NCG550639_Regional Office Historical File Pre 2018

Lab Name 1 Lab_ rtnta I... . ' Lab Ares, Lab Cittv " .i Phone Numbed' 'E-mailf Addosi
[e-mail];
Beacham Labs- Division of [e-mail];
Ray Porter 6602 Windmill Way Wilmington 910-392-0223
Environmental Chemists [e-mail];
[e-mail]
[e-mail];
Environment 1, Inc. Mark Oliveira PO Box 7085 Greenville 252-756-6208 [e-mail]
[e-mail];andrew.gaydos
Microbac Laboratories, Inc. Rob Dermer 2592 Hope Mills Road Fayetteville 910-864-1920
@microbac.com
Pace Analytical Services, Inc.- Cheryl Johnson 9800 Kincey Avenue, Huntersville 704-875-9092 [e-mail]
Huntersville Suite 100 (243)
PAR Laboratories, Inc. Russell Everett Box 411483 Charlotte 704-588-8333 [e-mail]
Vann Laboratories James W.Vann P.O. Box 668 Wallace 910-285-3966 [e-mail]
Research &Analytical Sidney L. P.O. Box 473 Kernersville 336-996-2841 [e-mail];schampion@randalabs
Laboratories Champion .com
TBL Environmental Pamela S. Hester P.O. Box 589 Lumberton 910-738-6190 [e-mail]
Laboratory, Inc.
PACE Analytical Services, Inc. Barry Johnson 2225 Riverside Drive Asheville 828-254-7176 [e-mail]
Asheville (29)LaF
Water Tech Labs, Inc. ayette A. P.O. Box 1056 Granite Falls 828-396-4444 [e-mail]
Gra
gg
Environmental, Inc.-Sylva Anthony Tirona P.O. Box 954 Cullowhee 828-586-5588 [e-mail]
6701 Conference
Pace Analytical Services, Inc. Barry Johnson Drive Raleigh 919-834-4984 [e-mail]
Environmental Chemists, Inc. Ray Porter 6602 Windmill Way Wilmington 910-392-0223 [e-mail]
(Envirochem)
Moore Co. Water Pollution Janna Scherer 1094 Addor Road Aberdeen 910-281-3146 [e-mail]
Control Plant
Meritech, Inc. Kris Pawlak P.O. Box 27 Reidsville 336-342-4748 [e-mail]
Water&Sewer Authority of 704-788-4164
Cayce Atkinson 6400 Breezy Lane Concord [e-mail]
Cabarrus County (116)

Charlotte Water-
Environmental Laboratory Rhonda Hutson 4222 Westmont Drive Charlotte 704-336-3690 [e-mail]
Services
City of Gastonia-Crowders Annette Utilities Dept. Gastonia 704-854-6658 [e-mail]
Creek Laboratory McMurray P.O. Box 1748
Michael Bolt-
Cherokee WWTP Laboratory EBCI106 Water P.O. Box 547 Cherokee 828-554-6772 [e-mail]
Quality
Perdue, Incorporated Tina B. Rawls P.O. Box 460 Lewiston 252-348-4400 [e-mail]
Woodville
Duke Power Company LLC 13339 Hagers Ferry
d/b/a Duke Energy Carolinas, Girish Sharma Road Huntersville 980-875-5213 [e-mail]
LLC
Blue Ridge Labs David Wessinger P.O. Box 2940 Lenoir 828-728-0149 [e-mail]
Earth Environmental Services Michael J. Ladd 75 Bison Lane Murphy 828-479-6428 [e-mail]
Prism Laboratories, Inc. Helmuth M.B. P O. Box 240543 Charlotte 704-529-6364 [e-mail]
Janssen
Statesville Analytical Dena Myers P.O. Box 228 Statesville 704-872-4697 [e-mail]
SGS North America, Inc. Jeannie 5500 Business Drive Wilmington 910-350-1903 [e-mail]
Milholland
James&James
Environmental Management, Juanita James PO Box 1354 Mountain 828-697-0063 [e-mail]
Home
Inc.
Water Quality Labs, Inc. Paul Isenhour PO Box 1167 Banner Elk 828-898-6277 [e-mail]
[e-mail];
K&W Laboratories Gosia Kraska 1121 Hwy. 24/27 W Midland 704-888-1211 [e-mail]
Agronomic Division Colleen Hudak- 1040 Mail Service Raleigh 919-733-2655 [e-mail]
Laboratory- NCDA Wise Center (204)
Environmental Conservation Dale Mori 102 Woodwinds Cary 919-467-3090 [e-mail]
Laboratories, Inc. Industrial Ct.Ste.A

Environmental Testing Kelley E. Keenan PO Box 7565 Asheville 828-350-9364 [e-mail]
Solutions, Inc.
Stephanie
Meritech, Inc. II 4350 Sea Pines Drive Southport 910-617-1353 [e-mail]
Moore
6319-D Carolina Beach
Element One, Inc. Ken Smith Rd Wilmington 910-793-0128 [e-mail]
Environment 1, Inc.Satellite Mark Oliveira P.O. Box 7085 Greenville 252-756-6208 [e-mail]
Laboratory
Environmental Chemists, Ray Porter P.O Box 2228 Manteo 252-473-5702 [e-mail]
Inc./Outer Banks Div.
Columbia Technologies, LLC- Bob George 6701 Conference Raleigh 352-538-6507 [e-mail]
Mobile Unit 9 Drive
Pace Analytical Services, Inc.- 1 205 East Meadow
Barry Johnson Eden 828-254-7176 [e-mail]
Eden Road-Suite A
Aquatic Ecology Lab-UNCW Matthew McIver 5600 Marvin Moss Wilmington 910-962-2357 [e-mail]
Center for Marine Science Lane
Cameron Testing Services, Chris Cameron 219 S.Steele Street Sanford 919-208-4240 [e-mail]
Inc.
First Analytical Laboratories Steve Hunter 7517 Precision Drive, Raleigh 919-942-8607 [e-mail]
Suite 101
Biota Diagnostics, LLC Keith D 2401 Whitehall Park Charlotte 704-936-8260 [e-mail]
Hambright Drive,Suite 700

Fab Nit [ tab Contact 1, tab Addretti ; CRY ' f Phone Number E-mail Address
[e-mail];
Beacham Labs- Division of [e-mail];
Ray Porter 6602 Windmill Way Wilmington 910-392-0223
Environmental Chemists [e-mail];
[e-mail]
[e-mail];
Environment 1, Inc. Mark Oliveira PO Box 7085 Greenville 252-756-6208
[e-mail]
[e-mail];andrew.gaydos
Microbac Laboratories, Inc. Rob Dermer 2592 Hope Mills Road Fayetteville 910-864-1920
@microbac.com
Pace Analytical Services, Inc.- Cheryl Johnson 9800 Kincey Avenue, Huntersville 704-875-9092 [e-mail]
Huntersville Suite 100 (243)
PAR Laboratories, Inc. Russell Everett Box 411483 Charlotte 704-588-8333 [e-mail]
Vann Laboratories James W.Vann P.O. Box 668 Wallace 910-285-3966 [e-mail]
Research &Analytical Sidney L. P.O. Box 473 Kernersville 336-996-2841 [e-mail];schampion@randalabs
Laboratories Champion .com
TBL Environmental Pamela S. Hester P.O. Box 589 Lumberton 910-738-6190 [e-mail]
Laboratory, Inc.
PACE Analytical Services, Inc. 828-254-7176
Barry Johnson 2225 Riverside Drive Asheville [e-mail]
Asheville (29)
Water Tech Labs, Inc. ayette A. P.O. Box 1056 Granite Falls 828-396-4444 [e-mail]
Gra
gg
Environmental, Inc.-Sylva Anthony Tirona P.O. Box 954 Cullowhee 828-586-5588 [e-mail]
Pace Analytical Services, Inc. Barry Johnson 6701 Conference Raleigh 919-834-4984 [e-mail]
Drive
Environmental Chemists, Inc. Ray Porter 6602 Windmill Way Wilmington 910-392-0223 [e-mail]
(Envirochem)
Moore Co.Water Pollution Janna Scherer 1094 Addor Road Aberdeen 910-281-3146 [e-mail]
Control Plant
Meritech, Inc. Kris Pawlak P.O. Box 27 Reidsville 336-342-4748 [e-mail]
Water&Sewer Authority of 704-788-4164
Cayce Atkinson 6400 Breezy Lane Concord [e-mail]
Cabarrus County (116)

Charlotte Water-
Environmental Laboratory Rhonda Hutson 4222 Westmont Drive Charlotte 704-336-3690 [e-mail]
Services
City of Gastonia-Crowders Annette Utilities Dept. Gastonia 704-854-6658 [e-mail]
Creek Laboratory McMurray P.O. Box 1748
Michael Bolt-
Cherokee WWTP Laboratory EBCI106 Water P.O. Box 547 Cherokee 828-554-6772 [e-mail]
Quality
Lewiston
Perdue, Incorporated Tina B. Rawls P.O. Box 460 Woodville 252-348-4400 [e-mail]
Duke Power Company LLC 13339 Hagers Ferry
d/b/a Duke Energy Carolinas, Girish Sharma Road Huntersville 980-875-5213 [e-mail]
LLC
Blue Ridge Labs David Wessinger P.O. Box 2940 Lenoir 828-728-0149 [e-mail]
Earth Environmental Services Michael J. Ladd 75 Bison Lane Murphy 828-479-6428 [e-mail]
Helmuth M.B.
Prism Laboratories, Inc. P.O. Box 240543 Charlotte 704-529-6364 [e-mail]
Janssen
Statesville Analytical Dena Myers P.O. Box 228 Statesville 704-872-4697 [e-mail]
Jeannie
SGS North America, Inc. Milholland 5500 Business Drive Wilmington 910-350-1903 [e-mail]
James&James
Environmental Management, Juanita James PO Box 1354 Mountain 828-697-0063 [e-mail]
Home
Inc.
Water Quality Labs, Inc. Paul Isenhour PO Box 1167 Banner Elk 828-898-6277 [e-mail]
[e-mail];
K&W Laboratories Gosia Kraska 1121 Hwy. 24/27 W Midland 704-888-1211 [e-mail]
Agronomic Division Colleen Hudak- 1040 Mail Service 919-733-2655
Raleigh [e-mail]
Laboratory- NCDA Wise Center (204)
Environmental Conservation Dale Mori 102 Woodwinds Cary 919-467-3090 [e-mail]
Laboratories, Inc. Industrial Ct. Ste.A

F1LECOOPER
Governor
MICHAEL S. REGAN
Secretary
Environmental V S. JAY ZIMVERMAN
Quality Director
May 5, 2017
Mr. Richard Elder or current tenant
1114 Stanley Lucia Road
Mount Holly,NC 28120
Subject: Compliance Evaluation Inspection
1114 Stanley Lucia Road
Certificate of Coverage No.NCG550639
Gaston County
Dear Mr. Elder or current tenant:
Please be advised that NCDEQ inspector will be coming to inspect subject permit on
May 31, 2017, at about 11 AM. Your presence during the inspection is advised to discuss
compliance with the conditions listed in subject permit.
If you wish to reschedule or have any questions,please contact Ori Tuvia at(704)235-
2190, or via email at ori.tuvia(a✓ncdenr.gov.
Sincerely,
Ori Tuvia, Environmental Engineer
Mooresville Regional Office
Division of Water Resources,DEQ
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

RECEIVED/NCDENR/DWR
OCT 2 2015
NCDENR
WQROS
North Carolina Department of Environment and Natural Risoiaces REGIONAL OFFICE
Pat McCrory, Governor Donald R. van der Vaart, Secretary
September 15, 2015
Richard G. Elder
1114 Stanley-Lucia Road
Mount Holly, NC 28120
Subject: General Permit NCG550000
1114 Stanley-Lucia Road
Certificate of Coverage NCG550639
Gaston County
Dear Permittee:
The Division received your request to transfer ownership of the subject Certificate of Coverage (CoC)
on August 6, 2015. The Division does not object to your request. Therefore, the Division hereby issues
NCG550639 under General Permit NCG550000. It 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 Charles Weaver of the NPDES staff[919 807-6391 or
[e-mail]].
Sinc rely,
for S.Jay Zimmerman, irector
Division of Water Resources
ccille Regional e_;
NPDES file
1617 Mail Service Center,Raleigh,North Carolina 27699-1617 512 North Salisbury Street, Raleigh, North Carolina 27604
Phone: [phone]/FAX [phone]/Internet:www.ncwaterquality.org
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 RESOURCES
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG550639
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,
Richard G. Elder
is hereby authorized to discharge <1000 gallons per day of domestic wastewater from a
facility located at
1114 Stanley-Lucia Road
Mount Holly
Gaston County
to receiving waters designated as an unnamed tributary to Stanley Creek, a class WS-IV stream in
subbasin 03-08-33 of the Catawba River Basin in accordance with the effluent limitations,
monitoring requirements, and other conditions set forth in Parts I, II, III and IV hereof.
This certificate of coverage takes effect September 15, 2015.
This Certificate of Coverage shall remain valid for the duration of the General Permit.
Signed this day September 15, 2015
for>:. Jay Zimmerman, Director
Division of Water Resources
By Authority of the Environmental Management Commission
I

Alt1/4: • 41s,
NCD NR
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald R. van der Vaart
Governor Secretary
July 22, 2015
Mr.Garth Elder,Owner
1114 Stanley-Lucia Road
Mount Holly, NC 28120
Subject: Notice of Deficiency
Compliance Evaluation Inspection
NOD-2015-SP-001
Elder Residence
Certificate of Coverage No. NCG550639
Gaston County
Dear Mr. Elder:
Please find enclosed the Compliance Evaluation Inspection for the site visit conducted on July 21,2015
by Mr.Ori Tuvia and myself. Your cooperation during the site visit was much appreciated.
Two areas of concern were identified during the site visit. First,the subject permit has not been
reissued in your name since you purchased the property from Mr.Stroupe,which may have occurred as
far back as 2010 or earlier based on documentation found in our files. It is imperative that the subject
COC be issued to the current property owner,therefore, a Change of Ownership form is enclosed with
this inspection report for you to complete and return to the address listed on the form within 30 days
from receipt of this letter. A copy of this form should also be forwarded to this Office.
Secondly,annual effluent testing is not being performed as required by the permit.This testing is
necessary to ascertain whether or not your wastewater treatment system is functioning properly. You
indicated that Stanley Environmental is currently servicing your septic tank and they may offer analytical
testing services as well. If not, a list of laboratories certified to perform the testing required by your
permit is enclosed for your use. Please note that your prompt attention to these issues will help avoid
future compliance problems.
If you have any questions, please contact me at [phone].
incerely,
Michael Parker, Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional Office, DWR
Enclosures
610 East Center Avenue,Suite 301,Mooresville,NC 28115
Phone:[phone]\Internet:www.ncwaterquality.org

United States Environmental Protection Agency
Form Approved.
E PA 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 IL j 2 151 3 NCG550639 111 121 15/07/21 117 181.p] 19 I G I 201 I
21I I I I I I I I 11II 111 l l I l l l l l l l l l l l l l I I I I II I I I I I p6
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA ---- Reserved---
67I I 70I3 I 711 I 72 I 731
I 174 751 I I l I I I 180
Section B:Facility Data L J I
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) 08:45AM 15/07/21 13/08/01
1114 Stanley-Lucia Road
1114 Stanley-Lucia Rd Exit Time/Date Permit Expiration Date
Stanley NC 28164 09:20AM 15/07/21 18/07/31
Name(s)of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s) Other Facility Data
Garth Elder///
Name,Address of Responsible Official/Title/Phone and Fax Number
Contacted
Robert E Stroupe,PO Box 1236 Bessemer City NC 28016//704-629-3436/
No
Section C:Areas Evaluated During Inspection(Check only those areas evaluated)
II Permit II Operations&Maintenance 111 Records/Reports II Self-Monitoring Program
Sludge Handling Disposal • Facility Site Review II Effluent/Receiving Waters
Section D:Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s)and Signature(s)of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Michael L Parker MRO WQ//704-663-1699 Ext.2194/
re of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3(Rev 9-94)Previous editions are obsolete.
Page# 1

NPDES yr/mo/day Inspection Type (Cont.) 1
3[ NCG550639 (11 121 15/07/21 117 18 i,I
Section D:Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
The subject residence is currently owned by Mr. Garth Elder. Division records indicatet that an attempt
to contact Mr. Elder as far back as 2010 was made to perform and inspection and to have the permit
reissued in his name. No Change of Ownership form has been submitted to-date, but a copy will be
forwarded with this inspection.
The area where the WWT facilites are located is well maintained and access is readily available.
Chlorine tablets were found in one of the two chlorine tubes.
According to Mr. Elder, Stanly Environmental has been pumping the septic tank.
The system was not discharging at the time of the site visit. Some water was observed in the bottom
of the chlorine contact chamber, but it was not exiting the effluent pipe.
Annual effluent testing as required by the permit is not being performed. Once the permit has been
reissued to Mr. Elder, annual testing should be performed to ascertain the performance of the system.
•
Page# 2

Permit: NCG550639 Owner-Facility: 1114 Stanley-Lucia Road
Inspection Date: 07/21/2015 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 ❑
#Are there any special conditions for the permit? ❑ • ❑ ❑
Is access to the plant site restricted to the general public? 11 0 0 ❑
Is the inspector granted access to all areas for inspection? • ❑ 0 0
Comment: Owner has yet to submit a requested Change of Ownership form.
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? • ❑ ❑ 0
Does the facility analyze process control parameters,for ex:MLSS, MCRT, Settleable 0 0 I ❑
Solids, pH, DO,Sludge Judge,and other that are applicable?
Comment: The area where the WWT components were located is well maintained.
Record Keeping Yes No NA NE
Are records kept and maintained as required by the permit? ❑ • ❑ 0
Is all required information readily available,complete and current? 0 0 ❑ •
Are all records maintained for 3 years(lab. reg.required 5 years)? 0 ❑ 0 II
Are analytical results consistent with data reported on DMRs? 0 0 0 •
Is the chain-of-custody complete? 0 0 ❑ •
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 0
Are DMRs complete:do they include all permit parameters? ❑ ❑ 0111
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 • 0 0
on each shift?
Is the ORC visitation log available and current? 0 0 MI ❑
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 ❑ • 0
Is a copy of the current NPDES permit available on site? 0 0 0
Page# 3

Permit: NCG550639 Owner-Facility: 1114 Stanley-Lucia Road
Inspection Date: 07/21/2015 Inspection Type: Compliance Evaluation
Record Keeping Yes No NA NE
Facility has copy of previous year's Annual Report on file for review? ❑ 0 • 0
Comment: The current owner did not have a copy of the current NPDES permit.
Disinfection-Tablet Yes No NA NE
Are tablet chlorinators operational? 0 0 0
Are the tablets the proper size and type? II 0 0 0
Number of tubes in use? 1
Is the level of chlorine residual acceptable? ❑ 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: Chlorine tablets were found in one of the two chlorine tubes.
Effluent Sampling Yes No NA NE
Is composite sampling flow proportional? ❑ ❑ • ❑
Is sample collected below all treatment units? 00011
Is proper volume collected? 0 0 II ❑
Is the tubing clean? 0 0 • 0
#Is proper temperature set for sample storage(kept at less than or equal to 6.0 degrees 0 DE 0
Celsius)?
Is the facility sampling performed as required by the permit(frequency,sampling type ❑ U 0 0
representative)?
Comment: Effluent samplinq is not beinq performed as required by the permit(see 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? • ❑ 0 0
Are pumps or syphons operating properly? 0 0 0
Are high and low water alarms operating properly? ODOM
Comment: Septic tank is being serviced by Stanley Environmental. The Septic tank should be pumped
every 5 years or when the solids depth is found to be 1/3 of the liquid depth in any
compartment.
Page# 4

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
Pat McCrory Donald R.van der Vaart
Governor WATER QUALITY PERMITTING SECTION Secretary
•
This form is for ownership changes or name changes of NPDES wastewater permits.
• "Permittee"references the existing permit holder
• "Applicant"references the entity applying for the ownership/name change.
I. NPDES Permit No.(for which the change is requested): N C 0 0
or
Certificate of Coverage#: N C G 5
II. Existing Permittee Information:
a. Permit issued to(company name):
b. Person legally responsible for permit:
First MI Last
Title
Permit Holder Mailing Address
City State Zip
( ) ( )
Phone Fax
c. Facility name:
d. Facility's physical address:
Address
City State Zip
e. Facility contact person: ( )
First / MI / Last Phone
III. Applicant Information:
a. Request for change is a result of: ❑ Change in ownership of the facility
El Name change of the facility or owner
If other please explain:
b. Permit issued to(company name):
c. Person legally responsible for permit:
First MI Last
Title
Permit Holder Mailing Address
City State Zip
( )
Phone E-mail Address

d. Facility name:
e. Facility's physical address:
Address
City State Zip
f. Facility contact person:
First MI Last
Title
)
Phone E-mail Address
IV. Will the permitted facility continue to conduct the same commercial/industrial activities conducted prior to
this ownership or name change?
❑ Yes
❑ No(please explain)
If applicable,the applicant shall submit a major permit modification request to DWR.A major modification shall be
defined as one that increases the volume,increases the pollutant load,results in a significant relocation of the
discharge point,or results in a change in the characteristics of the waste generated.
V. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS ARE
INCOMPLETE OR MISSING:
1. This completed application is required for both name change and/or ownership change requests.
2. Legal documentation of the transfer of ownership(such as relevant pages of a contract deed,or a bill of sale)is
required for an ownership change request. Articles of incorporation are not sufficient for an ownership change.
Applicable regulations:40 CFR 122.41,40 CFR 122.61 and 15A NCAC 02H.0114
The certifications below must be completed and signed by both the permit holder prior to the change(Permittee),and the
new applicant in the case of an ownership change request. For a name change request,the signed Applicant's Certification
is sufficient.
PERMITTEE CERTIFICATION(Permit holder prior to ownership change):
I, ,attest that this application for a name/ownership change has been reviewed and is accurate and complete to the best
of my knowledge. I understand that if all required parts of this application are not completed and that if all required
supporting information is not included,this application package will be returned as incomplete.
Signature Date
APPLICANT CERTIFICATION
I, ,attest that this application for a name/ownership change has been reviewed and is accurate and complete to the best
of my knowledge. I understand that if all required parts of this application are not completed and that if all required
supporting information is not included,this application package will be returned as incomplete.
Signature Date
**************************
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Water Resources
Water Quality Permitting Section
1617 Mail Service Center
Raleigh,North Carolina 27699-1617
NPDES PERMIT NAME/OWNERSHIP CHANGE REQUEST

248 Duke Power Company LLC d/b/a Duke Energy Girish Sharma 13339 Hagers Ferry Huntersville 28078-7929 980-875-5213
677 First Analytical Laboratories Steve Hunter 7517 Precision Raleigh 27617- 919-942-8607
572 Agronomic Division Laboratory-NCDA Colleen Hudak-Wise 1040 Mail Service Raleigh 27699-1040 919-733-2655
591 Environmental Conservation Laboratories,Inc. Dale Mori 102 Woodwinds Cary 27511-6204 919-467-3090
79 CompuChem Division of Liberty Analytical Corp. Robert Meierer 501 Madison Cary 27513- 919-379-4004
654 Cameron Testing Services,Inc. Chris Cameron 219 S.Steele Street Sanford 27330- 919-208-4240
638 Aquatic Ecology Lab-UNCW Center for Marine Matthew McIver 5600 Marvin Moss Wilmington 28409- 910-962-2357
11 Microbac Laboratories,Inc. Rob Dermer 2592 Hope Mills Fayetteville 28306- 910-864-1920
604 Element One, Inc. Ken Smith 6319-D Carolina Wilmington 28412- 910-793-0128
37 TBL Environmental Laboratory,Inc. Pamela S.Hester P.O.Box 589 Lumberton 28359- 910-738-6190
602 Meritech, Inc. II Stephanie Moore 4350 Sea Pines Southport 28461- 910-617-1353
94 Environmental Chemists, Inc.(Envirochem) Ray Porter 6602 Windmill Way Wilmington 28405- 910-392-0223
481 SGS North America, Inc. Jeannie Milholland 5500 Business Drive Wilmington 28405- 910-350-1903
1 Beacham Laboratory Rod Reeves 1820 Wilmington Jacksonville 28540- 910-347-5843
22 Vann Laboratories James W.Vann P.O.Box 668 Wallace 28466- 910-285-3966
134 Moore Co.Water Pollution Control Plant Janna Scherer 1094 Addor Road Aberdeen 28315- 910-281-3146
544 Water Quality Labs, Inc. Paul Isenhour PO Box 1167 Banner Elk 28604- 828-898-6277
275 Blue Ridge Labs David Wessinger P.O.Box 2940 Lenoir 28645- 828-728-0149
67 Pace Analytical Services, Inc. Barry Johnson 6701 Conference Raleigh 27636-3190 828-713-2725
482 James&James Environmental Management,Inc. Juanita James PO Box 1354 Mountain 28758- 828-697-0063
57 Environmental, Inc.-Sylva Anthony Tirona P.O.Box 954 Cullowhee 28723- 828-586-5588
235 Cherokee WWTP Laboratory Michael Bolt P.O. Box 547 Cherokee 28719- 828-554-6772
352 Earth Environmental Services Michael J.Ladd 75 Bison Lane Murphy 28906- 828-479-6428
50 Water Tech Labs, Inc. LaFayette A.Gragg P.O. Box 1056 Granite Falls 28630- 828-396-4444
600 Environmental Testing Solutions, Inc. Kelley E.Keenan PO Box 7565 Asheville 28802-7565 828-350-9364
40 PACE Analytical Services,Inc.Asheville Barry Johnson 2225 Riverside Drive Asheville 28804- 828 252 7176
Pace
StatesvilleAnDena
Analytical Services, Inc. Huntersville Johnson P.O Bo 228 Statesville esvisle le 28078- 704 875 9092
440
Analytical Myers 28687- 704-872-4697
210 City of Gastonia-Crowders Creek Laboratory Annette McMurray Utilities Dept. Gastonia 28053-1748 704-854-6658
177 Water&Sewer Authority of Cabarrus County Cayce Atkinson 6400 Breezy Lane Concord 28025- 704-788-4164
20 PAR Laboratories, Inc. Russell Everett Box 411483 Charlotte 28273 704-588-8333
[;.._
559 K&W Laboratories Gosia Kraska 1121 Hwy, 24/27 W Midland 28107- 704-569-1800
402 Prism Laboratories, inc. Helmuth M.B.Janssen P.O. Box 240543 Charlotte 28224-O543 704-529-6364
192 CMU-Environmental Laboratory Services 1: , t pnda Hutsont u,ra 4222rWestmont Charlotte 28217 ,704-336 3690
34 Research&Analytical Laboratories Sidney L.Champion P.O, Box 473 Kernersville 27285- 336-996-2841
633'Pace Analytical Services,Inc.-Eden Barry Johnson 205 East Meadow Eden 27288- 336-623-8921
165 Meritech,Inc. Kris Pawlak P.O.Box 27 Reidsville 27320- 336-342-4748
10 Environment 1, Inc. Mark Oliveira PO Box 7085 Greenville 27835- 252-756-6208
628 Environmental Chemists,Inc./Outer Banks Div. Ray Porter P.0 Box 2228 Manteo 27954- 252-473-5702
245 Perdue, Incorporated Tina B. Rawls P.O. Box 460 Lewiston 27849- 252-348-4400

Pr
: 980-875- [e-mail]
919-882- [e-mail]
'204 919-733- [e-mail]
'919-467- [e-mail]
919-379- [e-mail] _
919-776- [e-mail]
910-962- [e-mail]
910-864- [e-mail]
910-792- [e-mail]
910-671- [e-mail]
910-457- [e-mail] �
910-392- [e-mail]
910-350- [e-mail]
910-347- [e-mail]; [e-mail]
[e-mail]
910-281- [e-mail]
828-898- [e-mail]
828-728- [e-mail]
919-834- [e-mail]
828-697- [e-mail]
828-586- [e-mail]
828-497- [e-mail]
828-479- [e-mail]
828-396- [e-mail]
828-350- [e-mail]
29 ,828-252- [e-mail]
'243 704 875- [e-mail]
704 878 [e-mail]
704 866- [e-mail]
116 704-786- [e-mail]
704-588- [e-mail]
704-569 ;'- [e-mail]
704-525- ', [e-mail]
n _
704 632- [e-mail]
336-996-
„ [e-mail]
336-623- [e-mail]
336-342- [e-mail]
252-756- [e-mail];[e-mail]
252-473- [e-mail]
252-348- [e-mail]

K)oJ -wl S P-ooi
„tk,•.A,
ALE
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald R. van der Vaart
Governor Secretary
July 8, 2015
Mr. Garth Elder
1114 Stanley-Lucia Road
Mt. Holly,NC 28120
Subject: Single Family Residence WWT System
NPDES General Wastewater Permit Certificate of
Coverage No. NCG550639
Compliance Evaluation Inspection
Gaston County
Dear Mr. Elder:
Division of Water Resources (DWR) database records show that you currently own/operate a
single family residence (SFR) wastewater treatment and disposal system. It has been approximately five
years since staff from this Office last visited your facility; therefore it is time to schedule a comprehensive
review of your system with you in order to verify that your system is operating properly and to determine
the compliance status of the system pursuant to the terms and conditions in your permit. We anticipate
such a review would take approximately an hour or so, provided all necessary documentation and
monitoring data is readily available at the time of the site visit.
Due to the difficulties involved with catching owners at home during the workday, the purpose
of this letter is to pre-schedule this site visit with you to ensure that both you and MRO staff can meet and
complete the required system review as expeditiously as possible. Our visit to your residence has been
tentatively scheduled for July 21 St at 9:00 am. In order to confirm your availability for this site visit,
please contact me at 704-663-1699, between the hours of 8AM and 4PM, Monday through Friday to
confirm that the aforementioned date and time are acceptable.
Also, in the interest of conducting the most efficient evaluation possible, we ask that you have
certain items of documentation on hand at the time of the site visit. These items include the following:
1. Permit/Certificate of Coverage: Issued by DWR, you would have received this via regular U.S.
Postal Service mail.
2. A Schematic of the Treatment/Disposal System: A schematic or other technical drawing and/or
design specifications that show the complete and/or partial layout of your treatment/disposal
system.
3. Documentation of Analytical Monitoring: As required in Part I (A) of your Single Family
General Permit (NCG550000), please have available all official records of analytical monitoring
conducted to date.
Mooresville Regional Office , l C- i3 6' , '
610 East Center Avenue,Mooresville,NC 28115 �C3/L�/Z
An Equal Opportunity\Affirmative Action Employer—Made in part by recycled paper .Jj9 c ue(�C
Phone:[phone] Internet:www.ncdenr.gov

Mr.Garth Elder SFR Wastewater Treatment System Inspection
NCG550639 July 8,2015
4. Documentation of Septic Tank Inspections/Pumping: As required in Part I (A) of the General
Permit, please have available all records of annual septic tank inspections and septic tank
pumping.
5. Chlorination/Dechlorination Tablets: Please have available the original containers in which
both the chlorination and/or dechlorination tablets were stored when you purchased them.
We appreciate your time and understanding of our mission to preserve the natural resources of our
great state and look forward to you contacting us to confirm your availability for this site visit. If you
have questions or concerns about this letter or the proposed inspection, please contact me between the
hours of 8:00 AM and 4:00 PM, Monday through Friday at 704-663-1699.
' Sincerely,
Michael L. Parker, Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, DENR

�JITFRQ , n BPS ge-ijirLep.A-11-.,,1- 60jMich 0F.�aSAi�y E //G n �jQQ�J � �✓/ll���Cl ` �� t 7�VZliam .Ross,Jr..Secretary
j . • I' orth Cma Depau�ICi�t of Environment and Natural Resources
5l�Coleen H.Sullins,Director
,,i,;t
'�y &LA- ,Q� 1�ifrj
�� Division of Water Quality
611)2A.V1
n 6141 b23 May 2008t��,�
, / Mr. Robert E. Stroupe �^74/0 i 3 tAY — �,, ,,s/j,
P.O. Box 1236 a �``.�Gca�sc �`/ `
Bessemer City,NC 28016 mecca 'J � Go.e.;-4
,
ko,.. 714,1„. s IP-ff
L ,S,ub'ect: Single Family Residence ewater Treatment
/(/ g 11 la( -Luc le, ! NPDES General Wastewate ermit No./Certificate
/V 6. 1 , (�,I h Ci of Coverage NCG550639
911 l t�� ?5 Compliance Evaluation Inspecti
P'fIll Dear Mr. Stroupe: (-6 -61- 717."- -17 ,
Division of Water Quality (DWQ) database records show that you currently own/operate a single
family residence (SFR) wastewater treatment and disposal system. DWQ personnel from the Mooresville
p- Regional Office (MRO) need to conduct a c.a>iiprehensive review of your system with you in order to
verify,that your system is operating proper .=and to determine the compliance status of the system
pursuant to'your NCG550639 permit. We anticipate such a review would take approximately one to two
hours; provided that all needed documentation and data is readily available at the time of the site visit.
Due to the difficulties involved with catching owners at home during the workday, we would like
rfrvt`o pre-schedule this site visit with you to ensure we can meet and complete the required system review as
tAfrd
expeditiously as possible. In order to facilitate this we ask that you contact Mr. Ron Boone, of our office,
at 704-663-1699, between the hours of 8AM and 4PM, Monday through Friday. Please contact Mr.
Boone within the next 10 days to identify the best possible time for an evaluator to visit your SFR and
conduct this review with you.
ciA
Pkii4 Also, in the interest of conducting the most efficient evaluation possible, we ask that you have
certain items of documentation on hand at the time of the site visit. These items include the following:
i
4.
1. Permit/Certificate of Coverage: Issued by DWQ, you would have received this via regular U.S.
Postal Service mail.
2. A Schematic of the Treatment/Disposal System: Please have available all schematics or other
technical drawings and/or design specifications that show the complete and/or partial layout of
your treatment/disposal system.
3. Documentation of Analytical Monitoring: Required in Part I(A) of the general NCG550000
permit, please have available all official records of analytical monitoring conducted to date.
4. Documentation of Septic Tank Inspections/Pumping: Required in Part I(A) of the general
NCG550000 permit, please have available all records of annual septic tank inspections and septic
tank pumping.
5. Chlorination/Dechlorination Tablets: Please have available the original containers in which
both the chlorination and dechlorination tablets were stored when you purchased them.
North Carolina Division of Water Quality Mooresville Regional Office Surface Water Protection Phone[phone] Customer Service
Internet: h2o.enr.state.nc.us 610 East Center Avenue,Suite 301 Mooresville,NC 28115 FAX [phone]
a
An Equal Opportunity/Affirmative Action Employer—50%Recycled/10%Post Consumer Paper AN7at ra ly
,Naturally

p .Stroupe Single Family Residence Wastewater Treatment System
39 23 May 2008
We appreciate your time and understanding of our mission to preserve the natural resources of our
great state and look forward to you contacting us to schedule this site visit. If for some reason you're
unable to contact us, we will make every effort to contact you to schedule the review of your system. If
you have questions or concerns about this letter or the required review, please contact Mr. Boone between
the hours of 8AM and 4PM, Monday through Friday at 704-663-1699. If he is not there when you call,
please leave your name and a good contact phone number and he will return your call as soon as possible.
Sincerely,
1?-71 ° /Z---
Robert B. Krebs
Surface Water Protection Section Supervisor
Division of Water Quality
' Mooresville Regional Office

P3 741s,
RECEIVEDINCDENR/DWR
AUG 6 2015
NCDENR WORDS
North Carolina Department of Environment and Natulalit§§15 IONAL OFFICE
Division of Water Resources
Pat McCrory Donald R.van der Vaart
Governor WATER QUALITY PERMITTING SECTION Secretary
F z 'PERMIT NAME/OWNERS NAME/OWNERSIHP CHANGE REQUEST : 4 i t-
This form is for ownership changes or name changes of NPDES wastewater permits.
• "Permittee"references the existing permit holder
• "Applicant'references the entity applying for the ownership/name change.
I. NPDES Permit No.(for which the change is requested): N C U
Or
Certificate of Coverage#: N C G 5 SOO 3?
H. Existing Permittee Information:
a. Permit issued to(company name): -R V L y-p Li.
b. Person legally responsible for permit:
first MI Last
Title
1 / t ,.. -4'cryv(e:v
Permit HolMailing Address
f'l - I
City State Zip
hone Fax
c. Facility name:
d. Facility's physical address: /I l t
, Address
ael
City State/ Zip
e. Facility contact person: ' 'nr c L 7 V t4 3 � /
First / MI / Last Phone
III. Applicant Information:
a. Request for change is a result of: ;Change in ownership of the facility
Name change of the facility or owner
If other please explain:
b. Permit issued to(company name): t2-c.,ce, P_iik Cn t
c. Person legally responsible for permit:
first MI Last
its ti i- --
Title
// iM-v
� to:
ermit Holder Mailing Address
/)1 -/J Q'v .AjC.. � {
City / State Zip
Phone E-maii Address

d. Facility name: )
e. Facility's physical address: /( ( . ' y . . v L—. t.,,t,.„. a
dress
f (i }" C: Vie'
u�}— �' /city_ �` State Zip
f. Facility contact person: ;mac.ev -.f L•j I
First MI Last
Title
76LP -B iq
Phone E-mail Address
IV. Will the permitted facility continue to conduct the same commercial/industrial activities conducted prior to
this ownership or name change?
❑ Yes _
1 No(please explain) _y,�, ,_ _ _a' CC>'h a t. ,
If applicable,the applicant shall submit a major perA6 modification request to DWR. major modification shall be
defined as one that increases the volume,increases the pollutant load,results in a sign cant relocation of the
discharge point,or results in a change in the characteristics of the waste generated.
V. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS ARE
INCOMPLETE OR MISSING:
1. This completed application is required for both name change and/or ownership change requests.
2.)(Legal documentation of the transfer of ownership(such as relevant pages of a contract deed,or a bill of sale)is
required for an ownership change request. Articles of incorporation are not sufficient for an ownership change.
Applicable regulations:40 CFR 122.41,40 CFR 122.61 and 15A NCAC 02H.0114
The certifications below must be completed and signed by both the permit holder prior to the change(Permittee),and the
new applicant in the case of an ownership change request. For a name change request,the signed Applicant's Certification
is sufficient.
PERMITTEE CERTIFICATION(Permit holder prior to ownership change): 44 0"Cs_YLA d.
I. _.attest that this application for a name/ownership change has been revie ed and is accurate and complete to the best
of my knowledge. I understand that if all required parts of this application are not completed and that if all required
supporting information is not included,this application package will be returned as incomplete.
Signature Date
APPLICANT CERTIFICATION
I, '(L�'attest that this application for a name/ownership change has been reviewed and is accurate and complete to the best
of my knowledge. I understand that if all required parts of this application are not completed and that if all required
su porting information is not included,this application package will be returned as incomplete.
s , CQ 7— £i , i5
' Signature Date
**************************
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Water Resources
Water Ouality Permitting Section
1617 Mail Service Center
Raleigh.North Carolina 27699-161"
NPDES PERMIT NAME/OWNERSHIP CHANGE REQUEST

A•.411),,,
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
November 30, 2010
Mr. Garth Elder
1114 Stanley-Lucia Road •
Mt. Holly,NC 28120
Subject: Compliance Evaluation Inspection
Single Family Residence
NPDES Permit No.NCG550639
• Gaston County
Dear Mr. Elder:
Enclosed is a copy of the Compliance Evaluation Inspection(CEI) for the site visit conducted on
November 22, 2010,by Ms. Barbara Sifford with this Office. The system appeared to be operational although
no discharge was occurring at that time. Several items need to be corrected for our files and documentation of
the system.
Per your phone conversations with Ms. Sifford several items have been noted that need to be corrected.
Enclosed with this letter is the change of ownership form. This should be completed and mailed to Raleigh as
soon as possible. You will be billed the annual fees each year in December which are $60.00. Analytical data
for compliance monitoring for the treatment system has not been evaluated. To complete this requirement a list
of commercial certified labs is included with this letter for you to contact. The parameters listed on page 2 of
the General Permit NCG550000 should be completed by February 2011, and annually thereafter.
The chlorine tablet dispenser was appropriately located in the wastewater flow. Chlorine tablets for
pools should not be used in the system as they are toxic to aquatic life. Chlorine tablets can be purchased from
USA Blue Book on line or McCall Brothers plumbing supply in Charlotte. A MSDS is enclosed stating the
required type of chlorine compound and proper product use. Please submit a copy of the laboratory data and
pump records for the septic tank within 90 days of receipt of this letter.
Mooresville Regional Office
Location:610 East Center Ave.,Suite 301 Mooresville,NC 28115 One
Phone:[phone] I Fax:[phone] I Customer Service:1-877-623-6748 NorthCarolina
Internet:www.ncwaterquality.org t'/�+��l�'/
An Equal Opportunity'.Affirmative Action Employer-50%Recycled/109 Naturallyt
0 Post Consumer paper

SEMI
Page 2
Elder CEI
November 2010
In conclusion note the following items:
1. Permit change owner name and pay annual fees that are due.
2. Perform analytical annually. (List of contract labs included)
3. Pump tank regularly every three to five years.
4. Make sure that chlorine tablets are submerged in flow for proper disinfection and are the correct
type of chlorine.
The enclosed reports should be self-explanatory. If you have any questions, comments, or need
assistance with understanding any aspect of your permit or this report, please do not hesitate to contact Ms.
Sifford at [phone].
Sincerely,
(''''Z'iler-------
Robert Krebs
Regional Supervisor Surface Water Protection
Mooresville Regional Office
Enclosure—Inspection report
Commercial lab list
Chlorine tablet information
Copy of NCG550000
Technical Bulletin Information for NCG550000.

i� FILE
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
November 1, 2010
Richard Elder and Jacqueline Elder
1114 Stanley-Lucia Road
Mt. Holly,NC 28120
Subject: Single Family Residence Wastewater Treatment
System
NPDES General Wastewater Permit No./Certificate
of Coverage NCG550639
Compliance Evaluation Inspection
Dear Mr. & Mrs. Elder:
Division of Water Quality (DWQ) database records show that you currently own/operate a single
family residence (SFR) wastewater treatment and disposal system. DWQ personnel from the Mooresville
Regional Office (MRO) need to conduct a comprehensive review of your system with you in order to
verify that your system is operating properly and to determine the compliance status of the system
pursuant to your NCG550639 permit. We anticipate such a review would take approximately one to two
hours,provided that all needed documentation and data is readily available at the time of the site visit.
Due to the difficulties involved with catching owners at home during the workday,we would like
to pre-schedule this site visit with you to ensure we can meet and complete the required system review as
expeditiously as possible. In order to facilitate this we ask that you contact Ms. Barbara Sifford, of our
office, at 704-663-1699, between the hours of 8AM and 5PM, Monday through Friday. Please contact
Ms. Sifford within the next 10 days to identify the best possible time to inspect your SFR and conduct this
review with you.
Also, in the interest of conducting the most efficient evaluation possible, we ask that you have
certain items of documentation on hand at the time of the site visit. These items include the following:
1. Permit/Certificate of Coverage: Issued by DWQ, you would have received this via regular U.S.
Postal Service mail.
2. A Schematic of the Treatment/Disposal System: Please have available all schematics or other
technical drawings and/or design specifications that show the complete and/or partial layout of
your treatment/disposal system.
Mooresville Regional Office
Location:610 East Center Ave.,Suite 301 Mooresville,NC 28115 One
Phone:[phone] t Fax:[phone] t Customer Service:1-877-623-6748 N orth Carolina
Internet:www.ncwaterquality.org • Naturally
An Equal Opportunity`Affirmative Action Employer—50%Recyciea;l0%Post Consumer paper ��"'��� ���

3. Documentation of Analytical Monitoring: Required in Part I(A) of the general NCG550000
permit,please have available all official records of analytical monitoring conducted to date.
4. Documentation of Septic Tank Inspections/Pumping: Required in Part I(A) of the general
NCG550000 permit,please have available all records of annual septic tank inspections and septic
tank pumping.
5. Chlorination/Dechlorination Tablets: Please have available the original containers in which
both the chlorination and dechlorination tablets were stored when you purchased them.
We appreciate your time and understanding of our mission to preserve the natural resources of our great
state and look forward to you contacting us to schedule this site visit. If you have questions or concerns about
this letter or the required review, please contact Ms. Sifford between the hours of 8AM and 5PM, Monday
through Friday at 704-663-1699. If she is not available when you call, please leave your name and a contact
phone number and-she will return your call as soon as possible.
Sincerely,
Robert Krebs
Regional Supervisor
Surface Water Protection Section Supervisor
Mooresville Regional Office
3, 0-6 _ (off 46 4)20 a-�
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1114 Stanley Lucia Road,
Stanley, NC 28164
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Gaston County,NC
Disclaimer:The information provided is not to be considered as a Legal Document or Description.The Map and Parcel Data is believed to be accurate,but
Gaston County does not guarantee the accuracy of this information.
http://egovl.co.gaston.nc.us/website/ParcelDataSite/MapFrame.htm 6/20/2008

GASTON COUNTY, NC YR 2007 REQUESTED BY G400SEC RUN 10/17/07 TIME 8:32:46 PAGE 1
ELDER RICHARD GARTH ELDER RICHARD GARTH NBHD: 3A025 176007
1114 STANLEY LUCIA RD 1114 STANLEY LUCIA RD 3588-49-4403 PAR DESC3: NSO3K
14 057 018 00 000 MT HOLLY NC 28120-0000 MT HOLLY NC 28120-0000 1114 STANLEY LUCIA RD
Plat Bk/Pg 03986894 03986894
Bldg No. 1 Appraiser: WC Appr Date: APPR: CRH APPR DT: 7/20/2006 LAND VALUE 38,040 38,040
Imp Desc: R1 RESIDENTIAL 1 STORY Eff Yr: USE CODE: 1111 SINGLE FAMILY MISC VALUE 4,101 4,101
Grade • B+ ABOVE AVERAGE QLTY 1 Act Yr Bt: 1964 DISTRICT: 330 EAST GASTON FD BLDG VALUE 212,735 212,735
1.00 Stories/ 9 Rms/ 4 Bed/ 3.0 Bth/ HBth NBHD: 3A025 SANDY FORD RD RB/ TOTAL VALUE 254,876 254,876
Finished Area: 2,960.00 ASV SqFt 86.11 Sales SqFt 104.73 2006 PRIOR YEAR 251,584 251,584
COMPONENT TYPE/CODE/DESC PCT UNITS RATE STR# STR% SIZE HGT% PER% CDS% COST %CMPL
AC BSMT BASEMENT 50 1480.00 11.40 100.00 75.00 12,654
AC BSMTR BASEMENT RECREATION 20 592.00 18.90 100.00 75.00 8,391
AC R11 COVERED PORCH 100 240.00 25.05 98.00 5,891
AC R11 COVERED PORCH 100 285.00 25.05 98.00 6,996
AC R35 TERRACE STONE/MASONR 100 610.00 13.25 90.00 7,274
AC R35 TERRACE STONE/MASONR 100 328.00 13.25 90.00 3,911
MA R1 RES 1 STORY 100 2960.00 78.30 1.00 75.00 173,826
- AR 31 OIL-FHA 100 2960.00 .00 0
- BI 20 Adequate 100 1.00 .00 0
- EW 18 BRICK VENEER 100 2960.00 3.50 75.00 7,770
- FC 06 CARPET 100 2960.00 .00 0
- FN 03 CONT WALL BRK 100 2960.00 .00 75.00 0
- FO Y FIREPLACE OPENING 100 3.00 1800.00 5,400
- FS Y FIREPLACE STACK 100 2.00 1800.00 3,600
- IF 01 DRYWALL 100 2960.00 .00 0
- PL Y ADDED FIXTURES YES 100 7.00 960.00 6,720
- RC 08 ASPHALT SHINGLES 100 2960.00 .00 0
- RT 03 DOUBLE PITCH 100 2960.00 .00 0
RCN. . . PCT COMPLETE 100 x 242,433
QUAL. . QG B+ ABOVE AVERAGE QLTY 1 135.00 x 327,284
DEPR. . GD GOOD CDU 35.00 - 114,549 114,549 T
--FMV. . . MKT 3A025 SANDY FORD RD RB/OS 100.00 x 212,735
PROPERTY NOTES: BOOK PAGE DT DATE QS SALES PRICE
2821 0206 WD 7/31/1998 A 310,000
PERMIT NO TYPE DATE AMOUNT
BLDG CODE DESC UNITS EYB DT PCT ADD.DEPR PCT QGCD VALUE
101 014 Paving Conc FEA 1,600.00 1964 MAV 65.00 C 1,512
104 004 Shed 20 X 30 600.00 1985 MAV 49.00 C 2,589
.00
.00
LND LAND TOTAL ACRES: 4.680 TOT CURRENT
# ZONE TYPE/CODE LAND QTY LAND ACRES LAND RATE DPTH DPT% TOP% LOC% SIZ% SHP% OTH% ADJ FMV EXMPT
1 AC RB 1.000 1.000 .00 .00 .00 .00 .00 .00 .00 .00 24,000
2 AC RR 3.680 3.680 .00 .00 .00 .00 .00 .00 .00 .00 14,040
176007 1114 STANLEY LUCIA RD

GASTON COUNTY 2007 176007 PAGE 2
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C= AC R11 COVERED PORCH G= AC R11 COVERED PORCH E= AC R35 TERRACE STONE/MASONRY
F= AC R35 TERRACE STONE/MASONRY D= MA R1 RES 1 STORY

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Tax Field Name • <;;'i'
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Tax Information 176007
Click to enlarge image!
PID# 176007
PIN# 3588-49-4403
NEIGH.HOOD# 3A025
NEIGH.HOOD NAME SANDY FORD RD
OWNER ID# 03986894
'CURRENT OWNER 1 ELDER RICHARD GARTH
CURRENT OWNER 2 ELDER JACQUELINE F
MAILING ADDRESS 1 1114 STANLEY LUCIA RD
MAILING ADDRESS 2
CITY MT HOLLY
STATE NC
'ZIP CODE 28120-0000
JAN1 OWNER 1 ELDER RICHARD GARTH
JAN1 OWNER 2 ELDER JACQUELINE F
PROPERTY ADDRESS 1114 STANLEY LUCIA RD
DEED BOOK 2821
DEED PAGE 0206
DEED TYPE WD
1 SALES AMOUNT $310,000
DEED RECORDING DATE 07/31/1998
PLAT BOOK
PLAT PAGE
LEGAL DESC 1 .
'LEGAL DESC 2
'STRUCTURE CODE# R1
'STRUCTURE TYPE RESIDENTIAL 1 STORY
YEAR BUILT 1964
SQ FT 2960
BASEMENT YES
'#BEDROOMS 4
#BATHS 3
MULTI-STRUCTURES NO
'ACREAGE 4.68
DISTRICT CODE 330
TAX DISTRICT 'EAST GASTON FD

TOWNSHIP CODE 14
TOWNSHIP DESC RIVER BEND TOWNSHIP
VOLUNTARY AG DIST NO
LAND VALUE $38,040
IMPV.VALUE $216,836
TOTAL VALUE $254,876
PRESENT USE VALUE ASSESSMENT NO
Property Record Card Click

Michael I-.Easley,Governor
William G. Ross.Jr.,Secretary
_ • 1 North Carolina Department of Environment and Natural Resources
O �
Coleen H.Sullins,Director
Division of Water Quality
23 May 2008
Mr. Robert E. Stroupe
P.O. Box 1236
Bessemer City,NC 28016
Subject: Single Family Residence Wastewater Treatment
System
NPDES General Wastewater Permit No./Certificate
of Coverage NCG550639
Compliance Evaluation Inspection
Dear Mr. Stroupe:
Division of Water Quality (DWQ) database records show that you currently own/operate a single
family residence (SFR) wastewater treatment and disposal system. DWQ personnel from the Mooresville
Regional Office (MRO) need to conduct a comprehensive review of your system with you in order to
verify 1 that your system is operating properly and to determine the compliance status of the system
pursuahit to your NCG550639 permit. We anticipate such a review would take approximately one to two
hours,provided that all needed documentation and data is readily available at the time of the site visit.
Due to the difficulties involved with catching owners at home during the workday, we would like
to pre-schedule this site visit with you to ensure we can meet and complete the required system review as
expeditiously as possible. In order to facilitate this we ask that you contact Mr. Ron Boone, of our office,
at 704-663-1699, between the hours of 8AM and 4PM, Monday through Friday. Please contact Mr.
Boone within the next 10 days to identify the best possible time for an evaluator to visit your SFR and
conduct this review with you.
Also, in the interest of conducting the most efficient evaluation possible, we ask that you have
certain items of documentation on hand at the time of the site visit. These items include the following:
1. Permit/Certificate of Coverage: Issued by DWQ, you would have received this via regular U.S.
Postal Service mail.
2. A Schematic of the Treatment/Disposal System: Please have available all schematics or other
technical drawings and/or design specifications that show the complete and/or partial layout of
. your treatment/disposal system.
3. Documentation of Analytical Monitoring: Required in Part I(A) of the general NCG550000
permit, please have available all official records of analytical monitoring conducted to date.
4. Documentation of Septic Tank Inspections/Pumping: Required in Part I(A) of the general
NCG550000 permit, please have available all records of annual septic tank inspections and septic
tank pumping.
S. Chlorination/Dechlorination Tablets: Please have available the original containers in which
both the chlorination and dechlorination tablets were stored when you purchased them.
North Carolina Division of Water Quality Mooresville Regional Office Surface Water Protection Phone[phone] Customer Service
Internet: h2o.enr.state.nc.us 610 East Center Avenue,Suite 301 Mooresville,NC 28115 FAX [phone]
An Equal Opportunity/Affirmative Action Employer—50%Recycled/10%Post Consumer Paper NorthCarolina
,Naturally

b39 23 May 2UUS
We appreciate your time and understanding of our mission to preserve the natural resources of our
great state and look forward to you contacting us to schedule this site visit. If for some reason you're
unable to contact us, we will make every effort to contact you to schedule the review of your system. If
you have questions or concerns about this letter or the required review, please contact Mr. Boone between
the hours of 8AM and 4PM, Monday through Friday at 704-663-1699. If he is not there when you call,
please leave your name and a good contact phone number and he will return your call as soon as possible.
Sincerely,
1?-71
l
Robert B. Krebs
Surface Water Protection Section Supervisor
Division of Water Quality
Mooresville Regional Office

Aip,A•
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor January 24, 2006 William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
Robert E. Stroupe
PO Box 1236
Bessemer City,NC 28016
Subject: NPDES Permit NCG550639
Gaston County
Dear Mr. Stroupe <or> Current Occupant:
Our files indicate that the domestic wastewater discharge permit that was issued to
Robert E. Stroupe for a domestic wastewater discharge from the subject single family residence
has expired. The Surface Water Protection Section requests that you contact our staff to work
toward acquiring the necessary permitting, or if a change in property ownership has occurred.
Initially, all active sites must be properly permitted, and then adhere to the appropriate General
Permit conditions which became effective on August 1, 2002 and will expire on July 31, 2007.
Pursuant to the conditions of North Carolina General Permit NCG550000, the following
documentation is required to be maintained, and readily available for inspection for a period of at
least three (3) years:
O All operation and maintenance activities relating to the wastewater treatment system
Q Analytical monitoring results for the parameters listed in Part I, Section A — "Effluent
Limitations and Monitoring Requirements — Final" to be performed annually by a North
Carolina Certified Laboratory
O Inspections of septic tank and disinfection/dechlorination apparatus (if applicable)
Thank you in advance for your cooperation. Should you have any questions concerning
this matter, please contact me at [phone].
Sincerely,
. i f►d 4 �
es B. Bealle III
Environmental Technician
enclosures
cc: Gaston County Environmental Health Department
Mooresville Regional Office One
610 East Center Avenue,Suite 301,Mooresville,North Carolina 28115 NorthCarolina Phone: [phone]/Fax:[phone]/Internet:h2o.enr.state.nc.us
An Equal Opportunity/Affirmative Action Employer—50%Recycled/10%Post Consumer Paper \?i1thh1uh1t'/f

C `Le .)
SOC PRIORITY PROJECT: No
To: Permits and Engineering Unit
Water Quality Section
Attention: Mack Wiggins
Date: June 23 , 1993
NPDES STAFF REPORT AND RECOMMENDATIONS
County: Gaston
NPDES Permit No. : NC0083381
MRO No. : 93-128
PART I - GENERAL INFORMATION
1 . Facility and Address : Robert E. Stroupe Residence
Post Office Box 1236
Bessemer City, N. C. 28016
2 . Date of Investigation: May 12 , 1993
3 . Report Prepared By: Michael L . Parker , Environ. Engr . II
4 . Person Contacted and Telephone Number : Mr . Robert Stroupe ,
(704) 263-4545
5 . Directions to Site: The residence is located on the right
(south) side of SR 1918 (Stanly-Lucia Rd. ) approx. 0 . 8 mile
east of the junction of SR 1918 and SR 1923 (Old NC 27) .
6 . Discharge Point (s) , List for all discharge Points : -
Latitude: 35° 21 ' 08"
Longitude : 81° 03 ' 55"
Attach a USGS Map Extract and indicate treatment plant site
and discharge point on map .
USGS Quad No. : F 14 SE
7 . Site size and expansion area consistent with application:
Yes .
8 . Topography (relationship to flood plain included) : Hilly,
5-15% slopes . The site is not in a flood plain.
9. Location of Nearest Dwelling: Two other dwellings are
located within 500 feet of the site. The nearest dwelling is
approx. 200 feet from the site.

Page Two
10 . Receiving Stream or Affected Surface Waters : Unnamed
Tributary to Stanley Creek
a . Classification: C
b. River Basin and Subbasin No. : Catawba 030833
c. Describe receiving stream features and pertinent
downstream uses : Flow was observed in the receiving
stream, which was approx . 1 foot wide and 1-3 inches
deep with a defined stream channel . Information from
the County H.D. indicates there may be an additional
SFR discharger (unpermitted) upstream of this facility
and there may be others downstream. The receiving
stream passes in close proximity to at least one other
residence before entering a pond.
PART II - DESCRIPTION OF DISCHARGE AND TREATMENT WORKS
1 . a. Volume of Wastewater: 0 . 00036 MGD (Design Capacity)
b. What is the current permitted capacity: N/A
c. Actual treatment capacity of current facility (current
design capacity) : Actual treatment capacity
is unknown. No information is available to the Division
that indicates actual treatment capacity.
d. Date(s) and construction activities allowed by previous
ATCs issued in the previous two years : N/A
e. Description of existing or substantially constructed
WWT facilities : The existing WWT facilities consist of
a 1000 gallon capacity septic tank followed by a
subsurface sand filter and tablet disinfection.
f . Description of proposed WWT facilities : N/A
g. Possible toxic impacts to surface waters : Chlorine is
added to the wastewater .
h. Pretreatment Program (POTWs only) : N/A
2 . Residual handling and utilization/disposal scheme : Residuals
are disposed of by a septage disposal contractor, when
necessary.
3 . Treatment Plant Classification: Less than 5 points; no
rating (include rating sheet ) . Class I
4 . SIC Code(s) : 9999
Wastewater Code(s) :
Primary: 04
Secondary :
5 . MTU Code(s) : 44007

Page Three
PART III - OTHER PERTINENT INFORMATION
1 . Is this facility being constructed with Construction Grant
Funds or are any public monies involved (municipals only)?
No •
2 . Special monitoring or limitations (including toxicity)
requests : None at this time .
3 . Important SOC/JOC or Compliance Schedule dates : N/A
4 . Alternative Analysis Evaluation
a. Spray Irrigation: Insufficient area .
b . Connect to regional sewer system: None available .
c. Subsurface: Poor Soils .
d. Other disposal options : N/A
PART IV - EVALUATION AND RECOMMENDATIONS
The applicant (Mr . Stroupe) requests issuance of an NPDES
Permit for the operation of a septic tank/sand filter WWT
facility that serves a three ( 3) bedroom SFR . According to Mr .
Stroupe, the WWT facility has been in operation for 25+ years and
was originally permitted by the Gaston County Health Department .
There has been no previous attempt by Mr . Stroupe to obtain a
Permit for this facility.
It appears that this facility meets the criteria for
issuance of a SFR General Permit . Eventually, upgrades may be
necessary in order for this facility to meet the conditions
and/or limitations contained in the GP . It is recommended that an
NPDES Permit be issued as requested.
teierte ‘0,3
S ' gnature Report Preparer •ate
�,'- •� - 6�f J
W r Qua y Regional pervisor Dy to

STATE OF NORTH CAROLINA
• , DEPARTMENT OF NATURAL AND ECONOMIC RESOURCES
RALEIGH, NORTH CAROLINA
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• RATING SCALE FOR CLASSIFICATION OF FACILITIES
Name of Plant: !LDi.✓' 'D f'G':,/^ r!- /ae.c/c�,c)c
Owner or Contact Person:
Mailing Address:• !1 d - cX /7 3
f r'S-r-f,-a/2 ri s ?ti•C • �u J'v
County: /9S7o,J Telephone: 7 V- 2 b3 —7$$—
NPDES Permit No. NC00 e3 5/ Nondisc. Per. No.
IssueDate: Expiration Date: •
Existing Facility C New Facility
Rated By: Al L'N.I'EL r 11/W6n Date: l_s 4 Z V
Reviewed (Train. & Cert.) Reg. Office
Reviewed (Train. & Cert.) Central Office
• ORC Grade
ITEM POINTS ITEM POINI
(1) Industrial Pretreatment Units and/or (4) PRIMARY TREATMENT UNITS • ,
Industrial Pretreatment Program (a) Septic Tank (see definition no. 43) 12
(see definition No. 33) 4 (b) Imhoff Tank `S
12) DESIGN FLOW OF PLANT IN GPD (c) Primary Clarifiers 5
(not applicable to non-contaminated cooling (d) Settling Ponds of Settling Tanks for Inorganic
• waters, sludge handling facilities for water Nontoxic Materials (sludge handling facilities
purification plants, totally closed cycle for water purification plants, sand, gravel,
systems (del. No. 11), and facilities stone,.and other mining operations except
consisting only of Item (4) (d) or Items (4) (d) recreational activities such as gem or gold
and (11) (d)) mining) 2
0 -- 2O 000 2 `
20,000 (5)SECONDARY TREATMENT UNITS
20,001 0,001 -• 100,000 (a) Carbonaceous Stage .
3 (i)Aeration - High Purity Oxygen System 20
100,001 •- 250,000 4 Diffused Air System 1 d
250,001 •• 500,000 5 Mechanical Air System (fixed,
500,001 ••1.000,000 8 floating or rotor) 8
1,000.001 --2,000,000 10 Separate Sludge Reaeration 3
2.000,001 (and up) - rate I point additional for each (ii) Trickling Filler
200,000 gpd capacity up to a _ High Rate 7
maximum of 30 Standard Rale 5
Packed Tower S
Design Flow (gpd) : (iii) Biological Aerated Filler or Aerated
Biological Filler 1 0
(iv) Aerated Lagoons 10
(v) Rotating Biological Contactors 10
f;3) PRELIMINARY UNITS (see definition no. 32) •
(vi) Sand Fillers-
(a) Bar Screens 1 intermittent biological (-2)
or recirculating biological 3
(vii) Stabilization Lagoons 5
(b) Mechanical Screens, Static Screens or v
Comminuting Devices 2 ( im)Clarilier 5
(c) Grit Removal 2 (ix) Single stage system for combined
or carbonaceous removal of 80D and
(d) Mechanical or Aerated Grit Removal nitrogenous removal by nitrification
2 (see def. No. 12) (Points for this item
(e) Flow Measuring Device 1 have to be in addition to items (5) (a)
Of
(1) Instrumented Flow Measurement (i)through (5) (a) (viii) 8
(g)Palmation2 removal
(x) Nutrient additions to enhance 80D
5
(h) Influent Flow Equalization 2 (xi) Biological Culture ('Super Bugs') addition
_ (i) Grease or Oil Separators• Gravity 2 to enhance organic compound removal 5
Mechanical 3
Dissolved Air Flotation. a
07 Prethlorination 5

s.
(i) Aeration • High Purity Oxygen System 20 (i) Sludge Holding Tank - Aerated 5
Diffused Air System 10 ' Non�
Mechanical Air System (fixed, {(not i rated 2
G
floating. or rotor) 8 ) Sludge Incinerator - not ncluding activated
Carbon regeneration) 10
Separate Sludge Reaeration 3 (k) Vacuum Filter. Centrifuge or Filter Press or other
(ii) Trickling Filter - similar dewatering devices
High Rate 7 10
Standard Rate 5 (8) SLUDGE DISPOSAL (including incinerated ash)
Packed Tower 5 (a)Lagoons 2
(iii) Biological Aerated Fitter or Aerated (b) Land Application (surface and subsurface)
Biological Filler 10 (see definition 22a)
(iv) Rotating Biological Contactors 10 -where the facility holds the land app. permit . . , 10
(v) Sand Filter- •by contracting to a land application operator who
intermittent biological 2 holds the land application permit
recirculatingbiological 3 2
og -land application of sludge by a contractor who does
(vi) Clarifier 5 not hold the permit for thi wastewater treatment
facility where the sludge is generated 10
(6) TERTIARY OR ADVANCED TREATMENT UNIT (c) Landtilled(burial)
(a) Activated Carbons Beds - (9) DISINFECTION 5
without carbon regeneration 5 (a) Chlorination
with carbon regeneration 15 (b) Dechlorination 5
(b) Powdered or Granular Activated Carbon Feed - (c) Ozone 5
without carbon regeneration 5 (d) Radiation 5
with carbon regeneration 15 (10) CHEMICAL ADDITION SYSTEM (S) (See definition No. 9)
(c) Air Stripping 5 (not applicable to chemical additions rated as item
(d) Denitrification Process (separate process) 10 (3) (j). (5) (a) (xi), (6) (a), (6) (b), (7) (b), (7) (e),
(e) Electrodialysis » 5 (9) (a), (9) (b). or (9) (c) 5 points each: List:
(f) Foam Separation 5
(g) Ion Exchange 5 5
(h) Land Application of Treated Effluent 5
S
(see definition no. 22b) (not applicable for � 5
sand, gravel, stone and other similar mining (11) MISCELLANEOUS UNITS
: operations) (a) Holding Ponds, Holding Tanks or Settling Ponds
:Si) on agriculturally managed sites (See def. for Organic or Toxic Materials including wastes
No.4) 10 from mining operations containing nitrogen and/or
(ii) by high rate infiltration on non-agriculturally phosphorous compounds in amounts significantly
managed sites (includes rotary distributors greater than is common for domestic wastewater 4
and similar fixed nozzle systems) 4 (b) Effluent Flow Equalization (not applicable to storage
(iii) by subsurface disposal (includes low pressure basins which are inherent in land application systems). 2
pipe systems and gravity systems except at (c) Stage Discharge (not applicable to storage basins
plants consisting of septic tank and nitrifica- inherent in land application systems 5
lion lines only) ' 4 (d) Pumps...__ .•_.,» _»»
(i) Microscreens 5 (e) Stand-By Power Supply...»_._»...»...»._».....-». 3
(j) Phosphorus Removal by Biological Processes (f) Thermal Pollution Control Device 3
(See def.No.26) 20
(k) Polishing Ponds • without aeration 2
with aeration 5 •
(I) Post Aeration • cascade 0
diffused or mechanical . . . 5
(m) Reverse Osmosis 5 TOTAL POINTS
(n) Sand or Mixed-Media Fillers -low rate 2
high rate 5 CLASSIFICATION
(o) Treatment processes for removal of metal or
cyanide 15 Class I._.» .».». S - 25 Points
(p) Treatment processes for removal of toxic Class II.. _.... ., ..» 26. 50 Points
materials other than metal or cyanide 15 Class III._.....-------.---. 51. 65 Points
Class IV._....»_..._»»»•_„•• 66• Points
P) SLUDGE TREATMENT »
Facilities having a rating of one through four points, inclusive,
(a) Sludge Digestion Tank - Heated 10 do not require a certified operator. Classification of all other
Aerobic...._ 5 facilities requires a comparable grade operator in responsible
Unheated 3 charge.
(b) Sludge Stabilization (chemical or thermal) 5
(c) Sludge Drying Beds - Gravity 2 Facilities having an activated sludge process will be assigned
Vacuum Assisted 5 a minimum classification of Class II.
(d) Sludge Elutriation 5
(e) Sludge Conditioner (chemical or thermal) 5 Facilities having treatment processes for the removal of metal
(I) Sludge Thickener(gravity) 5 or cyanide will be assigned a minimum classification of Class II.
(g) Dissolved Air Flotation Unit
(not applicable to a unit rates as (3) (i) 8 Facilities having treatment processes for the biological removal
(h) Sludge Gas Utilization (including gas storage) . . . . 2 of phosphorus will be assigned a minimum classification of Class`
III.

e of North Carolina �(ti0
Department of Environment, Tx-m-A6�j
Health and Natural Resources •
Division of Environmental Management
�� . , Jonathan James B. HuntBH7owes Secreta Jr. Govern r
Secretary r � HNR.
. A. Preston Howard, Jr., P.E., Director
AsimmidiJAmmmemm
- 1 II a DEFT. OF NATURAL
tq 7 RESOURCES AND
Al) �J 'COMMUNITY DEVELOPMENT
1 r (1-
'd JUN 1 6 1993
June 14, 1993 $IYISION OF ENYIRONIAE"TAl h',ANAGEME111
MOORESVILLE REGIONAL OFFICE
Robert E. Stroupe Subject: NPDES Permit Application
Po Box 1236 NPDES Permit No.Nc0083381
Bessemer City, NC 28016 Stroupe Residence
Dear Mr. Stroupe Gaston County
This is to acknowledge receipt of the following documents on May 14, 1993 :
Application Form
Engineering Proposal (for proposed control facilities) ,
Request for permit renewal,
Application Processing Fee of $240 . 00,
Engineering Economics Alternatives Analysis ,
Local Government Signoff,
Source Reduction and Recycling,
Interbasin Transfer,
Other ,
The items checked below are needed before review can begin:
Application Form ,
Engineering proposal (see attachment) ,
Application Processing Fee of
Delegation of Authority (see attached)
Biocide Sheet (see attached)
Engineering Economics Alternatives Analysis, .
Local Government Signoff,
Source Reduction and Recycling,
Interbasin Transfer,
Other
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

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,
7 :40)CC• Mooresville Regional Officens, P.E.

1,q6c,)
evlw
NORTH CAROLINA DEPARTMENT OF NATURAL RESOURCES AND COMMUNITY DEVELOPMENT
ENVIRONMENTAL MANAGEMENT COMMISSION
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
APPLICATION FOR PERMIT TO DISCHARGE - SHORT FORM D-SFR FOR AGENCY USE
L� DATE RECEIVED
93I os ) 'y
YEAR MONTH DAY
TO BE FILED BY SINGLE FAMILY RESIDENCES ONLY et( i# O39 /
Z• a(/0.o-15
FEES: NEW APPLICATION
$240 PERMIT MODIFICATION $240 c fp
PERMIT RENEWAL $240 PERMIT NAME CHANGE $50 UV
1 . Mailing address of applicant: -ter
A. Name Pobefvf
�'1/Zo�/o�
B. Street Address ��l7, �p)L )7-3b mrr
'
••7�i
C. City Ae6.scvii01- �/ �7 p
D. County 674STDA/
E ZIP Code
F. Telephone No. (Home) AREA
2 �/3' ,(9'S� (Work) 7DG �2? 3•'
CODE AO A
CODE
2. Location of residence producing discharge:
A. Street Address and State Road # 11 f s%fj/I(� �- [�C�,g a,4 ,
A(1) Parcel/Lot # Deed Book #/Page# /
B. City
C. County t)/--Siva
D. ZIP Code 2g1C 7
3. This NPDES Permit application applies to which of the following (check appropriate space):
A. New or Proposed
B. Existing Unpermitted
C. Existing Renewal
D. Modification
E Renewal w/ Modification
Description of Modification
4. Number of bedrooms at residence: Number of Homes on System: /
5. Type of system being used to treat wastewater (check appropriate space):
A. Septic Tank and Sand Filter
B. Septic Tank, Dual or Recirculating Sandfilters, Cascade Reaeration
C. Conventional Septic Tank _
D. Other (describe treatment)
6. Does your treatment system have chlorination? Yes No
(continued on back)
Short Form D-SFR
Revised 3/93

7. Name of receiving water or waters which will accept the discharge &OA J�D /1411G
8. Is any activity being performed at the residence which would generate pastes other than domestic wastes,
such as photographic processing? Yes No }L
If yes, please explain;
I certify that I am familiar with the infui rnation contained in the
application and that to the best of my knowledge and belief such
information is true, complete and accurate.
Printed Name of Person Signing
/40inc D UJ)CN
Title (homeowner, etc.)
4--//-9 3
Date Application Signed
/ 1/.// f?(
Signature of Applicant
,�- e oily 4Fr
Mali three copies of the completed application, a map or drawing showing the location of
discharge, along with the appropriate processing fee to:
DIVISION OF ENVIRONMENTAL MANAGEMENT
WATER QUALITY SECTION - PERMITS & ENGINEERING UNIT
ATTENTION: NPDES GROUP
POST OFFICE BOX 29535
RALEIGH, NORTH CAROLINA 27626-0535
North Carolina General Statute 143-215.6(B) provides that: Any person who knowingly mt
any false statement, representation, or certification In any application, record, report,
or other document flied or required to be maintained under Article 21 or regulations of
Environmental Management Commission implementing that Article, or who falsifies, tarr
with, or knowingly renders inaccurate any recording or monitoring device or method rec
to be operated or maintained under Article 21 or regulations of the Environmental Manage
Commission implementing that Article, shall be guilty of a misdemeanor punishable by a
not to exceed $10,000, or by imprisonment not to exceed six months, or by both, (18 U.:
Section 1001 provides a punishment by a fine of not more than $10,000 or imprisonment
more than 5 years, or both, for a similar offense).
Short Fnrm fl_CGR

Page 1
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1114 Stanley Lucia Road, Stanley, NC 28164

LX�
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
HVA
MOORESVILLE REGIONAL OFFICE
NCDENR DIVISION OF WATER QUALITY
June 3, 1999
JAMES B.HUNT JR.
GOVERNOR Robert E. Stroupe or Current Occupant
Post Office Box 1236
Bessemer City,North Carolina 28016
WAYNE MODE V ITT
Subject: Wastewater Discharge Permit
SECRETARY
Robert E. Stroupe Residence
NPDES Permit No. NCG550000
Cert. of Coverage No.NCG550639
Gaston County,NC
Dear Mr. Stroupe or Current Occupant:
Our files indicate that the subject wastewater discharge permit was issued to
Robert E. Stroupe for a wastewater discharge from the subject residence. Division records
indicate that the permit has not been renewed as required. Please contact the Mooresville
., � Regional Office immediately to clarify if the permit is still required for the
residence. According to North Carolina General Statute 143-215.1 (a), no person shall
operate any sewer system, treatment works, or disposal system within the State without
a permit.
Pursuant to NCGS 143-215.6A, a civil penalty of not more than ten thousand
f dollars ($10,000.00) or ten thousand dollars ($10,000.00)per day if the violation is of a
continuing nature, may be assessed against any person who is required but fails to apply
for or secure a permit required by NCGS 143-215.1, or who violates or fails to act in
1 a accordance with the terms, conditions, or requirements of any permit required by NCGS
143-215.1.
Please contact Linda Love at [phone] to resolve this matter.
Sincerely,
D. Rex Gleason, P.E.
Water Quality Regional Supervisor
-.aftt cc: Gaston County Health Department
17 4, 919 NORTH MAIN STREET, MOORESVILLE, NORTH CAROLINA 28115
y PHONE [phone] FAX [phone]
e ., AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER-50%RECYCLED/10%POST-CONSUMER PAPER
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,i
of North Carolina
apartment of Environment,
ealth and Natural Resources ;4 _ 4 • •
1,
Division of Environmental Management : :,;
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary ,
A. Preston Howard, Jr., P.E., Director
,, • ?C 1.4 AND
OMMU;N?'rY DEVELOPMENT
September 30,1993 J, 2 99?3
MNIS:;;i SF tAIrP,thEE L AM.G1MEKT
ROBERT E STROUPE ldbd:tE.M.LE Riala Gf1IFE
STROUPE, ROBERT E.(RESIDENCE)
PO BOX 1236
BESSEMER CITY NC 28016 Subject: STROUPE, ROBERT E.(RESIDENCE)
Certificate of Coverage NCG550639
General Permit NCG550000
Formerly NPDES Permit NC0083381
Gaston 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
NC0083381. 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

age 2
ROBERT E STROUPE
STROUPE, ROBERT E.(RESIDENCE)
Certificate of Coverage No. NCG550639
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,
A.Preston Howar .,P.E.
�
cc: Mooresville Regional Office
Central Files

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATUR4I,RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT" 'lsrr OF Ni.
_4 9 VEL01.., :,ci,
GENERAL PERMIT NO. NCG550000 `r k ' a >j
CERTIFICATE OF COVERAGE No.NCG53�.
t
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,
STROUPE, ROBERT E.(RESIDENCE)
is hereby authorized to discharge treated domestic wastewater from a facility located at
STROUPE, ROBERT E.(RESIDENCE)
Gaston County
to receiving waters designated as the UT TO STANLEY CREEK/CATAWBA 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.
46)a`".4°C--- r' /
d..
A.Preston Howar•,Jr.,P.E.,Director
Division of Environmental Management
By Authority of the Environmental Management Commission