shall, upon conviction, be
punished by a fine of not more than $10,000 per violation, or by imprisonment
for not more than six months per violation, or by both.
SECTION E. DEFINITION
1. Permit Issuing Authority
The Director of the Division of Environmental Management.
2. DEM or Division
Means the Division of Environmental Management, Department of Natural
Resources and Community Development.

Part II
Page 11 of 14
3. EMC:
Used herein means the North Carolina Environmental Management Commission.
4. Act or "the Act"
The Federal Water Pollution Control Act, also known as the Clean Water Act, as
amended, 33 USC 1251, et. seq.
5. Mass/Day Measurements
a. The "monthly average discharge: is defined as the total mass of all
daily discharges sampled and/or measured during a calendar month on
which daily discharges are sample and measured, divided by the number
of daily discharges samples and/or measured during such month. It is
therefore, an arithmetic mean found by adding the weights of the
pollutant found each day of the month and then dividing this sum by
the number of days the tests were reported. The limitation is
identified as "Daily Average" or "Monthly Average" in Part I of the
permit.
b. The "weekly average discharge" is defined as the total mass of
all daily discharges sampled and/or measured during the calendar week
(Sunday-Saturday) on which daily discharges are sampled and measured,
divided by the number of daily discharges samples and/or measured
during such week. It is, therefore, an arithmetic mean found by
adding the weights of pollutants found each day of the week and then
dividing this sum by the number of days the tests were reported. This
limitation is identified as "Weekly Average" in Part: I of the permit.
c. The "maximum daily discharge" is the total mass (weight) of a
pollutant discharged during a calendar day. If only on' sample is
taken during any calendar day the weight of pollutant calculated from
it is the "maximum daily discharge." This limitation is identified as
"Daily Maximum," in Part I of the permit.
d. The "average annual discharge" is defined as the total mass of all
daily discharges sample and/or measured during the calendar year on
which daily discharges are sampled and measured, divided by the number
of daily discharges sampled and/or measured during such year. It is,
therefore, an arithmetic mean found by adding the weights of
pollutants found each day of the year and then dividing this sum by the
number of days the tests were reported. This limitation is defined as
"Annual Average" in. Part I of the permit.

•
Part II
Page 12 of 14
6. Concentration Measurement
a. The "average monthly concentration," other than for fecal coliform
bacteria, is the sum of the concentrations of all daily discharges
samples and/or measured during a calendar month on which daily discharges
are sampled and measured, divided by the number of daily discharges sampled
and/or measured during such month (arithmetic mean of the daily
concentration values). The daily concentration value is equal to the
concentration of a composite sample or in the case of grab samples is the
arithmetic mean (weighted by flow value) of all the samples collected
during that calendar day. The average monthly count for fecal coliform
bacteria is the geometric mean of the counts for samples collected during a
calendar month. This limitation is identified as "Monthly Average" or
"Daily Average" under "Other Limits" in Part I of the permit.
b. The "average weekly concentration," other than for fecal coliform bacteria,
is the sum of the concentrations of all daily discharges sampled and/or
measured during a calendar week (Sunday/Saturday) on which daily discharges
are sampled and measured divided by the number of daily discharges sampled
and/or measured during such week (arithmetic mean of the daily
concentration values) . The daily concentration value is equal to the
concentration of a composite sample or in the case of grab samples is the
arithmetic mean (weighted by flow value) of all the samples collected during
that calendar day. The average weekly count for fecal coliform bacteria is
the geometric mean of the counts for samples collected during a calendar
week. This limitation is identified as "Weekly Average" under "Other
Limits" in Part I of the permit.
c. The "maximum daily concentration" is the concentration of a pollutant
discharge during a calendar day. It is identified as "Daily Maximum"
under "Other Limits" in Part I of the permit.
d. The "average annual concentration," other than for fecal coliform bacteria,
is the sum of the concentrations of all daily discharges sampled and/or
measured during a calendar year on which daily discharges are sampled and
measured divided by the number of daily discharges sampled and/or measured
during such year. (arithmetic mean of the daily concentration values). The
daily concentration value is equal to the concentration of a composite
sample or in the case of grab samples is the arithmetic mean (weighted by
flow value) of all the samples collected during that calendar day. The
average yearly count for fecal coliform bacteria is the geometric mean
of the counts for samples collected during a calendar year. This limitation
is identified as "Annual Average" under "Other Limits" in Part I of the
permit.

Part II
Page 13 of 14
7. Other Measurements
a. Flow, (MGD): The flow limit expressed in this permit is the 24 hours
average flow, averaged monthly. It is determined as the arithmetic mean
of the total daily flows recorded during the calendar month.
b. An "instantaneous flow measurement" is a measure of flow taken at the time
of sampling, when both the sample and flow will be representative of the
total discharge.
8. Types of Samples
a. Composite Sample: These samples consist of grab samples collected at
equal intervals and combined proportional to flow, a sample continuously
collected proportionally to flow, or equal volumes talren at varying time
intervals. If a composite sample is obtained from grab samples, the
following requirements apply. The intervals between influent grab
samples shall be no greater than hourly. Intervals between effluent grab
samples shall be no greater than hourly except where the detention time
of the wastewater in the facility is greater than 24 hours, in which
case, the interval between grab samples shall be no greater in number of
hours than the detention time in number of days; provided, however, in
no case may the time between effluent grab samples be greater than six
hours nor the number of grab samples less than four during any discharge
period of 24 hours or less.
b. Grab Sample: Grab samples are individual samples collected over a
period of time not exceeding 15 minutes; the grab sample can be taken
manually.
9. Calculation of Means
a. Arithmetic Mean: The arithmetic mean of any set of values is the summation
of the individual values divided by the number of individual values.
b. 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 individual values. For
purposes of calculating the geometric mean, values of zero (0) shall be
considered to be one (1) .
c. Weighted by Flow Value: Weighted by flow value means the summation of each
concentration times its respective flow divided by the summation of the
respective flows.

•
Part II
Page 14 of 14
10. Calendar Day
A calendar day is defined as the period from midnight of one dRy until midnight
of the next day. However, for purposes of this permit, any consecutive 24-hour
period that reasonably represents the calendar day may be used for sampling.
11. Hazardous Substance
A hazardous substance means any substance designated under 40 CFR Part 116
pursuant to Section 311 of the Clean Water Act.
12. Toxic Pollutant
A toxic pollutant is any pollutant listed as toxic under Section 307(a)(1) of
the Clean Water Act.

•
PART III
OTHER REQUIREMENTS
•
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 has been issued.
C. Certified Operator
Pursuant to Chapter 90A of North Carolina General Statutes, the permittee shall
employ a certified wastewater treatment plant operator in responsible charge
of the wastewater treatment facilities. Such operator must hold a certification
of the grade equivalent to or greater than the classification assigned to the
wastewater treatment facilities.
D. Groundwater Monitoring
The permittee shall, upon written notice from the Director of the Division of
Environmental Management, conduct groundwater monitoring as may he required
to determine the compliance of this NPDES permitted facility with the current
groundwater standards.
E. Limitations Reopener
This permit shall be modified or alternatively, revoked and reissued, to comply
with any applicable effluent guideline or water quality standard issued or
approved under Sections 302(b) (2) (c), and. (d), 304(b) (2), and 307(a) (2)
of the Clean Water Act, if the effluent guideline or water quality standard
so issued or approved:
1. contains different conditions or is otherwise more stringent than any
effluent limitation in the permit; or
2. controls any pollutant not limited in the permit.
The permit as modified or reissued under this paragraph shall also contain any
other requirements in the Act then applicable.

Part III
Continued
F. Toxicity Reopener
This permit shall be modified, or revoked and reissued to incorporate toxicity
limitations and monitoring requirements in the event toxicity testing or other
studies conducted on the effluent or receiving stream indicate that detrimental
effects may be expected in the receiving stream as a result of this discharge.

e".SWto
t
VMS � .
•
'oet
RRECE1vED
�y1Si0N OE ENNRONMEN` '`M.aNACEE�
State of North Carolina
Department ,of--Natural Resources and Community Development
Division of Environmental Management
512 NoTgh Satt bury Street • Raleigh, North Carolina 27611
James G. Martin, Governor R. Paul Wilms
S. Thomas Rhodes, Secretary February 1986 Director
Mr. Charles G. Moore /15EP!A��dQ
126 Kaywood Dr. pti.ev`e- r- '`
Statesville, N.C. 28677 ( y vtee°
SUBJECT: Permit No. NC0062332
Charles G. Moore Residence
Wastewater Treatment Facility
Iredell County
Dear Mr. Moore:
With reference to the above mentioned project, please provide two sets
of plans indicating the following:
a. A site plan for your residence,
b. The size (gallons) of the existing septic tank,
c. A sand filter with an area of 396 S.F. (either 132' x 3' for a single
distribution pipe or 66' x 6' for double pipes) ,
d. Chlorination by a tablet chlorinator and chlorine contact tank, and
e. Post aeration.
The plans must be received prior to issuing an Authorization to Construct
and should be resolved as soon as possible so that your project document can be
completed without delay. You may either submit your own plans or adopt the at-
tached example plans and return them with a site plan for your residence.
Satisfactory plans and specifications must be submitted to this office no later
than April 14, 1986, to prevent your project from being subject to return as
incomplete. Construction of the treatment facility without an Authorization to
Construct is illegal and subject to civil penalty assessment.
If there are any questions concerning this project, please contact me
at this number (919) 733-5083, ext. 170.
Sincerely yours,
%Ø4CJ
Samuel Bridges
Environmental Engineer
Permits and Engineering Unit
cc: Mooresville Regional Supervisor
Mr. Dennis R. Ramsey Pollution Prevention Pays
P.O. Box 27687, Raleigh,North Carolina 27611-7687 Telephone [phone]
SB/ad
An Equal Opportunity Affirmative Action Employer

s�.surro
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 December 4 , 1985 R. Paul Wilms
S. Thomas Rhodes, Secretary Director
Mr . Charles G. Moore
124 Kaywood Place
Statesville , NC 28677
Subject : Permit No . NC0062332
Moore Residence
Dear Mr . Moore :
In accordance with your application for discharge permit received on
April 11 , 1985, we are forwarding herewith the subject State - NPDES
permit . This permit is issued pursuant to the requirements of North
Carolina and the US Environmental Protection Agency dated December 6 ,
1983 .
If any parts , requirements , or limitations contained in this permit
are unacceptable to you, you have the right to an adjudicatory hearing
before a hearing officer upon written demand to the Director within 30
days following receipt of this permit , identifying the specific issues to
be contended . Unless such demand is made , this permit shall be final and
binding .
Please take notice that this permit is not transferable . Part II,
B . 2. addresses the requirements to be followed in case of change in
ownership or control of this discharge .
This permit does not affect the legal requirement to obtain other
permits which may be required by the Division of Environmental
Management . If you have any questions concerning this permit , please
contact Mr . Mack Wiggins , at telephone number 919/733-5083 .
Sincerely, OE NATURAL
DEFT.
RESOURCES AND
ARTH U R M r`i i 1"7°R Y COMMUNITY DEVELOPMENT
FOR R. Paul Wilms DEC 9 1985
cc : Mr. Jim Patrick , EPA
Mooresville Regl-o iT firFrfrkftriki, :SIA:t115:CL3FS:Eilt1115‘1E15211;14A1110Crlititill
6EMEIRfiCEPollution Prevention Pays
P.O. Box 27687, Raleigh, North Carolina 27611-7687 Telepho99- 0
An Equal Opportunity Affirmative Action Employer

Permit No . NC0062332
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 provisions of North Carolina General
Statute 143-215 . 1 , other lawful standards and regulations promulgated
and adopted by the North Carolina Environmental Management Commission ,
and the Federal Water Pollution Control Act , as amended , d
Mr . Charles G . Moore a
is hereby authorized to discharge wastewater from a facility located
at
Charles G. Moore Residence
on NCSR 2515
Iredell County
to receiving waters designated as an unnamed tributary to Fourth Creek
in the Yadkin-Pee Dee River Basin
in accordance with effluent limitations , monitoring requirements , and
other conditions set forth in Parts I , II , and III hereof .
This permit shall be effective December 4 , 1985
This permit and the authorization to discharge shall expire at
midnight on November 30, 1990
Signed this day of December 4, 1985
ORIGINAL SIGNED BY
ARTHUR MOUBERRY
FOR
R. Paul Wilms , Director
Division of Environmental Management
By Authority of the Environmental
Management Commission

Permit No. NC0062332
SUPPLEMENT TO PERMIT COVER SHEET
Mr . Charles G. Moore
is hereby authorized to :
1 . Enter into a contract for construction of a wastewater
treatment facility, and
2. Make an outlet into an unnamed tributary to Fourth Creek, and
3. After receiving an Authorization to Construct from the
Division of Environmental Management , construct and operate a
0 . 001 MGD wastewater treatment facility located on NCSR 2515
in Iredell County (See Part III, Condition No . B. of this
permit) , and
4. Discharge from said treatment works into an unnamed tributary
to Fourth Creek which is classified Class "C" waters in the
Yadkin-Pee Dee River Basin

a
w •
A. ( 1). EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS Final •
During the period beginning on the effective date of the Permid las 1 g until expiration,
• the pereittee Is authorize Perms:
and
to discharge from outfall(s) serial numbers 001.
Such discharges shall be limited and monitored by the permittee as specified below:
•
Effluent Characteristics plscharoe Limitations tbnitorina Requirements
Wdu (103/4 ) Other•Uni is S• Cif
1' a a...11. I Salad
Monthly Avg, ee Y Ave. ..• ,n'I.1Y• 1ILA A. • Lora c
Flow 0.001 MGD
BOD, 5Day, 20°C 30.0 mg/1 45.0 mg/1
Total Suspended Residue 30.0 mg/1 45.0 mg/1
Nil as N
Didsolved Oxygen (minimum) 6 .0 mg/1 6. 0 mg/1
Fecal Coliform (geometric mean) 1000.0/100 ml 2000.0/100 ml
Residual Chlorine
Temperature
Pt
The pH shall not be less than 6,0 standard units nor greater than 9,9 standard units
. W
There shall be no discharge of floating solids or visible foss in other than trace amounts. N

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.
"EMC" 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 is 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 (ii) 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 prospec-
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:

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 sewer 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 180 days of its availability
to the site.

A %\ :
` '� c. n
DE 0p
Rv/ dr EPT. OF NAT
t RESOURCES AU
AL
�L11 p 7 yl' $'� COMMR SITY RESOURCES
ANME.
V\ ' ST
•°�� Al P 1 8 1990
State of North Carolina lgYlSl"N CF �H'd' ,l9t k'Att G'?RENT
Department of Environment, Health and Natural ResoulPesSillif RECI3NAL OFFICE
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 Director
April 18, 1990
Mr. & Mrs. Gary Wayne Edwards
126 Raywood Drive
Statesville, NC 28677
Subject: NPDES Permit No. NC0062332
Mr. & Mrs. Gary W. Edwards Residence
Iredell County
Dear Mr. & Mrs. Edwards:
On December 22, 1988, the Division of Environmental Management issued NPDES Permit
No. NC0062332 to Mr. & Mrs. Gary Wayne Edwards. A review of the permit file has indicated
that an error was inadvertently made in the permit. Accordingly, we are forwarding herewith
modifications to the subject permit to correct the error. These permit modifications are issued
to delete the monitoring requirements from the permit.
Please find enclosed an amended effluent limitations page which should be inserted into your
permit. The old effluent limitations page should be discarded. All other terms and conditions
contained in the original permit remain unchanged and in full effect. These permit modifications
are issued pursuant to the requirements of North Carolina General Statutes 143-215.1 and the
Memorandum of Agreement between North Carolina and the U. S. Environmental Protection
Agency.
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 150E of the North Carolina General Statutes, and filed
with the Office of Administrative Hearings, Post Office Drawer 11666, Raleigh, North Carolina
27604. Unless such demand is made, this decision shall be final and binding.
Pollution Prevention Pays
P.O.Box 27687,Raleigh,North Carolina 27611-7687 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

If you have any questions concerning these permit modifications, please contact Mr. Mack
Wiggins at telephone number 919/733-5083.
Sincerely yours,
It'€)24L
George T. Everett
cc. Mr. Jim Patrick, EPA
Central Files

A. (). EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS FINAL Permit No. NC0062332
During the period beginning on the effective date of the permit and lasting until expiration, the Permittee is authorized to discharge from
outfall(s) serial number 001. Such discharges shall be limited and monitored by the permittee as specified below:
Effluent Characteristics Discharge Limitations Monitoring Requirements
Units (specify) Measurement Sample `Sample
Monthly Avg,. Weekly Avg. Frequency Type Location
Flow 0.001 MGD
BOD, 5 day, 20°C 30.0 mg/I 45.0 mg/I
Total Suspended Residue 30.0 mg/I 45.0 mg/I
NH3 as N
Dissolved Oxygen (minimum) 6.0 mg/I 6.0 mg/I
Fecal Coliform (geometric mean) 200.0 /100 ml 400.0 /100 ml
Total Residual Chlorine
Temperature
The chlorinator shall be inspected weekly to ensure there is an ample supply of chlorine tablets for continuous disinfection of the effluent.
The pH shall not be less that 6.0 standard units nor greater than 9.0 standard units.
There shall be no discharge of floating solids or visible foam in other than trace amounts.

1:iRDavid A. Roberts Engineering :,,:, .ka,;y:
SPECIALIZING IN WATER AND WASTEWATER ENGINEERING PROJECTS i�`e SEAL 1 I
szn 1�
MailingAddress Office Location a`.. ,
BUS.PHONE[phone] n•'f/':f'voiNF..tt cc"
309 N.ZION ST. ANS.SERVICE(T04)857-58GI HIGHWAY 29+,01 and '-.Oq '•••••',,c
LANDIS,N.C.28088 DALK?1ERTV ROAD RiHUR
February 10, 1986
MEMO
To: Mr. Michael Parker
Mr. Charles Go Moore
Subject: Revisions to Engineering Specifications
Proposed Sand Filter System
Lot #124 Kaywood Place
Iredell County, N.C.
Permit Number NC0062332( -Pe tiVPZ4144-3'(
Enclosed you will find two pages of additions to the specifications
for this wastewater system. These pages depict the post aeration
system which should be added to the existing specifications you
now have in your possessions. This addition to engineering plans
and specifications will require the addition of post aeration
system to the discharge piping adjacent to and downhill from the
chlorination contact tank.
Please let me know if you have any questions.
A phone call from Cecil Madden in Raleigh revealed that Lisa Creech
will be doing the plan review and all contact concerning this
project should be directed to her.
Your help with this project approval is greatly appreciated.
ago,:tc a. 2,,
oy
10211*- S 10 1COIL
EflVIRG`eKEHTAE �4,.�.St�
p���S�O�`�Sy`� . GIV1S III ©E„ k'c41Ds:M. O�EI
1�GGZES,tlLE

State of North Carolina
Department of Natural Resources and Community Development
Mooresville Regional Office
James G. Martin, Governor Albert F. Hilton, Regional Manager
William W. Cobey, Jr., Secretary
DIVISION OF ENVIRONMENTAL MANAGEMENT
January 5 , 1989
Mr. Gary Wayne Edwards
126 Raywood Drive
Statesville, North Carolina 28677
Subject: NPDES Permit No. NC 0062332
Mr. & Mrs. Gary Wayne Edwards
formerly issued to
Mr. Charles G. Moore
Iredell County, NC
Dear Mr. Edwards :
Our records indicate that NPDES Permit No. NC 0062332 was
issued on December 21, 1988 for the discharge of wastewater to
the surface waters of the State from your facility. The purpose
of this letter is to advise you of the importance of the Permit
and the liabilities in the event of failure to comply with the
terms and conditions of the Permit. If you have not already done
so, it is suggested that you thoroughly read the Permit. Of
particular importance is Page M3 .
Page M3 sets forth the effluent limitations and monitoring
requirements for your discharge( s) . Your discharge( s) must not
exceed any of the limitations set forth. The section headed
"Monitoring Requirements" describes the measurement frequencies,
sample types and sampling locations. Upon commencement of your
discharge (or operation) , you must initiate the required
monitoring. The monitoring results must be entered on the DMR
forms furnished to you by this Agency. If you have not received
these forms, they should be arriving shortly. If you fail to
receive the form, please contact this Office as quickly as
possible. I have enclosed a sample of the "Effluent" reporting
form (DEM Form MR-1) , plus instructions for completing the form.
It is imperative that all applicable parts be completed.
The remaining Parts of the Permit (Parts II and III ) set
forth definitions, general conditions and special conditions
applicable to the operation of wastewater treatment facilities
and/or discharge( s) . The conditions include special reporting
requirements in the event of noncompliance, bypasses, treatment
919 North Main Street, P.O. Box 950, Mooresville, N.C. 28115-0950•Telephone [phone]
An Equal Opportunity Affirmative Action Employer

Mr. Gary Wayne Edwards
Page Two
January 5, 1989
unit/process failures, etc. Also addressed are requirements for
a certified wastewater treatment plant operator if you are
operating wastewater treatment facilities. Any changes in
operation of wastewater treatment facilities, quantity and type
of wastewater being treated or discharged, expansions and/or
upgrading of wastewater treatment facilities must be permitted or
approved by this Agency. Failure to comply with the terms and
conditions of an NPDES Permit subjects the Permittee to
enforcement action.
As a final note, an NPDES Permit is normally issued for a
five-year period. Permits are not automatically renewed.
Renewal requests must be submitted to this Agency no later than
180 days prior to expiration. Please make note of the expiration
date of your Permit. This date is set forth on Page M-1 or I-i
of the Permit. Also note that NPDES Permits are not
transferable. If you, as the Permittee, cease to need this
Permit, then you should request that the Permit be rescinded.
As mentioned previously, the purpose of this letter is to
advise you of the importance of your NPDES Permit. Please read
the Permit and contact this Office at 704/663-1699 in Mooresville
if you have any questions or need clarification. We look forward
to providing any assistance.
Sincerely,
D. Rex Gleason, P. E.
Water Quality Regional Supervisor
Enclosure
DRG: se

i
% David A. Roberts Engineering 'a�Q;o Egsbti '
SPECIALIZING IN WATER AND WASTEWATER ENGINEERING PROJECTS -' 114 SEAL
Moiling Address Office Location a', 6271 f,,
BUS.PHONE[phone] Q
'"•1s-%•fhOI e.."cQ?
,,-,
309 N.ZION ST ANS.SERVICE(T04I857-'5861 HIGHWAY 2�01 one "•",O ••..... p0,.
LANDIS,N.C.28088 DAUGFERTY ROAD q RTHUR ,
February 10, 1986
Mr. Cecil Madden
Division of Environmental Management
Post Office Box 27687
Raleigh, North Carolina 27611
Subject: Proposed Sand Filter System
#124 Kaywood Place
Iredell County, N.C. '
Charles G. Moore, Owner
Permit Number NC0062332
Dear Mr. Madden:
During our conversations by telephone today, in discussing
the proposed post aeration system for this project, we talked
about the recommended system being similiar to the one used at
Heritage Home in Rowan County, and you were interested in the
levels of dissolved oxygen being found in the effluent from
the system at Heritage Home. A phone call to Michael Banker
at BAW Labs in Charlotte revealed dissolved oxygen levels
ranging from 6.2 to 9.4 ppm. I copy of those readings is
enclosed for your information.
Please let me know if you have any questions or if we can
be of additional service to you.
With kind
'rregards,
a.„-,1-a-
7
David A. Roberts
Copy: Michael Parker
Charles G. Moore

David A. Roberts Engineering
: FR SPECIALIZING IN WATER AND WASTEWATER ENGINEERING PROJECTS 14q- SEAL l'‘i
114
Mailing Address
3900
309 N.ZION ST. WS.PHONE(704)857-
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State of North Carolina
Department of Environment,
Health and Natural Resources • A
Division of Water Quality
James B. Hunt, Jr., Governor a'°} t``9 H N
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director July 21, 1997
Ronald Coleman
164 Kaywood Lane
Statesville, NC 28677
Subject: Certificate of Coverage No. NCG550342
Renewal of General Permit
Coleman, Ronald & Linda-Res.
Iredell 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,
•
fel,'" A. Preston Howard,Jr.,P.E.
cc: Central Files
Mitibiltsville Regional Office
NPDES Group
Facility Assessment Unit
P.O. Box 29535, Raleigh, North Carolina 27626-0535 [phone] FAX[phone] p&e©dem.ehnr.state.nc.us
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. NCG550342
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,
Ronald Coleman
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
Coleman, Ronald & Linda-Res.
164 Kaywood Lane
Statesville
Iredell County
to receiving waters designated as subbasin 30706 in the Yadkin 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.
• 1)IPSIL--. 4. 9,-,4,,,,A___„' .
(0)17A. Preston Howard, Jr., P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

State of North Carolina -
Department of Environment,
/ Health and Natural Resources 7:49rA�
Division of Environmental Management 4 i V
`v° James B. Hunt, Jr., Governor �`
`/ Jonathan B. Howes, Secretary ammemem
I E I . 1
A. Preston Howard, Jr., P.E., Director NI. 1:-.3,. F
n ENV IRONMEN•r. HEALTH,
`V\ - & NATURAL RT:4CJt)R.CES
January 22, 1996
Joan 25 1996
Ronald and Linda Coleman DIVISION OF ENVIGONMENTAL MANAGEMENT
164 Kaywood Lane MOORESVILLE REGIONAL OFFICE
Statesville,North Carolina 28677
Subject: Permit Modification-Ownership Change
NPDES #NCG550342
Coleman Residence
(formerly the Cassell Residence)
Iredell County
Dear Mr. and Mrs. Coleman:
In accordance with your request received November 25, 1995, the Division is forwarding the
subject permit. The only change in this permit regards ownership. All other terms and conditions
in the original permit remain unchanged and in full effect. This permit modification 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.
This permit does not affect the legal requirement to obtain other permits which may be
required by the Division of Environmental Management or permits required by the Division of
Land Resources, Coastal Area Management Act, or any other Federal or Local governmental
permit that may be required.
If you have any questions concerning this modification,please contact Alan Jones at telephone
number [phone], extension 538.
Sincerely,
Original Signed By
David A. Goodrich
A. Preston Howard, Jr., P.E.
cc: Central Files
IM' ville-Regipnal Offi Water Quality Section
Permits and Engineering Unit
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
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 ENVIRONMENTAL MANAGEMENT
CERTIFICATE OF COVERAGE
GENERAL PERMIT NO. NCG550342
TO DISCHARGE DOMESTIC WASTEWATERS FROM SINGLE FAMILY RESIDENCES AND OTHER
DISCHARGES WITH SIMILAR CHARACTERISTICS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act,as amended,
Ronald and Linda Coleman
is hereby authorized to operate a wastewater treatment facility that consists of dual septic tanks, dual surface
sandfilters, tablet chlorinator, chlorine contact tank, and associated appurtenances with the discharge of treated
wastewater from a facility located at the
Coleman Residence
164 Kaywood Lane
Statesville
Iredell County
to receiving waters designated as an unnamed tributary to UT Fourth Creek in the Yadkin-Pee Dee 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 January 22,1996
This Certificate of Coverage shall remain in effect for the duration of the General Permit
Signed this day January 22, 1996
Original Signed By
David A. Goodrich
A.Preston Howard,Jr.,P.E.,Director
Division of Environmental Management
By Authority of the Environmental Management Commission

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QUADRANGLE LOCATIO:l
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FOR SALE BY U.S. GEOLOGICAL SURVEY, WASHINGTON, D.C. 20242
A FOLDER DESCRIBING TOPOGRAPHIC MAPS AND SYMBOLS IS AVA_.ABLE ON REQUEST

PART I
Section B. Schedule of Compliance
1. The permittee shall comply with Final Effluent Limitations specified for discharges in
accordance with the following schedule:
Permittee shall comply with Final Effluent Limitations by the effective date of the permit unless
specified below.
2. Permittee shall at all times provide the operation and maintenance necessary to operate the
existing facilities at optimum efficiency.
3. No later than 14 calendar days following a date identified in the above schedule of compliance,
the permittee shall submit either a report of progress or, in the case of specific actions being
required by identified dates, a written notice of compliance or noncompliance. In the latter
case, the notice shall include the cause of noncompliance, any remedial actions taken, and the
probability of meeting the next schedule requirements.

Part II
Page 1 of 14
PART II
STANDARD CONDITIONS FOR NPDES PERMITS
SECTION A. DEFINITIONS
1. Permit Issuing Authority
The Director of the Division of Environmental Management.
2. DEM or Division
Means the Division of Environmental Management, Department of Environment, Health and
Natural Resources.
3. JMC
Used herein means the North Carolina Environmental Management Commission.
4. Act or "the Act"
The Federal Water Pollution Control Act, also known as the Clean Water Act, as amended, 33
USC 1251, et. seq.
5. jvlass/Day Measurements
a. The "monthly average discharge" is defined as the total mass of all daily discharges
sampled and/or measured during a calendar month on which daily discharges are sampled
and measured, divided by the number of daily discharges sampled and/or measured during
such month. It is therefore, an arithmetic mean found by adding the weights of the
pollutant found each day of the month and then dividing this sum by the number of days
the tests were reported. The limitation is identified as "Monthly Average" in Part I of the
permit.
b. The "weekly average discharge" is defined as the total mass of all daily discharges sampled
and/or measured during the calendar week (Sunday - Saturday) on which daily discharges
are sampled and measured, divided by the number of daily discharges sampled and/or
measured during such week. It is, therefore, an arithmetic mean found by adding the
weights of pollutants found each day of the week and then dividing this sum by the
number of days the tests were reported. This limitation is identified as "Weekly Average"
in Part I of the permit.
c. The "maximum daily discharge" is the total mass (weight)of a pollutant discharged during
a calendar day. If only one sample is taken during any calendar day the weight of pollutant
calculated from it is the "maximum daily discharge." This limitation is identified as "Daily
Maximum," in Part I of the permit.
d. The "average annual discharge" is defined as the total mass of all daily discharges sampled
and/or measured during the calendar year on which daily discharges are sampled and
measured,divided by the number of daily discharges sampled and/or measured during such
year. It is, therefore, an arithmetic mean found by adding the weights of pollutants found
each day of the year and then dividing this sum by the number of days the tests were
reported. This limitation is defined as "Annual Average" in Part I of the permit.

Part II
Page 2 of 14
6. Concentration Measurement
a. The "average monthly concentration," other than for fecal coliform bacteria, is the sum of
the concentrations of all daily discharges sampled and/or measured during a calendar month
on which daily discharges are sampled and measured, divided by the number of daily
discharges sampled and/or measured during such month (arithmetic mean of the daily
concentration values). The daily concentration value is equal to the concentration of a
composite sample or in the case of grab samples is the arithmetic mean (weighted by flow
value) of all the samples collected during that calendar day. The average monthly count for
fecal coliform bacteria is the geometric mean of the counts for samples collected during a
calendar month. This limitation is identified as "Monthly Average" under "Other Limits"in
Part I of the permit.
b. The "average weekly concentration," other than for fecal coliform bacteria,is the sum of the
concentrations of all daily discharges sampled and/or measured during a calendar week
(Sunday/Saturday) on which daily discharges are sampled and measured divided by the
number of daily discharges sampled and/or measured during such week (arithmetic mean of
the daily concentration values). The daily concentration value is equal to the concentration
of a composite sample or in the case of grab samples is the arithmetic mean (weighted by
flow value)of all the samples collected during that calendar day. The average weekly count
for fecal coliform bacteria is the geometric mean of the counts for samples collected during
a calendar week. This limitation is identified as "Weekly Average" under"Other Limits" in
Part I of the permit.
c. The "maximum daily concentration" is the concentration of a pollutant discharge during a
calendar day. If only one sample is taken during any calendar day the concentration of
pollutant calculated from it is the "Maximum Daily Concentration". It is identified as
"Daily Maximum" under"Other Limits" in Part I of the permit.
d. The "average annual concentration," other than for fecal coliform bacteria, is the sum of the
concentrations of all daily discharges sampled and/or measured during a calendar year on
which daily discharges are sampled and measured divided by the number of daily
discharges sampled and/or measured during such year (arithmetic mean of the daily
concentration values). The daily concentration value is equal to the concentration of a
composite sample or in the case of grab samples is the arithmetic mean (weighted by flow
value) of all the samples collected during that calendar day . The average yearly count for
fecal coliform bacteria is the geometric mean of the counts for samples collected during a
calendar year. This limitation is identified as "Annual Average" under "Other Limits" in
Part I of the permit.
e. The "daily average concentration" (for dissolved oxygen)is the minimum allowable amount
of dissolved oxygen required to be available in the effluent prior to discharge averaged
over a calendar day. If only one dissolved oxygen sample is taken over a calendar day, the
sample is considered to be the "daily average concentration" for the discharge. It is
identified as "daily average" in the text of Part I.
f. The "quarterly average concentration" is the average of all samples taken over a calendar
quarter. It is identified as "Quarterly Average Limitation" in the text of Part I of the permit.
g. A calendar quarter is defined as one of the following distinct periods: January through
March, April through June, July through September, and October through December.

Part II
Page 3 of 14
7. Other Measurements
a. Flow, (MGD): The flow limit expressed in this permit is the 24 hours average flow,
averaged monthly. It is determined as the arithmetic mean of the total daily flows recorded
during the calendar month.
b. An "instantaneous flow measurement" is a measure of flow taken at the time of sampling,
when both the sample and flow will be representative of the total discharge.
c. A "continuous flow measurement" is a measure of discharge flow from the facility which
occurs continually without interruption throughout the operating hours of the facility. Flow
shall be monitored continually except for the infrequent times when there may be no flow
or for infrequent maintenance activities on the flow device.
8. Types of Samples
a. Composite Sample: A composite sample shall consist of:
(1) a series of grab samples collected at equal time intervals over a 24 hour period of
discharge and combined proportional to the rate of flow measured at the time of
individual sample collection,or
(2) a series of grab samples of equal volume collected over a 24 hour period with the time
intervals between samples determined by a preset number of gallons passing the
sampling point. Flow measurement between sample intervals shall be determined by
use of a flow recorder and totalizer, and the present gallon interval between sample
collection fixed at no greater than 1/24 of the expected total daily flow at the treatment
system, or
(3) a single, continuous sample collected over a 24 hour period proportional to the rate of
flow.
In accordance with (1) above, the time interval between influent grab samples shall be no
greater than once per hour, and the time interval between effluent grab samples shall be no
greater than once per hour except at wastewater treatment systems having a detention time
of greater than 24 hours. In such cases, effluent grab samples may be collected at time
intervals evenly spaced over the 24 hour period which are equal in number of hours to the
detention time of the system in number of days. However, in no case may the time interval
between effluent grab samples be greater than six (6) hours nor the number of samples less
than four (4) during a 24 hour sampling period.
b. Grab Sample: Grab samples are individual samples collected over a period of time not
exceeding 15 minutes; the grab sample can be taken manually. Grab samples must be
representative of the discharge or the receiving waters.
9. Calculation of Means
a Arithmetic Mean: The arithmetic mean of any set of values is the summation of the
individual values divided by the number of individual values.
b. 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 individual
values. For purposes of calculating the geometric mean, values of zero (0) shall be
considered to be one (1).

Part II
Page 4 of 14
c. Weighted by Flow Value: Weighted by flow value means the summation of each
concentration times its respective flow divided by the summation of the respective flows.
10. Calendar Day
A calendar day is defined as the period from midnight of one day until midnight of the next
day. However, for purposes of this permit, any consecutive 24-hour period that reasonably
represents the calendar day may be used for sampling.
11.Hazardous Substance
A hazardous substance means any substance designated under 40 CPR Part 116 pursuant to
Section 311 of the Clean Water Act.
12. Toxic Pollutant
A toxic pollutant is any pollutant listed as toxic under Section 307(a)(1)of the Clean Water Act.
SECTION B. GENERAL CONDITIONS
1. Duty to Comply
The permittee must comply with all conditions of this permit. Any permit noncompliance
constitutes a violation of the Clean Water Act and is grounds for enforcement action; for permit
termination, revocation and reissuance, or modification; or denial of a permit renewal
application.
a. The permittee shall comply with effluent standards or prohibitions established under
section 307(a) of the Clean Water Act for toxic pollutants and with standards for sewage
sludge use or disposal established under section 405(d) of the Clean Water Act within the
time provided in the regulations that establish these standards or prohibitions or standards
for sewage sludge use or disposal, even if the permit has not yet been modified to
incorporate the requirement.
b. The Clean Water Act provides that any person who violates a permit condition is subject to
a civil penalty not to exceed $25,000 per day for each violation. Any person who
negligently violates any permit condition is subject to criminal penalties of $2,500 to
$25,000 per day of violation, or imprisonment for not more than 1 year, or both. Any
person who knowingly violates permit conditions is subject to criminal penalties of$5,000
to$50,000 per day of violation,or imprisonment for not more than 3 years,or both. Also,
any person who violates a permit condition may be assessed an administrative penalty not
to exceed $10,000 per violation with the maximum amount not to exceed$125,000. [Ref:
Section 309 of the Federal Act 33 U.S.C. 1319 and 40 CFR 122.41 (a)]
c. Under state law, a civil penalty of not more than ten thousand dollars ($10,000) per
violation may be assessed against any person who violates or fails to act in accordance with
the terms, conditions, or requirements of a permit. [Ref: North Carolina General Statutes
§ 143-215.6A]
d. Any person may be assessed an administrative penalty by the Administrator for violating
section 301, 302, 306, 307, 308, 318, or 405 of the Act, or any permit condition or
limitation implementing any of such sections in a permit issued under section 402 of the
Act. Administrative penalties for Class I violations are not to exceed$10,000 per violation,
with the maximum amount of any Class I penalty assessed not to exceed $25,000.

Part II
Page 5 of 14
Penalties for Class II violations are not to exceed $10,000 per day for each day during
which the violation continues, with the maximum amount of any Class II penalty not to
exceed $125,000.
2. Duty to Mitigate
The permittee shall take all reasonable steps to minimize or prevent any discharge or sludge use
or disposal in violation of this permit which has a reasonable likelihood of adversely affecting
human health or the environment.
3. Civil and Criminal Liability
Except as provided in permit conditions on "Bypassing" (Part II, C-4) and "Power Failures"
(Part II, C-7), nothing in this permit shall be construed to relieve the permittee from any
responsibilities, liabilities, or penalties for noncompliance pursuant to NCGS 143-215.3, 143-
215.6 or Section 309 of the Federal Act, 33 USC 1319. Furthermore, the permittee is
responsible for consequential damages, such as fish kills, even though the responsibility for
effective compliance may be temporarily suspended.
4. Oil and Hazardous Substance Liability
Nothing in this permit shall be construed to preclude the institution of any legal action or relieve
the permittee from any responsibilities, liabilities, or penalties to which the permittee is or may
be subject to under NCGS 143-215.75 et seq. or Section 311 of the Federal Act, 33 USG 1321.
Furthermore, the permittee is responsible for consequential damages, such as fish kills, even
though the responsibility for effective compliance may be temporarily suspended.
5. Property Rights
The issuance of this permit does not convey any property rights in either real or personal
property, or any exclusive privileges,nor does it authorize any injury to private property or any
invasion of personal rights, nor any infringement of Federal, State or local laws or regulations.
6. Onshore or Offshore Construction
This permit does not authorize or approve the construction of any onshore or offshore physical
structures or facilities or the undertaking of any work in any navigable waters.
7. Severability
The provisions of this permit are severable, and if any provision of this permit, or the
application of any provision of this permit to any circumstances, is held invalid, the application
of such provision to other circumstances, and the remainder of this permit, shall not be affected
thereby.
8. Duty to Provide Information
The permittee shall furnish to the Permit Issuing Authority, within a reasonable time, any
information which the Permit Issuing Authority may request to determine whether cause exists
for modifying, revoking and reissuing, or terminating this permit or to determine compliance
with this permit. The permittee shall also furnish to the Permit Issuing Authority upon
request, copies of records required to be kept by this permit.

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9. Duty to Reapply
If the permittee wishes to continue an activity regulated by this permit after the expiration date
of this permit,the permittee must apply for and obtain a new permit.
10. Expiration of Permit
The permittee is not authorized to discharge after the expiration date. In order to receive
automatic 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 permittee that has not requested renewal at least
180 days prior to expiration, or any permittee that does not have a permit after the expiration
and has not requested renewal at least 180 days prior to expiration, will subject the permittee to
enforcement procedures as provided in NCGS 143-215.6 and 33 USC 1251 et. seq.
11. Signatory Requirements
All applications, reports, or information submitted to the Permit Issuing Authority shall be
signed and certified.
a. All permit applications shall be signed as follows:
(1) For a corporation: by a responsible corporate officer. For the purpose of this Section,
a responsible corporate officer means: (a) a president, secretary, treasurer or vice
president of the corporation in charge of a principal business function, or any other
person who performs similar policy or decision making functions for the corporation,
or (b) the manager of one or more manufacturing production or operating facilities
employing more than 250 persons or having gross annual sales or expenditures
exceeding 25 million (in second quarter 1980 dollars), if authority to sign documents
has been assigned or delegated to the manager in accordance with corporate procedures.
(2) For a partnership or sole proprietorship: by a general partner or the proprietor,
respectively; or
(3) For a municipality, State, Federal, or other public agency: by either a principal
executive officer or ranking elected official.
b. All reports required by the permit and other information requested by the Permit Issuing
Authority shall be signed by a person described above or by a duly authorized
representative of that person. A person is a duly authorized representative only if:
(1) The authorization is made in writing by a person described above;
(2) The authorization specified either an individual or a position having responsibility for
the overall operation of the regulated facility or activity, such as the position of plant
manager, operator of a well or well field, superintendent, a position of equivalent
responsibility, or an individual or position having overall responsibility for
environmental matters for the company. (A duly authorized representative may thus be
either a named individual or any individual occupying a named position.); and
(3)The written authorization is submitted to the Permit Issuing Authority.

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c. Certification. Any person signing a document under paragraphs a. or b. of this section
shall make the following certification:
"I certify, under penalty of law, that this document and all attachments were prepared under
my direction or supervision in accordance with a system designed to assure that qualified
personnel properly gather and evaluate the information submitted. Based on my inquiry of
the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and
belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for
knowing violations."
12. permit Actions
This permit may be modified, revoked and reissued, or terminated for cause. The filing of a
request by the permittee for a permit modification, revocation and reissuance, or termination,
or a notification of planned changes or anticipated noncompliance does not stay any permit
condition.
13. Permit Modification. Revocation and Reissuance.or Termination
The issuance of this permit does not prohibit the permit issuing authority from reopening and
modifying the permit, revoking and reissuing the permit,or terminating the permit as allowed
by the laws, rules, and regulations contained in Title 40, Code of Federal Regulations, Parts
122 and 123; Title 15A of the North Carolina Administrative Code, Subchapter 2H .0100; and
North Carolina General Statute 143-215.1 et. al.
14. Previous Permits
All previous National Pollutant Discharge Elimination System Permits issued to this facility,
whether for operation or discharge, are hereby revoked by issuance of this permit. [The
exclusive authority to operate this facility arises under this permit. The authority to operate the
facility under previously issued permits bearing this number is no longer effective. ] The
conditions, requirements, terms, and provisions of this permit authorizing discharge under the
National Pollutant Discharge Elimination System govern discharges from this facility.
SECTION C. OPERATION AND MAINTENANCE OF POLLUTION CONTROLS
1. Certified Operator
Pursuant to Chapter 90A-44 of North Carolina General Statutes, and upon classification of the
facility by the Certification Commission, the permittee shall employ a certified wastewater
treatment plant operator in responsible charge (ORC) of the wastewater treatment facilities.
Such operator must hold a certification of the grade equivalent to or greater than the
classification assigned to the wastewater treatment facilities by the Certification Commission.
The permittee must also employ a certified back-up operator of the appropriate type and any
grade to comply with the conditions of Title 15A, Chapter 8A .0202. The ORC of the facility
must visit each Class I facility at least weekly and each Class II, III, and IV facility at least
daily, excluding weekends and holidays, and must properly manage and document daily
operation and maintenance of the facility and must comply with all other conditions of Title
15A, Chapter 8A .0202. Once the facility is classified, the permittee shall submit a letter to the
Certification Commission which designates the operator in responsible charge within thirty
days after the wastewater treatment facilities are 50% complete.

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Page 8 of 14
2. Proper Operation and Maintenance
The permittee shall at all times properly operate and maintain all facilities and systems of
treatment and control (and related appurtenances) which are installed or used by the permittee to
achieve compliance with the conditions of this permit. Proper operation and maintenance also
includes adequate laboratory controls and appropriate quality assurance procedures. This
provision requires the operation of back-up or auxiliary facilities or similar systems which are
installed by a permittee only when the operation is necessary to achieve compliance with the
conditions of the permit.
3. Need to Halt or Reduce not a Defense
It shall not be a defense for a permittee in an enforcement action that it would have been
necessary to halt or reduce the permitted activity in order to maintain compliance with the
condition of this permit.
4. Bypassing of Treatment Facilities
a. Definitions
(1) "Bypass" means the known diversion of waste streams from any portion of a treatment
facility including the collection system, which is not a designed or established or
operating mode for the facility.
(2) "Severe property damage" means substantial physical damage to property, damage to
the treatment facilities which causes them to become inoperable, or substantial and
permanent loss of natural resources which can reasonably be expected to occur in the
absence of a bypass. Severe property damage does not mean economic loss caused by
delays in production.
b. Bypass not exceeding limitations.
The permittee may allow any bypass to occur which does not cause effluent limitations to
be exceeded, but only if it also is for essential maintenance to assure efficient operation.
These bypasses are not subject to the provisions of Paragraphs c. and d. of this section.
c. Notice
(1) Anticipated bypass. If the permittee knows in advance of the need for a bypass, it
shall submit prior notice, if possible at least ten days before the date of the bypass;
including an evaluation of the anticipated quality and affect of the bypass.
(2)Unanticipated bypass. The permittee shall submit notice of an unanticipated bypass as
required in Part II, E. 6. of this permit. (24 hour notice).
d. Prohibition of Bypass
(1) Bypass is prohibited and the Permit Issuing Authority may take enforcement action
against a permittee for bypass, unless:
(A) Bypass was unavoidable to prevent loss of life, personal injury or severe property
damage;
(B) There were no feasible alternatives to the bypass, such as the use of auxiliary
treatment facilities, retention of untreated wastes or maintenance during normal

Part II
Page 9 of 14
periods of equipment downtime. This condition is not satisfied if adequate backup
equipment should have been installed in the exercise of reasonable engineering
judgment to prevent a bypass which occurred during normal periods of equipment
downtime or preventive maintenance; and
(C)The permittee submitted notices as required under Paragraph c. of this section.
(2) The Permit Issuing Authority may approve an anticipated bypass, after considering its
adverse affects, if the Permit Issuing Authority determines that it will meet the three
conditions listed above in Paragraph d. (1) of this section.
5. Upsets
a. Definition.
"Upset " means an exceptional incident in which there is unintentional and temporary
noncompliance with technology based permit effluent limitations because of factors
beyond the reasonable control of the permittee. An upset does not include noncompliance
to the extent caused by operational error, improperly designed treatment facilities,
inadequate treatment facilities, lack of preventive maintenance, or careless or improper
operation.
b. Effect of an upset.
An upset constitutes an affirmative defense to an action brought for noncompliance with
such technology based permit effluent limitations if the requirements of paragraph c. of this
condition are met. No determination made during administrative review of claims that
noncompliance was caused by upset, and before an action for noncompliance, is final
administrative action subject to judicial review.
c. Conditions necessary for a demonstration of upset.
A permittee who wishes to establish the affirmative defense of upset shall demonstrate,
through properly signed, contemporaneous operating logs, or other relevant evidence that:
(1) An upset occurred and that the permittee can identify the cause(s)of the upset;
(2) The permittee facility was at the time being properly operated; and
(3) The permittee submitted notice of the upset as required in Part II, E. 6. (b) (B) of this
permit.
(4) The permittee complied with any remedial measures required under Part II, B. 2. of this
permit.
d. Burden of proof.
In any enforcement proceeding the permittee seeking to establish the occurrence of an upset
has the burden of proof.
6. Removed Substances
Solids, sludges, filter backwash, or other pollutants removed in the course of treatment or
control of wastewaters shall be utilized/disposed of in accordance with NCGS 143-215.1 and in
a manner such as to prevent any pollutant from such materials from entering waters of the State
or navigable waters of the United States. The permittee shall comply with all existing federal

Part II
Page 10 of 14
regulations governing the disposal of sewage sludge. Upon promulgation of 40 CF1t Part 503,
any permit issued by the Permit Issuing Authority for the utilization/disposal of sludge may be
reopened and modified, or revoked and reissued, to incorporate applicable requirements at 40
CFR Part 503. The permittee shall comply with applicable 40 CFR Part 503 Standards for the
Use and Disposal of Sewage Sludge (when promulgated) within the time provided in the
regulation, even if the permit is not modified to incorporate the requirement. The permittee
shall notify the Permit Issuing Authority of any significant change in its sludge use or disposal
practices.
7. Power Failures
The permittee is responsible for maintaining adequate safeguards as required by DEM
Regulation,Title 15A, North Carolina Administrative Code, Subchapter 2H, .0124 Reliability,
to prevent the discharge of untreated or inadequately treated wastes during electrical power
failures either by means of alternate power sources, standby generators or retention of
inadequately treated effluent.
SECTION D. MONITORING AND RECORDS
1. Representative Sampling
Samples collected and measurements taken, as required herein, shall be characteristic of the
volume and nature of the permitted discharge. Samples collected at a frequency less than daily
shall be taken on a day and time that is characteristic of the discharge over the entire period
which the sample represents. All samples shall be taken at the monitoring points specified in
this permit and, unless otherwise specified, before the effluent joins or is diluted by any other
wastestream, body of water, or substance. Monitoring points shall not be changed without
notification to and the approval of the Permit Issuing Authority.
2. Reporting
Monitoring results obtained during the previous month(s) shall be summarized for each month
and reported on a monthly Discharge Monitoring Report (DMR) Form (DEM No. MR 1, 1.1, 2,
3) or alternative forms approved by the Director, DEM,postmarked no later than the 30th day
following the completed reporting period.
The first DMR is due on the last day of the month following the issuance of the permit or in the
case of a new facility, on the last day of the month following the commencement of discharge.
Duplicate signed copies of these, and all other reports required herein, shall be submitted to the
following address:
Division of Environmental Management
Water Quality Section
ATTENTION: Central Files
Post Office Box 29535
Raleigh, North Carolina 27626-0535
3. Flow Measurements
Appropriate flow measurement devices and methods consistent with accepted scientific
practices shall be selected and used to ensure the accuracy and reliability of measurements of
the volume of monitored discharges. The devices shall be installed, calibrated and maintained
to ensure that the accuracy of the measurements are consistent with the accepted capability of
that type of device. Devices selected shall be capable of measuring flows with a maximum
deviation of less than + 10% from the true discharge rates throughout the range of expected

Part II
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discharge volumes. Once-through condenser cooling water flow which is monitored by pump
logs, or pump hour meters as specified in Part I of this permit and based on the manufacturer's
pump curves shall not be subject to this requirement.
4. Test Procedures
Test procedures for the analysis of pollutants shall conform to the EMC regulations published
pursuant to NCGS 143-215.63 et. seq, the Water and Air Quality Reporting Acts, and to
regulations published pursuant to Section 304(g), 33 USC 1314, of the Federal Water
Pollution Control Act, as Amended, and Regulation 40 CPR 136; or in the case of sludge use or
disposal, approved under 40 CFR 136, unless otherwise specified in 40 CFR 503, unless
other test procedures have been specified in this permit.
To meet the intent of the monitoring required by this permit, all test procedures must produce
minimum detection and reporting levels that are below the permit discharge requirements and
all data generated must be reported down to the minimum detection or lower reporting level of
the procedure. If no approved methods are determined capable of achieving minimum
detection and reporting levels below permit discharge requirements, then the most sensitive
(method with the lowest possible detection and reporting level) approved method must be used.
5. Penalties for Tampering
The Clean Water Act provides that any person who falsifies, tampers with, or knowingly
renders inaccurate, any monitoring device or method required to be maintained under this
permit shall, upon conviction, be punished by a fine of not more than $10,000 per violation, or
by imprisonment for not more than two years per violation, or by both. If a conviction of a
person is for a violation committed after a first conviction of such person under this paragraph,
punishment is a fine of not more than $20,000 per day of violation, or by imprisonment of not
more than 4 years, or both.
6. Records Retention
Except for records of monitoring information required by this permit related to the permittee's
sewage sludge use and disposal activities, which shall be retained for a period of at least five
years (or longer as required by 40 CFR 503), the permittee shall retain records of all
monitoring information, including all calibration and maintenance records and all original strip
chart recordings for continuous monitoring instrumentation, copies of all reports required by
this permit, for a period of at least 3 years from the date of the sample, measurement, report
or application. This period may be extended by request of the Director at any time.
7. Recording Results
For each measurement or sample taken pursuant to the requirements of this permit, the
permittee shall record the following information:
a. The date,exact place, and time of sampling or measurements;
b. The individual(s) who performed the sampling or measurements;
c. The date(s) analyses were performed;
d. The individual(s) who performed the analyses;
e. The analytical techniques or methods used; and
f. The results of such analyses.

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8. Inspection and Entry
The permittee shall allow the Director,or an authorized representative (including an authorized
contractor acting as a representative of the Director), upon the presentation of credentials and
other documents as may be required by law,to;
a. Enter upon the permittee's premises where a regulated facility or activity is located or
conducted, or where records must be kept under the conditions of this permit;
b. Have access to and copy, at reasonable times, any records that must be kept under the
conditions of this permit;
c. Inspect at reasonable times any facilities, equipment (including monitoring and control
equipment),practices, or operations regulated or required under this permit; and
d. Sample or monitor at reasonable times, for the purposes of assuring permit compliance or
as otherwise authorized by the Clean Water Act, any substances or parameters at any
location.
SECTION E. REPORTING REQUIREMENTS
1. 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.
2. Planned Changes
The permittee shall give notice to the Director as soon as possible of any planned physical
alterations or additions to the permitted facility. Notice is required only when:
a. The alteration or addition to a permitted facility may meet one of the criteria for determining
whether a facility is a new source in 40 CFR Part 122.29 (b); or
b. The alteration or addition could significantly change the nature or increase the quantity of
pollutants discharged. This notification applies to pollutants which are subject neither to
effluent limitations in the permit, nor to notification requirements under 40 CFR Part 122.42
(a) (1).
c. The alteration or addition results in a significant change in the permittee's sludge use or
disposal practices, and such alternation, addition or change may justify the application of
permit conditions that are different from or absent in the existing permit, including
notification of additional use or disposal sites not reported during the permit application
process or not reported pursuant to an approved land application plan.
3. Anticipated Noncompliance
The permittee shall give advance notice to the Director of any planned changes in the permitted
facility or activity which may result in noncompliance with permit requirements.

Part II
Page 13 of 14
4. Transfers
This permit is not transferable to any person except after notice to the Director. The Director
may require modification or revocation and reissuance of the permittee and incorporate such
other requirements as may be necessary under the Clean Water Act.
5. Monitoring Reports
Monitoring results shall be reported at the intervals specified elsewhere in this permit.
a. Monitoring results must be reported on a Discharge Monitoring Report (DMR) (See Part II.
D. 2 of this permit)or forms provided by the Director for reporting results of monitoring of
sludge use or disposal practices.
b. If the permittee monitors any pollutant more frequently than required by the permit, using
test procedures specified in Part II, D. 4. of this permit or in the case of sludge use or
disposal, approved under 40 CFR 503, or as specified in this permit, the results of this
monitoring shall be included in the calculation and reporting of the data submitted in the
DMR.
c. Calculations for all limitations which require averaging of measurements shall utilize an
arithmetic mean unless otherwise specified by the Director in the permit.
6. Twenty-four Hour Reporting
a. The permittee shall report to the central office or the appropriate regional office any
noncompliance which may endanger health or the environment. Any information shall be
provided orally within 24 hours from the time the permittee became aware of the
circumstances. A written submission shall also be provided within 5 days of the time the
permittee becomes aware of the circumstances. The written submission shall contain a
description of the noncompliance, and its cause; the period of noncompliance, including
exact dates and times, and if the noncompliance has not been corrected, the anticipated time
it is expected to continue; and steps taken or planned to reduce, eliminate, and prevent
reoccurrence of the noncompliance.
b. The following shall be included as information which must be reported within 24 hours
under this paragraph:
(1) Any unanticipated bypass which exceeds any effluent limitation in the permit.
(2) Any upset which exceeds any effluent limitation in the permit.
(3) Violation of a maximum daily discharge limitation for any of the pollutants listed by the
Director in the permit to be reported within 24 hours.
c. The Director may waive the written report on a case-by-case basis for reports under
paragraph b. above of this condition if the oral report has been received within 24 hours.
7. Other Noncompliance
The permittee shall report all instances of noncompliance not reported under Part H. E. 5 and 6.
of this permit at the time monitoring reports are submitted. The reports shall contain the
information listed in Part II. E. 6. of this permit.

Part II
Page 14 of 14
8. Other Information
Where the permittee becomes aware that it failed to submit any relevant facts in a permit
application, or submitted incorrect information in a permit application or in any report to the
Director,it shall promptly submit such facts or information.
9. Noncompliance Notification
The permittee shall report by telephone to either the central office or the appropriate regional
office of the Division as soon as possible, but in no case more than 24 hours or on the next
working day following the occurrence or first knowledge of the occurrence of any of the
following:
a. Any occurrence at the water pollution control facility which results in the discharge of
significant amounts of wastes which are abnormal in quantity or characteristic, such as the
dumping of the contents of a sludge digester; the known passage of a slug of hazardous
substance through the facility; or any other unusual circumstances.
b. Any process unit failure, due to known or unknown reasons, that render the facility
incapable of adequate wastewater treatment such as mechanical or electrical failures of
pumps, aerators, compressors, etc.
c. Any failure of a pumping station, sewer line, or treatment facility resulting in a by-pass
directly to receiving waters without treatment of all or any portion of the influent to such
station or facility.
Persons reporting such occurrences by telephone shall also file a written report in letter form
within 5 days following first knowledge of the occurrence.
10. Availability of Reports
Except for data determined to be confidential under NCGS 143-215.3(a)(2) or Section 308 of
the Federal Act, 33 USC 1318, all reports prepared in accordance with the terms shall be
available for public inspection at the offices of the Division of Environmental Management. As
required by the Act, effluent data shall not be considered confidential. Knowingly making any
false statement on any such report may result in the imposition of criminal penalties as provided
for in NCGS 143-215.1(b)(2) or in Section 309 of the Federal Act.
11. penalties for Falsification of Reports
The Clean Water Act provides that any person who knowingly makes any false statement,
representation, or certification in any record or other document submitted or required to be
maintained under this permit, including monitoring reports or reports of compliance or
noncompliance shall, upon conviction, be punished by a fine of not more than $10,000 per
violation,or by imprisonment for not more than two years per violation, or by both.

PART III
OTHER REQUIREMENTS
A. Construction
No construction of wastewater treatment facilities or additions to add to the plant's treatment
capacity or to change the type of process utilized at the treatment plant shall be begun until
Final Plans and Specifications have been submitted to the Division of Environmental
Management and written approval and Authorization to Construct has been issued.
B. Groundwater Monitoring
The permittee shall, upon written notice from the Director of the Division of Environmental
Management, conduct groundwater monitoring as may be required to determine the
compliance of this NPDES permitted facility with the current groundwater standards.
C. Changes in Discharges of Toxic Substances
The permittee shall notify the Permit Issuing Authority as soon as it knows or has reason to
believe:
a.That any activity has occurred or will occur which would result in the discharge, on a
routine or frequent basis, of any toxic pollutant which is not limited in the permit, if that
discharge will exceed the highest of the following "notification levels";
(1) One hundred micrograms per liter (100 ug/l);
(2)Two hundred micrograms per liter (200 ug/l) for acrolein and acrylonitrile; five
hundred micrograms per liter (500 ug/l) for 2.4-dinitrophenol and for 2-methyl-4.6-
dinitrophenol; and one milligram per liter(1 mg/1) for antimony;
(3) Five (5) times the maximum concentration value reported for that pollutant in the
permit application.
b. That any activity has occurred or will occur which would result in any discharge, on a
non-routine or infrequent basis, of a toxic pollutant which is not limited in the permit, if
that discharge will exceed the highest of the following "notification levels";
(1) Five hundred micrograms per liter(500 ug/l);
(2) One milligram per liter(1 mg/1) for antimony;
(3) Ten (10) times the maximum concentration value reported for that pollutant in the
permit application.
D. Requirement to Continually Evaluate Alternatives to Wastewater Discharges
The permittee shall continually evaluate all wastewater disposal alternatives and pursue the
most environmentally sound alternative of the reasonably cost effective alternatives. If the
facility is in substantial non-compliance with the terms and conditions of the NPDES permit
or governing rules, regulations or laws, the permittee shall submit a report in such form and
detail as required by the Division evaluating these alternatives and a plan of action within
sixty (60) days of notification by the Division.

} •
PART IV
ANNUAL ADMINISTERING AND COMPLIANCE MONITORING FEE REQUIREMENTS
A. The permittee must pay the annual administering and compliance monitoring fee within 30
(thirty) days after being billed by the Division. Failure to pay the fee in a timely manner in
accordance with 15A NCAC 2H .0105(b)(4) may cause this Division to initiate action to
revoke the permit.

e of North Carolina
Department of Environment,
Health and Natural Resources Alr;1.117A
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary p E H N
A. Preston Howard, Jr., P.E., Director
C. DEPT. OF NATURAL
RESOURCES AND
COMMUNITY DEVELOPMENT
September 30,1993
OCT 0 61993.
LYLE F. CASSELL IIYISION OF ENYIRONNIENTAL MANAGER
LYLE F.&ALICE C.CASSELL MOORESYILLE REGI6hAL elfin
126 KAYWOOD LANE
STATESVILLE NC 28677 Subject: LYLE F. &ALICE C.CASSELL
Certificate of Coverage NCG550342
General Permit NCG550000
Formerly NPDES Permit NC0062332
Iredell 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 NC0062332. 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 II, E.4. addresses the requirements to be followed
in case of change of ownership or control of this discharge.
In the event that the facilities fail to perform satisfactorily, including the creation of nuisance conditions, the
Permittee shall take immediate corrective action, including those as may be required by this Division, such as the
construction of additional or replacement wastewater treatment or disposal facilities. Construction of any
wastewater treatment facilities will require issuance of an Authorization to Construct from this Division.
Failure to abide by the requirements contained in this Certificate of Coverage and respective general permit may
subject the Permittee to an enforcement action by the Division of Environmental Management in accordance with
North Carolina General Statute 143-215.6A to 143-215.6C. Please note that the general permit does require
monitoring in accordance with federal law. The monitoring data is not required to be submitted to the Division
unless specifically requested, however, the permittee is required to maintain all records for a period of at least
three (3) years.
Post Office Box 29535,Raleigh,North Carolina 27626-0535 Telephone[phone] FAX[phone]
An Equal Opportunity Affirmative Action Employer 50%recycled-10%post-consumer paper

Page 2
LYLE F. CASSELL
LYLE F.&ALICE C.CASSELL
Certificate of Coverage No. NCG550342
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
Mooresville Regional Office,Water Quality Section at telephone number 704/ 663-1699,or a review engineer
in the NPDES Group in the Central Office at telephone number 919/733-5083.
S. erely,
&' T/
e __A.Preston Howar .,P.E.
cc: Mooresville 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.NCG550342
TO DISCHARGE TREATED DOMESTIC WASTEWATERS FROM SINGLE FAMILY 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,
LYLE F.&ALICE C.CASSELL
is hereby authorized to discharge treated domestic wastewater from a facility located at
LYLE F. &ALICE C.CASSELL
Iredell County
to receiving waters designated as the UT FOURTH CREEK/YADKIN-PEE DEE RV BS
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.
• /
(---- /
d_A. Preston Howar•,Jr., P.E.,Director
Division of Environmental Management
By Authority of the Environmental Management Commission

41)It
o,.s STATE.
V M,, ,h ^. �`
/1/III!r 61,- r r]f'3.
i A*1; 1 :----4 .$f
(W /
State of North Carolina
Department of Environment, Health, and Natural Resources
Mooresville Regional Office
James G. Martin, Governor Albert F. Hilton, Regional Manager
William W. Cobey, Jr., Secretary DIVISION OF ENVIRONMENTAL MANAGEMENT
May .20, 1991
Mr. Lyle F. Cassell
126 Kaywood Lane
Statesville, North Carolina 28677
Subject: Compliance Evaluation Inspection
Lyle F. Cassell Residence
NPDES Permit No. NC 0062332
Iredell County, NC
Dear Mr. Cassell:
Please find enclosed a copy of the Compliance Evaluation
Inspection Report for the inspection conducted at the subject
facility on May 9 , 1991, by Mr. Jeff Fritts of this Office. The
Report should be self-explanatory.
If you have any questions concerning this Report, please do not
hesitate to contact Mr. Fritts or me.
Sincerely,
D. Rex Gleason, P. E.
Water Quality Regional Supervisor
Enclosure
cc: Mr. Roger O. Pfaff, EPA
Iredell County Health Department
7/- JF/bb
t
919 North Main Street, Mooresville, N.C. 28115 •Telephone [phone] • FAX [phone]
An Equal Opportunity Affirmative Action Employer

itStates vu sawn Form Approved
PA Washington,D.C.20460 ,
aE P� NPDES Compliance Inspection Report OMB No.2040-0003
Approval Expires 7-31-85
Section A: National Data System Coding
Transaction Code NPDES yr/mo/day Inspection Type Mta actor Fat Type
'IN1 2151 3INICIOI0161213I3121t1 t� 911Iol5I0191t7 t�Cl t�, l 2d2)
Remarks
24IIIIIIIIIIIIIII1111111111Ii111IIIIIIIIII1III
Reserved Facility Evaluation Rating 81 QA served 66
ReJ
671 1 1169 704I 711N1 72INI 731 1 I74 751 I 1 l 1 1 180 .
Section B:Faoikty Data
Name and Location of Facility Inspected Entry Time ® AN ❑ PM Permit Effective Date
Lyle F. Cassell Residence 9: 17 90/10/01
126 Kaywood Lane Exit Time/Date Permit Expiration Date
Statesville,2 NC 28677 9:51 91/05/09 94/07/31
Name(s)of On-Site Representative(s) Titles) Phone No(s)
Mr. & Mrs . Lyle F. Cassell Owners • 704/873-0214
Name,Address of Responsible Official Title
Lyle F. Cassell Owner
126 Kaywood Lane Phone No. Contacted
Statesville, NC 28677 704/873-0214 (h) 70418.73-0507 (w) J yes ❑ No
Section C: Areas Evaluated During Inspection
(S=Satisfactory. M = Marginal, U=Unsatisfactory. N=Not Evaluated)
S ' Permit I N Flow Measurement N Pretreatment S Operations& Maintenance
N .Records/Reports 1 N ! Laboratory N Compliance Schedules S I Sludge Disposal
S Facility Site Review I s l Effluent/Receiving Waters S Sef-Monitoring Program I Other.
Section D: Summary of Findings/Comments(Attach additional sheets if necessary)
Permit
The facility appears to comply with permit conditions.
Facility Site Review
The area appeared to be well cared for. The chlorine contact chamber is covered with
a heavy cover that is removed with the use of a_ jack when removal is needed. It is_
recommended that a lighter cover be used as access is needed routinely to check
chlorine availability.
Effluent/Receiving Waters
No discharge was noted at the time of the inspection. The receiving stream had a
satisfactory appearance.
hame(sl and Signature(sl of Inspector(s) Agency/Office/Telephone Date
Jeff Fritts 01_� " �/� NC DEM/MRO (704) 663—'699 91105/14
Signature of Reviewer Agency/Office Date
Regulatory Office Use Only
Action Taken Date Compliance Status
ENoncompliance
❑ Compliance
EPA Form 3560-3 (Rev. 3-85) Previous eoitions are obsolete

Page Two
Self—Monitoring Program
1. No monitoring is required at this facility.
2. Chlorine availability is reported to be checked every six months with chlorine
still available (present and in contact with wastewater) .
3. Facility is considered in compliance.
Operations and Maintenance
This system requires very little operation and maintenance effort. The septic tank
is generally pumped at approximately two—year intervals. The owner pays attention
to water quality in chlorine contact chamber. He also pays attention to weeds/grass
over sandfilter and rainwater diversion.
Sludge Disposal
Sludge from septic tank is removed by licensed septage hauler and taken to a POTW or
otherwise properly disposed.

,. !.e__,)
it
State of North Carolina
Department of Environment, Health, and Natural Resources
Mooresville Regional Office
James G. Martin, Governor Albert F. Hilton, Regional Manager
William W. Cobey, Jr., Secretary DIVISION OF ENVIRONMENTAL MANAGEMENT
September 11, 1990
Mr. Lyle F. Cassell
126 Kaywood Lane
Statesville, North Carolina 28677
Subject: NPDES Permit No. NC 0062332
Lyle F. Cassell Residence
Iredell County, NC
Dear Mr. Cassell:
Our records indicate that NPDES Permit No. NC 0062332 was
issued on August 31, 1990 for the discharge of wastewater to the
surface waters of the State from your facility. The purpose of
this letter is to advise you of the importance of the Permit and
the liabilities in the event of failure to comply with the terms
and conditions of the Permit. If you have not already done so,
it is suggested that you thoroughly read the Permit. Of
particular importance is Page 4.
The remaining Parts of the Permit set forth definitions,
general conditions and special conditions applicable to the
operation of wastewater treatment facilities and/or discharge( s) .
The conditions include special reporting requirements in the
event of noncompliance, bypasses, treatment unit/process
failures, etc. Also addressed are requirements for a certified
wastewater treatment plant operator if you are operating
wastewater treatment facilities. Any changes in operation of
wastewater treatment facilities, quantity and type of wastewater
being treated or discharged, expansions and/or upgrading of
wastewater treatment facilities must be permitted or approved by
this Agency.
Failure to comply with the terms and conditions of an NPDES
Permit subjects the Permittee to enforcement action pursuant to
Section 143-215. 6 of the North Carolina General Statutes. A
civil penalty of up to $10,000 per violation plus criminal
penalties may be assessed for such violations. If you find at
any time that you are unable to comply with the terms and
conditions of the Permit, you should contact this Office
919 North Main Street, Mooresville, NC. 28115 •Telephone [phone] • FAX [phone]
An Equal Opportunity Affirmative Action Employer

Mr. Lyle F. Cassell
Page Two
September 11, 1990
immediately. A Consent Order may be necessary while pursuing
action to obtain compliance.
As a final note, an NPDES Permit is normally issued for a
five-year period. Permits are not automatically renewed.
Renewal requests must be submitted to this Agency no later than
180 days prior to expiration. Please make note of the expiration
date of your Permit. This date is set forth on Page 1 of the
Permit. Also note that NPDES Permits are not transferable. If
you, as the Permittee, cease to need this Permit, then you should
request that the Permit be rescinded.
As mentioned previously, the purpose of this letter is to
advise you of the importance of your NPDES Permit. Please read
the Permit and contact this Office at 704/663-1699 in Mooresville
if you have any questions or need clarification. We look forward
to providing any assistance.
Sincerely,
D. Rex Gleason, P. E.
Water Quality Regional Supervisor
Enclosure
DRG:se

h
r -+ Permit No. NC0062332
•
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
PERMIT
TO DISCHARGE WASTEWATER UNDER THE ip ? 6
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM /i(
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,
Mr. &Mrs. Lyle F. Cassell
is hereby authorized to discharge wastewater from a facility located at
Lyle F. Cassell Residence
126 Kaywood Lane
west of Elmwood
Iredell County
to receiving waters designated as an unnamed tributary to Fourth Creek in the Yadkin-Pee Dee 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 July 31, 1994 F`
Signed this day
George T. Everett,Director
Division of Environmental Management
By Authority of the Environmental Management Commission

. l-.
Permit No. NC0062332
SUPPLEMENT TO PERMIT COVER SHEET
Mr. &Mrs. Lyle F. Cassell
is hereby authorized to:
1. Continue to operate an existing wastewater treatment system consisting of a 1000 gallon septic
tank, 1200 gallon dosing tank, sandfilter, and chlorinator located at Lyle F. Cassell Residence,
126 Kaywood Lane, west of Elmwood, Iredell County (See Part III of this Permit), and
2. Discharge from said treatment works at the location specified on the attached map into an
unnamed tributary to Fourth Creek which is classified Class C waters in the Yadkin-Pee Dee
River Basin.
1
I
IF

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A. ().EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS FINAL Permit No. NC0062332
During the period beginning on the effective date of the permit and lasting until expiration,the Permittee is authorized to discharge from 1
outfall(s) serial number 001. Such discharges shall be limited and monitored by the permittee as specified below:
Effluent Characteristics Discharge Limitations Monitoring Requirements
Units (specify) Measurement Sample *Sample
Monthly Avg. Weekly Avg. Frequency Tvpe Location.
Flow 0.001 MCI
BOD, 5 day, 20°C 30.0 mg/I 45.0 mg/I
Total Suspended Residue 30.0 mg/I 45.0 mg/I
NH3 as N
Dissolved Oxygen (minimum) 6.0 mg/I 6.0 mg/I
Fecal Coliform (geometric mean) 200.0 /100 ml 400.0 /100 ml
Total Residual Chlorine
Temperature
The chlorinator shall be inspected weekly to ensure there is an ample supply of chlorine tablets for continuous disinfection of the effluent.
The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units.
There shall be no discharge of floating solids or visible foam in other than trace amounts.

To: Permits and Engineering Unit
Water Quality Section
Date: June 22, 1990
NPDES STAFF REPORT AND RECOMMENDATIONS
County: Iredell
NPDES Permit No. : NC0062332
MRO No. : 90-97
PART I - GENERAL INFORMATION
1. Facility and Address : Lyle F. Cassell Residence
( formerly Gary Wayne Edwards Residence)
126 Kaywood Lane
Statesville, N.C. 28677
2. Date of Investigation: June 19, 1990
3 . Report Prepared By: Kim H. Colson - Environmental Engineer I
4 . Person Contacted and Telephone Number: Lyle Cassell - ( 704 )
873-0214
5 . Directions to Site: From the intersection of SR 2316 (Bell
Farm Road) and SR 2514 (Bellwood Road) , travel approximately
0. 3 miles on SR 2514 . Turn right on SR 2515 (Kaywood Lane) .
The Cassell residence is the fourth house on the right.
6. Discharge Point( s) , List for all discharge Points: -
Latitude: 35° 46 ' 19"
Longitude: 80° 48 ' 04"
Attach a USGS Map Extract and indicate treatment plant site
and discharge point on map.
USGS Quad No. : D 15 SE
7 . Size ( land available for expansion and upgrading) : There is
limited size available for expansion and upgrading.
8 . Topography ( relationship to flood plain included) : Site is
steep, it is not located within a flood plain.
9 . Location of Nearest Dwelling: One dwelling located
approximately 600 feet.

Page Two
10 . Receiving Stream or Affected Surface Waters: UT Fourth Creek
a. Classification: C
b. River Basin and Subbasin No. : Yadkin 03-07-06
c. Describe receiving stream features and pertinent
downstream uses: General C classification uses. Stream
appears to have a 7Q10 flow of 0 . 0 CFS and probably a 30Q2
flow of 0 . 0 CFS .
PART II - DESCRIPTION OF DISCHARGE AND TREATMENT WORKS
1. Type of Wastewater: 100o Domestic
0o Industrial
a. Volume of Wastewater: 0 . 001 MGD (Design Capacity)
b. Types and quantities of industrial wastewater: N/A
c. Prevalent toxic constituents in wastewater: N/A
d. Pretreatment Program (POTWs only) : N/A
2 . Production Rates (industrial discharges only) in Pounds: N/A
3 . Description of Industrial Process (for industries only) and
Applicable CFR Part and Subpart: N/A
4 . Type of Treatment ( specify whether proposed or existing) :
Existing treatment consists of a 1000 gallon septic tank, a
1200 gallon dosing tank, sand filter and tablet chlorinator.
5 . Sludge Handling and Disposal Scheme: Private septic tank
pumping company.
6 . Treatment Plant Classification: Less than 5 points; no
rating (include rating sheet) . No rating
7 . SIC Code( s) : 9999
Wastewater Code( s) :
Primary: 04
Secondary:
PART III - OTHER PERTINENT INFORMATION
1. Is this facility being constructed with Construction Grants
Funds (municipals only) ? N/A
2. Special monitoring requests: None
3 . Additional effluent limits requests: None
4. Other: N/A

Page Three
PART IV - EVALUATION AND RECOMMENDATIONS
The Permittee, Lyle F. Cassell, has requested permit renewal.
The discharge is for a single family residence.
The facility discharges to a small UT to Fourth Creek. The
stream appears to have both 7Q10 and 30Q2 flows of 0 . 0 CFS . A
septic tank and nitrification field previously failed at this
site. No other non-discharge option appears viable due to the
limited size and steepness of the property.
This Office recommends that the permit be renewed with a clause
stating that this facility must be connected to a POTW when service
is available.
-1 1�L_ 6/2 / / o
Signature of Report Preparer Date
Water Quality Kgional Supervisor Date
KHC/bb

RECEIVED
r'ljC11° s` V i9 Water Qual tv Secfun
•
(I �G State of North Carolina MAY 3 119.,
T) el Department of Environment, Health, and Natural Resources
Division of Environmental Management Asheville Regional Office
• k\i 512 North Salisbucc-5tr'eet • Raleigh, North Carolina 27611 Asheville, North Carolina
James G.Martin,Governor c.0ti o.0RC George T. Everett, Ph.D.
\.)..//William W.Cobey,Jr.,Secretly WvcisvcstDirector
coA ' '\1g$3 4/16/90
Mr. & Mrs. Lyle F. Cassell
pF .0 E60 Subject : NPDES Permit Application
126 Kaywood Lane R
Statesville, NC 62332 V���S��pRES0 NPDES Permit No .NC00 62332
Lyle F. Cassell Residence
Dear Mr. Cassell Iredell County
This is to acknowledge receipt of the following documents on April 16, 1990:
-V Application Form
Engineering Proposal (for proposed control facilities) ,
"V Request for permit renewal,
Application Processing Fee of $60.00,
Other Deed showing ownership.,
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 be 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 Over ash, P .E .
CC : al Office
Pollution Prevention Pays
P.O.Box 27687,Raleigh,North Carolina 27611-7687 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

NORTH CAROLINA DEPT. OF NATURAL. RESOURCES AND COMMUNITY DEVELOPMENT
ENVIRONMENTAL MANAGEMENT COMMISSION
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM AML'CAT ION MINOR
APPLICATION FOR PERMIT TO DISCHARGE - SHORT FORM G FFcnt Aie1-0-101& r51.31A1
AGENCY
to be filed only by services, wholesale end retail trade, USE OATS REClIVIn
and other commercial establishments including vessels 91. 0 1 Q 15 -T o2 ji
YEAR lo, DAY
• dh. 71,0- v 7-3Si
Do not attempt to complete this for without reading the accompanying lnstnactlons 0.0D
Please print or type 1-- , ,.5-- D
1. haw, address, end telephone number of facility producing dlschar9e J 0
A. Name LyLe. F. c A.1ice e. C.OSsc,,1/
6. Street address 12(o KAYVV d LAJ.
C. City 6t-4TE5vl1/1 O. State 'C
E. County L f2F E L1-- i. zlP Z. k(0 77
G. Telephone No. 70Li , $73--o2.Ic,L
Area w h
Code RECEIVED
2. SIC [ MAY 2 5 19yu. ,
(Leave blare) •
PERMITS& ENGINEERINr
3. h,rnber of enloyees
4. Nature of business
5. (a) Check here 1f elscharge occurs all year, or
(b) Check the eontn(s) discharde occurs:
I.o January 2.0 February 3.0 Marct 4.0 April 5.O010
6.0 June 7.0Ju1y 8.0August 9.0 Sipt/ober 10.0October
11• 0 Novew+be r 12.0 December
(c) Mow many days per week :
1 .0 1 2.0 2-3 3.0 4-5 4. 6-7 •
6. Types of waste eater discharged to surface waters only (check as 1101lcable)
F1 , gallon: g rating day Volsaae treated before
Discharge per dtscharying (percent)
Operating day 0.1-999 1000-4999 6000-5999 10,000- 50,000 Mont 0.1- 30. 65- 95-
49,099 or more 29.9 64.9 94.9 107.
(1) (2) (3) (4) (s) (4) (7) (8) (9) ('IC,
A. Sanitary, daily / v •
average (/
1 i r v. e
8. Cooling water, etc. ,
daily average
C. Other discharpe(s(,
• • r
dally average;
Spec t fy
C. Man rn' per ooe-at-
�--
incc day for cow irec
clscnArge (all tvpeS '

7. If
ny of the
of
e
11
treated, art discharged tot plates identified other than tur eta meters, check below
as applicable.
Waste water is discharged to: 0.1-999 100049111 S000.11199 10.000-49.1 9 S0,000 Of nor.
(1) (t) (3) (4) (S)
A. Municipal colour cyst
II. 11,1.11.1,11'IMlllri M'1 I
C. ieptIr tank
T
U. Evaporation lagoon or pond •
E. Other. specify: .
8. Number f separate discharge points: ,
A. 1 6. 02-3 C.0 a-S D.O 6 or more
j%� `� t . •A._..
fiz,
Mum9. Me of receiving water or waters L ' C'it-�e-4 /
10. Does your discharge contain or is it possible for your discharge to contain
one or more of the following substances ____4 as a result of
f tNNsn
your operations,
activities, or processes: ammonia, cyMf�, alsaina, beryllium,ls. s meld
chrromium, Copper, lead, mercury, nickel, selenium, tlnc, pig
grease, and chlorine (residual).
A.O yes d.1no
I certify that 1 an familiar with the information contained in the epplicatito end
that to the best of my knowledge and belief such iMortation is true,
cemelete, gad
accurate.
Lite � 6+55C-/(
Printed Mime of Person Signing
.............-- —
Title
Date Appyfution Sig
919alaw70 of Applicant
North Carolina General Statute 141-215.6(b) (2 provides that: Any person who knowingly ca.,.
any false statement representation, or certification in any applirat$on, 'record, report, p
or other document files or required to be maintained under Article 21 or regulations of t'ne
Erryironaental Management Commission implementing that Article, or vho falsifies, tampers u:
c,r knovly renders inaccurate any recording or monitoring 4pvi u or method required to be
r•,serated or maintained under Article 21•ot regulatioas .of the Environmental Management Cot—
Imple=emting that Article, shell'.whell '.
heluiitv of a Misdemeanor punishable by aline not to exc
.ilr,,n^)0, or by imprisonment not to exceed six months, or by both. (18 U.S.C. Section lord F
pun:s`rlen: by a fine of'aot more than S10,000 or imprisonment not more than 5 years , or b
.,,r a sin'_1ar offense . ) .

• 4 (J�
(� Dgp1.
!it
O (gyp RE�URCESNA
Mh1TU2VITY IC 11"7
puravr
•
SEP0410
State of North Carolina
90
Department of Environment, Health, and Natural ResotilitesoF ENv�,? r;.,�j,,rgi h,
Division of Environmental Management MOORESVIUE RES1ONAL AN GEM(NT
512 North Salisbury Street • Raleigh, North Carolina 27611 OFFICE
Jaynes C. Martin,Governor George T. Everett, Ph.D.
William W.Cobey,Jr.,Secretary Director
August 31 , 19'1r)
Mr. Lyle F. Cassell
126 Kaywood Lane
Statesville, NC 28677
Subject: Permit No. NC0062332
Lyle I'. Cassell Residence
Tredel1 County
Dear Mr. Cassell:
In accordance with your application for discharge permit received on May 25,
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 11666, Raleigh, North Carolina 27604. Unless such. demand is made,
this decision shall be final and binding.
Please take notice that this permit is not transferable. }'art II, B. 2.
addresses the requirements to be followed in case of change in ownership or control of
this discharge.
This permit does not affect the legal requirements to obtain other permits
which may be required by the Division of Environmental Management or permits required
by the Division of Land Resources, Coastal Area Management. Act or any other Federal or
Local governmental permit that may be required.
If you have any questions concerning this permit:, plerse contact. Mr. Mack
Wiggins at telephone number 919/733-5083.
Sincerely,
Original signed by-
Dale Overcash for
George T. Everett.
cc: Mr. Jim Patrick, EPA
Mooresville Regional Offi.de
Pollution Prevention Pays
P.O.Box 27687,Raleigh,North Carolina 27611-7687 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

Permit No. NC0062332
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
PERMIT
TO DISCHARGE WASTEWATER 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,
Mr. & Mrs. Lyle F. Cassell
is hereby authorized to discharge wastewater from a facility located at
Lyle F. Cassell Residence
126 Kaywood Lane
west of Elmwood
Iredell County
to receiving waters designated as an unnamed tributary to Fourth Creek in the Yadkin-Pee Dee 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 October 1, 1990
This permit and the authorization to discharge shall expire at midnight on July 31, 1994
Signed this day August 31, 1990
Original signed 1)1
Dale Overcash for
George T.Everett,Director
Division of Environmental Management
By Authority of the Environmental Management Commission

Permit No. NC0062332
SUPPLEMENT TO PERMIT COVER SHEET
Mr. &Mrs. Lyle F. Cassell
is hereby authorized to:
1. Continue to operate an existing wastewater treatment system consisting of a 1000 gallon septic
tank, 1200 gallon dosing tank, sandfilter, and chlorinator located at Lyle F. Cassell Residence,
126 Kaywood Lane, west of Elmwood, Iredell County (See Part III of this Permit), and
•
2. Discharge from said treatment works at the location specified on the attached map into an
unnamed tributary to Fourth Creek which is classified Class C waters in the Yadkin-Pee Dee
River Basin.

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gTAT SVILLE E

A. (). EF LUENT LIMITATIONS AND MONITORING REQUIREMENTS FINAL Permit No. NC0062332
During the period beginning on the effective date of the permit and lasting until expiration,the Permittee is authorized to discharge from
outfall(s) serial number 001. Such discharges shall be limited and monitored by the permittee as specified below:
Effluent Characteristics Discharge Limitations Monitoring Requirements
Units Opecifyl • Measurement Sample *Sample
Monthly Avg. Weekly Avg, Frequency Tvoe Location
Flow 0.001 tv D
BOD, 5 day, 20°C 30.0 mg/I 45.0 mg/I
Total Suspended Residue 30.0 mg/I 45.0 mg/I
NH3 as N
Dissolved Oxygen (minimum) 6.0 mg/I 6.0 mg/I
Fecal Coliform (geometric mean) 200.0 /100 ml 400.0 /100 ml
Total Residual Chlorine
Temperature
The chlorinator shall be inspected weekly to ensure there is an ample supply of chlorine tablets for continuous disinfection of the effluent.
The pH shall not be less than 6.0 standard units nor greater than 9.0 standard units.
There shall be no discharge of floating solids or visible foam in other than trace amounts.

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.
"EMC" 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 is 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 (ii) where excessive storm drainage or runoff
would damage any facilities necessary for compliance with the
effluent limitations and prohibitions of this permit. The permitteF
shall promptly notify the Water Quality Section of DEM in writing o`
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 record:,
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 prospec-
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:

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 thiE. 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 sewer 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 180 days of its availability
to the site.

\V r..,a SEAR_e.
• >= ly
sois,oN df ENv.,NONMENIAL t
/V �
F 1989 k
•
F State of North Carolina
Department o, Q-airaral Resources and Community Development
Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27611
James G. Martin, Governor R. Paul Wilms
S. Thomas Rhodes. Secretary tel3 f-Utry) 31 6679 Director
�r Lyle F. Cassell -- 73-05-177 '^'b Qim;ve
Ses, :lt� �c +�
,
2 0 G 7�
SUBJECT: NPDES Permit Application
tJ S P0Wr ?lo. 'C o6233L_
f rA+tty_ r e ti 1'S RQ1��e�CF
P ect _._.—.. County
Dear - P4r. CSi01 --•
On 4r Z1 (50 _, 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:
A check for. $ 1S•00 _ made payable to the N. C. Department of
Natural Resources and Community Development.
The attached application, completed and signed by the appropriate
official, and submitted in triplicate;
For permit renewals, a letter requesting renewal ;
Engineering Proposal (see attached);
Nutrient Sensitive Waters information (see attached);
Other hel f Trotf s e..J_•'} a.t_.--�Qf�_Alt4lfif_eJ._t f._or__4 fPJc -.--
The Division of Environmental Management wi.l.l initiate the permit review process
upon receipt of the above requested information. The receipt of the above
information does not preclude this Division from reynest.ing additional information
at a future date.
If you have any questions, please contact. Mr. Dale llve.rcash at (919) 733-5083.
Sincerely,
r t:hur ouberr.y, P.E.
Supervisor, Permits and Engineering
cc: Ammo- Regional. Office
Pollution Preirnaon Pais
P.O. Box 27687, Raleigh, North Carolina 27611-7687 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

SUT[o
yin
DIVISION Of ENVIRONMENTAL MANAGEMENT
State of North Carolina
lat9atiffielit=of Natural Resources and Community Development
MOORESVILLE Division of Environmental Management
P5KI"AL 41912 North Salisbury Street • Raleigh, North Caroli.�a 27611
James G. Martin, Governor February 12, 1986 R. Paul Wilr
S. Thomas Rhodes, Secretary Direct
Mr. Charles G. Moore
124 Kaywood Place
Statesville, N.C. 28677
SUBJECT: Permit No. NC0062332
Authorization to Construct
Charles Moore Residence
Iredell County
Dear Mr. Moore:
A letter of request for Authorization to Construct was received February 6,
1986, 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 1000 GPD wastewater treatment facility consisting of
settling and storage in an estimated 1000 gallon septic tank, a 1200 gallon
capacity dosing tank, a 300 square feet standard surface filter bed with distri-
bution piping, an 800 gallon chlorine contact tank with Sanuril tablet chlorinator
and a distribution box for step aeration to serve the 3 bedroom Moore Residence
located at 124 Kaywood Place on Lot 37 (Bellwood Subdivision) .
This Authorization to Construct is issued in accordance with Part III para-
graph B of NPDES Permit No. NC0062332 issued December 4, 1985, and shall be
subject to revocation unless the wastewater treatment facilities are constructed
in accordance with the conditions and limitations specified in Permit NO. NC006232
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 Mooresville Regional Office, telephone number 704/663-1699 shall be
notified at least twenty-four (24) hours in advance of backfilling of the in-
stalled 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.
Pollution Prevention Pays
P.O. Box 27687, Raleigh, North Carolina 27611-7687 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

NC0062332
Page 2
In event the facilities fail to perform satisfactorily in meeting its
NPDES permit effluent limits, the permittee shall take such immediate corrective
action as may be required by this Division, including the construction of
additional wastewater treatment and disposal facilities.
The sand media of the sub-surface 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.
One (1) set of approved plans and specifications is being forwarded to
you. If you have any questions or need additional information, please contact
Ms. Lisa Creech, telephone number 919/733-5083, ext. 138.
Sincerely yours,
/-R. Paul Wilms
cc: Iredell County Health Department
Mooresville Regional Supervisor
Dennis R. Ramsey
LC/ad