NCG550692_permit issuance_20090318

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RCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue, Governor
Jeff Miller
P.O. Box 1621
Brevard, NC
Dear Permittee:
28712-1621
Division of Water Quality
Coleen H. Sullins, Director
March 18, 2009
Dee Freeman, -Secretary
Subject: Renewal of coverage / General Permit NCG550000
64 Cassell Rd
Certificate of Coverage NCG550692
Transylvania County
In accordance with your renewal application [received on March 16, 20091, the Division is renewing
Certificate of Coverage (CoC) NCG550692 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 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 Asheville Regional Office prior to any sale or transfer of the permitted facility.
Regional Office staff will assist you in documenting the transfer of this CoC.
This permit does not affect the legal requirements to obtain other permits which may be required by
the Division of Water Quality or permits required by the Division of Land Resources, Coastal Area
Management Act. or any other Federal or Local governmental permit that may be required.
If you have any questions concerning the requirements of the General Permit, please contact Charles
Weaver of the NPDES staff [919 807-6391 or [e-mail]].
Sincerely,
01M
au,
for Coleen H. Sullins
cc: Central Files
Asheville Regional Office / Surface Water Protection
NPDES file
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
512 North Salisbury Street, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Intemet: www.ncwaterquality.org
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NorthCarolina
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STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG550692
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,
Jeff Miller
is hereby authorized to discharge domestic wastewater [625 GPD] from a facility located at
64 Cassell Rd
Brevard
Transylvania County
to receiving waters designated as Peter Weaver Creek, a class C-Trout stream in subbasin 04-03-
01 of the French Broad River Basin in accordance with the effluent limitations, monitoring
requirements, and other conditions set forth in Parts I, II, III and IV hereof.
This certificate of coverage shall become effective March 18, 2009.
This Certificate of Coverage shall expire on July 31, 2012.
Signed this day March 18, 2009.
fo,CeeAfl "i
n H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND Nmr L REsouRLEs
Division of Water Quality / Water Quality Section
National Pollutant Discharge Elimination System
NCG550000
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
Certificate of Coverage
NCG
Check # Amount
Permit Assigned to
RENEWAL FORM FOR EXISTING PERMITTED FACILITIES
NPDES renewal application for continued coverage under General Permit NCG550000:
Certificate of Coverage NCG55
(Please verify the information in items I & 2 as correct, or note any corrections that should be made.)
(Please print or type)
1) Mailing address' of property owner:
Owner Name �-� , 1 l l
Street Address j� d • �Je? (�i
City at VOL VO iV V -7
Telephone (Hom��ee �(y� � JN� (Mobile)
(e-mail address) ` l e r head ° 0
Address to which all permit correspondence will be mailed
2) Location of facility producing discharge*:
Street Address CLC-SSi I r
City: B a va
EC-MED
MAR 16 2009
RO( DENR -WATER pUAUTY
POINT SOURCE BRANCH
County
Telephone (Home) �0 + (Mobile)
* If the facility is not: yet constructed, give the street address or lot number where the structure will
be built.
3) Description of Discharge:
a) Type of facility producing waste (please check one):
❑ Primary residence
❑ Vacation/second home
❑ Undeveloped property
Other [describe]: W-i�s
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NCG550000 renewal form
4) Please check the components that comprise the wastewater treatment system:
.Septic tank ❑ Dosing tank ❑ Primary sand filter ❑ Secondary sand filter
❑ Recirculating sand filter(s) '8f Chlorination ❑ Dechlorination
❑ Other form of disinfection: ❑ Post Aeration (describe)
5) Other Information:
a) When was the septic tank last pumped out?,
NOTE: the septic tank must be pumped out at least once ever, 3-5 years
b) Is the facility [home] occupied year-round, or only seasonally? LJA
'r— r-ouYId
c) Approximately how many people use the facility when it is occupied?�
d) When was the wastewater system installed? I 1 9 1
6) Certification:
I certify that I am familiar with the information contained in this application and that to the best
of my knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing: U All,
CJl
-1
r✓l�l.�
Applicant)
North Carolina General Statute 143-215.6 b (i) provides that:
(Date Signed)
Any person who knowingly makes any false statement, representation, or certification in any
application, record, report, plan or other document filed or required to be maintained under
Article 21 or regulations of the Environmental Management Commission implementing that
Article, or who falsifies, tampers with or knowingly renders inaccurate any recording or
monitoring device or method required to be operated or maintained under Article 21 or
regulations of the Environmental Management Commission implementing that Article, shall be
guilty of a misdemeanor punishable by a fine not to exceed $25, 000, or by imprisonment not to
exceed six months, or by both. (18 U.S.C. Section 1001 provides a punishment by a fine of not
more than $25, 000 or imprisonment not more than 5 years, or both, for a similar offense.)
Mail this completed form and a copy of the receipt for your last septic service to:
Mr. Charles H. Weaver, Jr.
NC DENR / DWQ / NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
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