NCG550797_Regional Office Historical File Pre 2018

TWO RIVERS LAB REPORT
UTILITIES
We are TR U to our customers!
Date: 5/14/19
Attn: Teresa Painter
Address: 1125 West Catawba Avenue
Mt.Holly,NC 28120
The following analytical results have been obtained for the indicated samples which were submitted to this laboratory:
Sample ID Sample Date Parameter Analysis Result Units Date Tested
Total residual 20 u I 5/8/2019Homeowners effleunt 5/8/2019 chlorine
Homeowners effleunt 5/8/2019 Fecals 22 cfu/100 ml 5/8/2019
Homeowners effleunt 5/8/2019 TSS 4.7 mg/I 5/9/2019
Homeowners effleunt 5/8/2019 BOD 7.8 mg/I 5/8/2019
Sample Comments: All samples were grab samples taken from 9:45 am to 10:23 am
Total residual chlorine was sampled at 10:21 am and not tested until 12:00 pm
(IAA l' (- / � 1 c
ftaKei e /�c/�l ✓✓✓
Crowders Creek Laboratory
NC Certification No. 210

'7'' T p C City of Gastonia-Crowders Creek Laboratory
1 V V O VE 5642 South York Road,Gastonia,NC 28054 Chain of Custody Record
U r I LIT I E 3 Phone: [phone]
We are iR U to our customerst Fax [phone]
Client Name: "C-e. rre6c` 'R 6.4104.Crecs / Attention:
Address: k\. 5 NNjrr!.. Cgr ,L ,Jetc ....../' `E'e• Email: . G25,5C% mc.,�l.f...c4.. .-!.......
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Preferred method of reporting(circle /herd copy I other(specify):
MCMx Code Semi is Collection Semple Corteh.r Preservative Analysts Requested
Lab ID Sample Identification ! Ys
Identification oi,swinsi 'ow yH
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t"1O.,t'°..-IniN Semple Type Cantan.rType
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Additional Comments: _rj' C L�/�l/21uy9 n_ 35 i
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NC Laboratory CertiflCation Nu tubber. o _ —7 -i Document* WCR-0101.190A
SC Laboratory CerbYlcation Number:9
90
60001 ReNelon Date: 07/03/12
Revision#: 0
Page of

TO: Billing Administrator
FROM: Annette McMurray,Laboratory Supervisor
DATE:5/14/19
SUBJECT:Teressa Painter
Laboratory Testing for samples received 5/8/19
• Billing Period:30 Days of receipt
• Total Customer Charge:$50.00
Please forward this bill to: Teressa Painter
1125 West Catawba Ave.
Mt. Holly, NC 28120
%.,;z ?C.ireak• : 6) •-•141 PkCjg "5--4‘‘—
euiace() by ..c-S_Joorr, Qc 5-i4-lq

r - ROY COOPER
- Governor
t.::1
y .
MICHAEL S. REGAN
Secretary
Environmental S. JAY ZIMMERMAN
Quality Director
June 6, 2017
Ms. Teresa Painter
1125 West Catawba Ave
Mount Holly,NC 28120
Subject: Compliance Evaluation Inspection
1125 West Catawba Ave.
Certificate of Coverage No.NCG550797
Gaston County
Dear Ms. Painter:
Enclosed is a copy of the Compliance Evaluation Inspection for the inspection conducted
at the subject facility on May 31, 2017, by Ori Tuvia. Your cooperation during the site visit was
much appreciated.
The following areas should be corrected:
1) Could not verify appropriate chlorine tablets are used in the chlorinator.
2) Change of name on the permit is needed, form was given during the inspection.
The report should be self-explanatory; however, should you have any questions
concerning this report, please do not hesitate to contact Ori Tuvia at(704) 235-2190, or at
ori.tuviaancdenr.gov
Sincerely, .
Ori Tuvia, Environmental Engineer
Mooresville Regional Office
Division of Water Resources,DEQ
Cc: NPDES Unit,
MRO Files
•
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

Fr
United States Environmental Protection Agency
Forrn 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 L 2 I5 3 I NCG550797 111 12 I 17/05/31 117 18 I r•I 19 I I 20 u
21I I I I I I I I I I II I I I I I I I I I I I I I I I I I I I I I I I II I I � I I r6
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA Reserved
6711.0 I 70 i, i 71 Nil J i 72 [ N I 73 I 174 751 I I I I I I 180
L_1 Section B:Facility Data LJ 1
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) 01:45PM 17/05/31 13/08/01
1125 West Catawba Avenue
1125 W Catawba Ave Exit Time/Date Permit Expiration Date
Mount Holly NC 28120 02:10PM 17/05/31 18/07/31
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
Douglas Painter,1125 W Catawba Ave Mount Holly NC 2 81 20//704-827-3 5 1 5/
No
Section C:Areas Evaluated During Inspection(Check only those areas evaluated)
III Permit El Operations&Maintenance Records/Reports •Self-Monitoring Program
Facility Site Review 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
Ori A Tuvia RO WQ//704-663-1699/
/6 / I�
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.a ��'
Ge.sut if/1-
Page# 1

NPDES yr/mo/day Inspection Type 1
31 NCG550797 111 121 17/05/31 117 18 I c
Section D:Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
c ,
Page# 2

Permit: NCG550797 Owner-Facility: 1125 West Catawba Avenue
Inspection Date: 05/31/2017 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 • ❑
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? 0 0 IN 0
Is the inspector granted access to all areas for inspection? III 0 0 0
Comment: The subject permit expires on 07/31/2018.
A change of name is needed (change of name form was given during the inspection).
Record Keeping Yes No NA NE
Are records kept and maintained as required by the permit? • 0 0 0
Is all required information readily available,complete and current? • 0 0 0
Are all records maintained for 3 years(lab. reg. required 5 years)? 0 0 0 •
Are analytical results consistent with data reported on DMRs? 0 0 II 0
Is the chain-of-custody complete? 0 0 0 III
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? • ❑ ❑ 0
Has the facility submitted its annual compliance report to users and DWQ? 00110
(If the facility is=or>5 MGD permitted flow)Do they operate 24/7 with a certified operator ❑ ❑ • ❑
on each shift?
Is the ORC visitation log available and current? 0 0 II ❑
Is the ORC certified at grade equal to or higher than the facility classification? 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? • 0 0 0
Facility has copy of previous year's Annual Report on file for review? ❑ 0 III 0
Comment: Two Rivers Utilities perform annual sampling.
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? • ❑ 0 0
Page# 3

Permit: NCG550797 Owner-Facility: 1125 West Catawba Avenue
Inspection Date: 05/31/2017 Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Does the facility analyze process control parameters,for ex: MLSS, MCRT,Settleable 0 0 • 0
Solids, pH, DO,Sludge Judge, and other that are applicable?
Comment: The sand filter been redone
Septic Tank Yes No NA NE
(If pumps are used)Is an audible and visual alarm operational? ❑ 0 • ❑
Is septic tank pumped on a schedule? • ❑ 0 0
Are pumps or syphons operating properly? ❑ 0 • 0
Are high and low water alarms operating properly? 0 ❑ I 0
Comment: Septic tank was pumped in the past 5 years.
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? ❑ ❑ ❑ •
Is sand filter free of ponding? • ❑ ❑ 0
Is the sand filter effluent re-circulated at a valid ratio? 0 ❑ II ❑
#Is the sand filter surface free of algae or excessive vegetation? • 0 ❑ ❑
#Is the sand filter effluent re-circulated at a valid ratio?(Approximately 3 to 1) 0 0 ❑ III
Comment:
Disinfection-Tablet Yes No NA NE
Are tablet chlorinators operational? ❑ 0 • 0
Are the tablets the proper size and type? 0 0 • 0
Number of tubes in use?
Is the level of chlorine residual acceptable? 0 ❑ • 0
Is the contact chamber free of growth, or sludge buildup? ❑ ❑ • 0
Is there chlorine residual prior to de-chlorination? ❑ 0 • ❑
Comment: Could not verify during the inspection.
Effluent Sampling Yes No NA NE
Is composite sampling flow proportional? ❑ ❑ • 0
Is sample collected below all treatment units? I 0 ❑ 0
Is proper volume collected? 0 ❑ II 0
Is the tubing clean? 0 0 • 0
Page# 4

Permit: NCG550797 Owner-Facility: 1125 West Catawba Avenue
Inspection Date: 05/31/2017 Inspection Type: Compliance Evaluation
Effluent Sampling Yes No NA NE
#Is proper temperature set for sample storage(kept at less than or equal to 6.0 degrees 0 0 • 0
Celsius)?
Is the facility sampling performed as required by the permit(frequency,sampling type 0 0 II 0
representative)?
Comment: The subject permit requires grab sampling.
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 • ❑
Comment: The effluent pipe was discharging a small amount at the time of the inspection.
Page# 5

FILE ROY COOPER
Governor
•
MICHAEL S. REGAN
Secretary
r
Environmental S. JAY ZIMMERMAN
Quality Director
May 5, 2017
Mr. Douglas Painter or current tenant
1125 West Catawba Ave
Mt Holly,NC 28120
Subject: Compliance Evaluation Inspection
1125 West Catawba Ave
Certificate of Coverage No. NCG550797
Gaston County
Dear Mr. Painter or current tenant:
Please be advised that NCDEQ inspector will be coming to inspect subject permit on
May 31, 2017, at about 2 PM. 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 [e-mail].
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

NIZ ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
Environmental S. JAY ZIMMERMAN
Quality Director
May 5, 2017
Mr. Douglas Painter or current tenant
1125 West Catawba Ave
Mt Holly,NC 28120
Subject: Compliance Evaluation Inspection
1125 West Catawba Ave
f , Certificate of Coverage No. NCG550797
Gaston County
Y Dear Mr. Painter or current tenant: '`'
t., '" Please be advised that NCDEQ inspector will be coming to inspect subject permit on ;
toy.
May 31, 2017, at about 2 PM. Your presence during the inspection is advised to discuss ;a.,.
� , compliance with the conditions listed in subject permit. r
t
.y
h If you wish to reschedule or have any questions, please contact Ori Tuvia at (704) 235-
2190, or via email at [e-mail].
Sincerely,
atME
Environmental Engineer
Mooresville Regional Office
Division of Water Resources, DEQ
i)
Mooresville Regional Office ii
Location:610 East Center Ave.,Suite 301 Mooresville,NC 28115 ._1
Phone[phone] I Fax:[phone] Customer Service 1-877-623-6748 " ';

RECENEDlNCDENRIDWR
TWO VE LAB REPORT JUL 1 0 2015
UTILITIES
ROADS
We are TRU to our customers! MOORESVIL E REaG1ONAL OFFICE
Date: 6/29/15
Attn: Teresa Painter
Address: 1125 West Catawba Avenue
Mt. Holly, NC 28120
The following analytical results have been obtained for the indicated samples which were submitted to this laboratory:
Sample ID Sample Date Parameter Analysis Result Units Date Tested
Homeowners effleunt 6/22/2015 Total residual 5.5 mg/I 6/22/2015
chlorine
Homeowners effleunt 6/22/2015 Fecals <100 cfu/100 ml 6/22/2015
Homeowners effleunt 6/22/2015 TSS <16.6 mg/I 6/23/2015
Homeowners effleunt 6/22/2015 BOD 4.2 mg/I 6/22/2015
Sample Comments: All samples were grab samples taken from 8:00 am through 11:00 am
Total residual chlorine was sampled at 10:05 and not tested until 12:41 pm.
,4iriette Ae/f as
Crowders Creek Laboratory
NC Certification No. 210
Page 1 of 1

Flow Report
Fites Creek
1125 W Catawba Ave
Mount Holly, NC
Date Ban_ Amami
AM EM Hour;
"1 - 15 X 6.51 -75/ Ow nz,
tt—i z -1,5 ( iaod- 13o 14 VI- o z -
Comments

FILE
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald R. van der Vaart
Governor Secretary
May 27, 2015
Ms.Teresa Painter
1125 West Catawba Avenue
Mount Holly,North Carolina 28120
Subject: Compliance Evaluation Inspection
Painter Single Family Residence
COC#NCG550797
Gaston County
Dear Ms.Painter:
Enclosed is a copy of the Compliance Evaluation Inspection report(CEI)for the inspection
conducted at the subject facility on May 20,2015 by Mr.Barry Love with this Office. Thank you for your
assistance and cooperation during the inspection.
The report should be self-explanatory. Please take special note of the comments sections for things
which need to be addressed. No analytical results were available at the time of the inspection. The permit
requires annual monitoring of the system. Please provide a copy of the analytical results when available.
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 me at(704)-663-1699.
Sincerely,
Barry Love,Environmental Specialist
Mooresville Regional Office
Water Quality Regional Operations Section
Division of Water Resources,NCDENR
Cc: MRO SFR-Painter
Central Files
Mooresville Regional Office,610 East Center Avenue,Suite 301,Mooresville,NC 28115
Phone:[phone]\Internet:www.ncwaterquality.org
An Equal Opportunity\Affirmative Action Employer-Made in part by recycled paper

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
2 Li 3 NCG550797 I11 121 15/05/20 117
18 L.J, 19 LI 201
21111I I I I I I I II 1 I I I I I I I I I I I I I I I I I I I I I I II I I I I I l66
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA -- —Reserved-------
67 I 70 Li 71 Li
72 LJ ti I 731
I" 751 I I I I I I 180
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) 03:55PM 15/05/20 13/08/01
1125 West Catawba Avenue
Exit Time/Date Permit Expiration Date
1125 W Catawba Ave
04:55PM 15/05/20 18/07/31
Mount Holly NC 28120
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
Douglas Painter,1125 W Catawba Ave Mount Holly NC 28120//704-827-3515/
No
Section C:Areas Evaluated During Inspection(Check only those areas evaluated)
El Permit Operations&Maintenance Records/Reports Facility Site Review
III 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
Barry F Love MRO WQU704-663-1699 Ext.263/
Signature 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

11 NPDES yr/mo/day Inspection Type 1
31 NCG550797 111 121 15/05/20 117 18 Isj
Section D:Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
Page# 2

Permit NCG550797 Owner-Facility: 1125 West Catawba Avenue
Inspection Date: 05/20/2015 Inspection Type: Compliance Evaluation
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: Analytical sampling has not been done. The permit requires annual analytical sampling. A
list of labs was provided to the permittee.
The permittee had the proper chlorine tablets, but stated she had trouble removing the
concrete cover. She was advised that it would be acceptable to switch to a lighter weight
cover.
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new ❑ ❑ • ❑
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? ❑ ❑ � ❑
Is the inspector granted access to all areas for inspection? • ❑ ❑ 0
Comment:
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? ❑ ❑ I ❑
Comment: The effluent pipe was discharging a small amount at the time of the inspection.
Septic Tank Yes No NA NE
(If pumps are used)Is an audible and visual alarm operational? 0 0 I 0
Is septic tank pumped on a schedule? II 0 ❑ 0
Are pumps or syphons operating properly? ❑ ❑ • 0
Are high and low water alarms operating properly? ❑ ❑ ID
Comment: Septic tank was last pumped on 7/17/13 by Stanley Environmental Solutions.
Sand Filters (Low rate) Yes No NA NE
(If pumps are used) Is an audible and visible alarm Present and operational? 011110
Is the distribution box level and watertight? ❑ ❑ ❑ •
Is sand filter free of ponding? • ❑ ❑ ❑
Page# 3

Permit: NCG550797 Owner-Facility: 1125 West Catawba Avenue
Inspection Date: 05/20/2015 Inspection Type: Compliance Evaluation
Sand Filters (Low rate) Yes No NA NE
Is the sand filter effluent re-circulated at a valid ratio? ❑ 0 0 II
#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 II
Comment: The sand filter has a removable cover over it. The owner has had trouble with stormwater
getting into the sandfilter and has dug a trench on the uphill side to try to route rainwater
around it.
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? ❑ U 0 ❑
#Is the facility using a contract lab? 0 • 0 0
#Is proper temperature set for sample storage(kept at less than or equal to 6.0 degrees ❑ 0 � ❑
Celsius)?
Incubator(Fecal Coliform)set to 44.5 degrees Celsius+/-0.2 degrees? ❑ ❑ • ❑
Incubator(BOD)set to 20.0 degrees Celsius+/-1.0 degrees? 0 ❑ I 0
Comment: Analytical sampling has not been done.
Page# 4

Inspection Date: S/',07 S Start T FT 3;5- r" End Time: Li- i _S—S
SINGLE FAMILY WASTEWATER SYSTEM CHECKLIST
10/28/2014
Permittee: '1:-e- r a S'I 1014. �� Permit:)/✓c- 6-S O 7 12
Address: I I �s W, C a 1 a bq A✓ —M f, FF-/� E-mail-
Phone:(20LO 12.7- 3 515 Cell Phone:( i�''1 ) S6 C- 5/3 11- County: G n s 4 o
The Permittee is responsible for the operation and maintenance of the entire wastewater treatment and disposal system.
Doesn't Did Not
Yes _. No Apply Investigate
1. Is the current resident in the home the Permittee? 12T ❑ ❑ ❑
2. If not does the resident rent from the permittee? ❑ ❑ ET ❑
3. Change of Ownership form needed? (mail the form with the inspection letter) ❑ ❑ ❑
4. Is there a inspection and maintenance agreement with a contractor? ❑ ❑ [2 ❑
5. If yes to#4 who is the contractor?
SEPTIC TANK The septic tank and filters should be checked annually and pumped/cleaned as nee .
6. Is all wastewater from the home connected to the septic tank? ❑ ❑ ❑
7. Does the permittee/resident know where the septic tan is loca d? [11C1 ❑ ❑
'2.18. Has the septic tank been pumped in the last 5 years. 2 O ) 3 )r:
9. If yes to#8 date, if known 2/7 3 If proof, describe - 4 n 1.7 46 N tfve M,w 4,
10. Does the septic tank have an EFFLUENT FILTER or SANITARY T? (circle one)���/ S�I���2 �'
11. If Ye to filter when was the filter cleaned? By who?
SAND ILTER REATMENT PODS YES ❑ NO ❑ If no proceed to the next section.
A filter surfaces shall be raked�pd leveled ev�six months and any vegetative growth shall be removed manually.
ft/c, ,h �P o s ,� ❑ ❑ ❑
12. Is system something other thyan a sapd filer? . jp 'Lela ( /
a i N i✓14 ,a..v _S Y vl o X(3 s -r 91'/i ✓r,3 O K b S ..l I1 W
13. If yes, what kind? (examples- Peat, Te the or brand name-Advantex, etc.)
14. Does the permittee know where the filter is? ❑ ❑ ❑ ❑
15. If above ground does the filter require maintenance? ❑ ❑ ❑ ❑
If maintenace is required explain in the comment section.
DISINFECTION/UV YES ❑ NO ❑ If no proceed to the next section.
The ultraviolet unit shall be checked weekly.The lamps and sleeves should be cleaned or replaced as needed to ensure proper disinfection.
16. Is UV working? ❑ ❑ 0 ❑
17. Has the UV Unit been serviced and bulbs cleaned? ❑ ❑ ❑ ❑
18. Who completes the weekly check for the UV?( Non-Discharge)
DISINFECTION/TABLETS YES ❑ NO ❑ If no proceed to the next section.
The tablet chlorinator unit shall be checked weekly to ensure continuous and proper operation.
19. Does the permittee have the correct chlorine tablets?(If none, mark No) lEf ❑ ❑ ❑
22. Does the Permittee know the location of the chlorinator? M ❑ ❑ ❑
2a2
23. Were chlorine tablets observed in the chlorinator? ❑ ❑
24. Are tablets contacting water? If possible poke them to determine. ❑ ❑ ❑
DECHLOR(Discharge only) YES ❑ NO ❑ If no proceed to the next section.
The dechlorinator unit shall be checked weekly to ensure continuous and proper operation.
25. Does the permittee know where the dechlor is? ❑ ❑ ❑ ❑
26. Does the permittee have the correct dechlor tablets? ❑ ❑ ❑ ❑
27. Were dechlor tablets observed in the dechlorination chamber? 0 0 0 0

DRAFT Doesn't Did Not
Yes No Apply Investigate
28. Are tablets contacting water? If possible poke them to determine. ❑ ❑ ❑ ❑
PUMP TANK YES ❑ ..NO ❑ If no proceed to the next section.
All pump and alarm sytems shall be inspected monthly. (non-discharge) -
29. Is the pump working? ❑ ❑ ❑ ❑
30. Is the audible and visual high wate rm operational? El ❑ ❑ ❑
31. Did the permittee know o check the pump& high water alarm? El ❑ ❑ ❑
32. Last functional test?
DISCHARGE ONLY YES El NO El If no proceed to the next section.
A visual review of the outfall location shall be executed twice each year(one at the time of sampling to ensure no v bl lids or evidence of a malfunction.
33. Does the permittee know where the outfall is? ❑ ❑ ❑
34. Were you able to locate the outfall? ID/ ❑ ❑ ❑
35. Is the end of the discharge pipe visible? If not, explain why. ❑ ❑ ❑
36. Is outlet discharging? lig / ❑ ❑ ❑
37. Is right of way maintained around the discharge point? ^/
38. Any Lab Results avail ��bl ?, . 4 ,, ,`7 P<n y w do U Kt - k at ❑ L] ❑ ❑
39. Is there evidence of soligs aroundf tiie dreharge point? ❑ ❑� ❑ ❑
DRIP or SPRAY YES ❑ NO ❑ If no proceed to the next section.
The irrigation sysetm shall be inspected monthly to ensure the system is free of leaks and equipment is operating as designed.
40. Is the system DRIP or IRRIGATION (circle one.)-?' If irrigation number of sprinkler heads.
41. Are the buffers adequate? ❑ ❑ ❑ ❑
42. Is the site free of ponding and r ? ❑ ❑ ❑ ❑
43. Does the application eq . ent appear to be working properly? ❑ El ❑ ❑
44. Is there a two wire fence? ❑ ❑ ❑ ❑
GENERAL
45. Are the treatment vp iS Iocke o,r'secured? / 1!-/ ❑� ❑ El ❑
c vav o✓e✓ S4noll, V� h�i_r.1 G�1/c YS(c A/o✓.iAa cvYt1q�J / ❑ ❑ ❑ ❑
37. Has resident had any ewage problems? If yes explain in the comment section.
37. Is the system compliant? I rl ❑ ❑ ❑
38. Is the system failing? If yes,take pictures if possible. CI III-- CI CI
39. If system is failing, any sign of children or animals contacting sewage? ❑ E ❑ ❑
Comments: Photos Taken? YES ❑ NO ❑
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NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald R. van der Vaart
Governor Secretary
May 4, 2015
Mr. Douglas Painter
1125 West Catawba Ave.
Mount Holly,NC 28120
Subject: Compliance Evaluation Inspection
Single Family Residence Wastewater
Treatment System
NPDES Permit No. NCG550797
Gaston County
Dear Mr. Painter:
•
Division of Water Resources (DWR) database records show that you currently own/operate a
single family residence (SFR) wastewater treatment and disposal system. Such being the case, it is
necessary to conduct a comprehensive inspection of your system and your records in order to verify
that your system is operating properly and to determine the compliance status of the system pursuant
to your NCG550455 permit. We anticipate such an inspection would take approximately one hour,
provided that all needed documentation and data is readily available at the time of the site visit.
Due to the difficulties involved with scheduling inspections with homeowners who work
during the workday, I would like to pre-schedule this site visit with you to ensure we can meet and
complete the inspection as expeditiously as possible. In order to set up a time that will be beneficial
to your schedule,please contact me at 704-663-1699,between the hours of 8AM and 5PM,Monday
through Friday to set up the best possible time for me to visit your residence.
Also, in the interest of conducting the most efficient inspection possible,we ask that you have
the following items 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: 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
610 East Center Avenue,Suite 301,Mooresville,North Carolina 28115
Phone:[phone]/Fax:[phone]/Customer Service 1-877-623-6748
Internet:www.ncdenr.gov
An Equal Opportunity\Affirmative Action Employer—Made in part by recycled paper

Mr.Painter
May 4,2015
Page 2
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
any 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. If the
containers are not available, documentation of purchase or the location where purchased
should be provided.
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
proposed inspection, I can be contacted between the hours of 8AM and 5PM,Monday through
Friday at 704-663-1699.
Sincerely,
Barry Love, Environmental Specialist
Water Quality Regional Operations
Mooresville Regional Office-NCDENR

WG
William G.Ross,Jr.,Secretary
North Carolina Department of Environment and Natural Resources
V
-c
Coleen H.Sullins,Director
Division of Water Quality
27 June 2008 pk_
Mr. Douglas Painter
1125 West Catawba Avenue
Mount Holly,NC 28120
Subject: Compliance Evaluation Inspection
Single Family Residence Wastewater Treatment
System
NPDES General Wastewater Permit No./Certificate
of Coverage NCG550797
Gaston County
Dear Mr. Painter:
1. Mr. Ron Boone of the NC Division of Water Quality (DWQ), Mooresville Regional Office (MRO)
conducted a compliance evaluation inspection (CEI) of the wastewater treatment system (WWTS) that
serves your single family residence (SFR) on 25 June 2008. Your cooperation and assistance during the
CEI was greatly appreciated. This letter is a summary/follow up for the CEI and inspection checklists are
attached for your records.
2. Inspection of the system revealed only two concerns:
A. The chlorine tablets you are currently using are for swimming pools and are not rated for use in
wastewater treatment. You should begin using tablets specifically formulated for wastewater
treatment. These tablets can often be found in plumbing supply stores or companies that offer well
drilling or septic system construction services. The correct tablets will explicitly specify application
to wastewater treatment on the outside of the container. Please be sure to carefully read all container
labels and strictly adhere to all safety precautions for chlorine disinfection chemicals.
B. Analytical monitoring is not being conducted in accordance with Part I(A) of the permit. You must
complete this monitoring annually using a NC certified laboratory.
3. No other discrepancies were noted during the inspection. The system appears to be well operated and
maintained. There were no signs of system failure noted.
4. Please take all steps necessary to correct the discrepancies noted above in paragraph 2. You should be
aware that failure to comply with any condition of your permit (NCG550535) constitutes a failure to
comply with NC General Statute (NCGS) 143-215.1, for which the Department has been delegated the
authority to assess civil penalties not to exceed $25,000 per day, per violation, in accordance with NCGS
143-215.6A.
orn`
NthCarolina
Naturally
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

NCG550797 uompuance nvaivanon mspecuon,z i Jun
5. We appreciate your time and understanding of our mission to preserve the natural resources of our great
state. Should you have any questions about the inspection or this letter, please contact Ms. Barbara
Sifford at 704-663-1699.
Sincerely,
Robert B. Krebs
Surface Water Protection Section Supervisor
Division of Water Quality
Mooresville Regional Office
Attachments:
1. Water Compliance Inspection Report
2. Field Inspection Checklist
CC: NPDES West Unit
Central Files
0111.11/Witis 7

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 NI 2 Li 3I NCG550797 11 121 08/06/25 117 18t l 191GI 20 u
1 Remarks !_ LJ
21IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIi66
Inspection Work Days Facility Self-Monitoring Evaluation Rating B1 QA Reserved
671 169 70I u f 711 I 72 I N uI 731 11 74 751 II I I I I 180
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)
09:33 AM 08/06/25 07/08/01
1125 West Catawba Avenue
1125 W Catawba Ave Exit Time/Date Permit Expiration Date
Mount Holly NC 28120 10:30 AM 08/06/25 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
Douglas Painter,1125 W Catawba Ave Mount Holly NC 28120//704-827-35]5/
0
Section C: Areas Evaluated During Inspection(Check only those areas evaluated)
•Permit •Operations&Maintenance IIII Records/Reports I Self-Monitoring Program
II Sludge Handling Disposal III Facility Site Review III Effluent/Receiving Waters I 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
Ron Boone MRO WQ//704-663-1699 Ext.2202/
Signature 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
31
NCG550797 111 121 08/06/25 117 18'^
Section D: Summary of Finding/Comments(Attach additional sheets of narrative and checklists as necessary)
See attached letter.
Page# 2

Fr.
Permit: NCG550797 Owner-Facility: 1125 West Catawba Avenue
Inspection Date: 06/25/2008 Inspection Type: Compliance Evaluation
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 00 . 0
Judge, and other that are applicable?
Comment:
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application? 00 . 0
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? U ❑ ❑ ❑
Is the inspector granted access to all areas for inspection? • ❑ ❑ ❑
Comment:
Record Keeping Yes No NA NE
Are records kept and maintained as required by the permit? U ❑ ❑ ❑
Is all required information readily available, complete and current? U ❑ ❑ ❑
Are all records maintained for 3 years(lab. reg. required 5 years)? • ❑ ❑ ❑
Are analytical results consistent with data reported on DMRs? ❑ ❑ 1E ❑
Is the chain-of-custody complete? ❑ ❑ E ❑
Dates,times and;location of sampling ❑
Name of individual performing the sampling ❑
Results of analysis and calibration 0
Dates of analysis ❑
Name of person performing analyses 0
Transported COCs ❑
Are DMRs complete:do they include all permit parameters? ❑ ❑ E1 ❑
Has the facility submitted its annual compliance report to users and DWQ? ❑ ❑ E ❑
(If the facility is=or>5 MGD permitted flow)Do they operate 24/7 with a certified operator on each shift? ❑ ❑ 1E ❑
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? • 0 0 ❑
Page# 3

Permit: NCG550797 Owner-Facility: 1125 West Catawba Avenue
Inspection Date: 06/25/2008 Inspection Type: Compliance Evaluation
Record Keeping Yes No NA NE
Facility has copy of previous year's Annual Report on file for review? n n • n
Comment:
Effluent Pipe Yes No NA NE
Is right of way to the outfall properly maintained? • n ❑ n
Are the receiving water free of foam other than trace amounts and other debris? S n ❑ 0
If effluent (diffuser pipes are required) are they operating properly? ■ ❑ ❑ ❑
Comment:
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? 00110
Are high and low water alarms operating properly? 0 ❑ E n
Comment:
Sand Filters (Low rate) Yes No NA NE
(If pumps are used) Is an audible and visible alarm Present and operational? 0 0 ■ n
Is the distribution box level and watertight? n Q Q •
Is sand filter free of ponding? U ❑ 0 n
Is the sand filter effluent re-circulated at a valid ratio? 001110
#Is the sand filter surface free of algae or excessive vegetation? n n ■ n
#Is the sand filter effluent re-circulated at a valid ratio?(Approximately 3 to 1) 0 0 ■ 0
Comment:
Laboratory Yes No NA NE
Are field parameters performed by certified personnel or laboratory? 0 ❑ E 0
Are all other parameters(excluding field parameters)performed by a certified lab? 0 ❑ E
0
#Is the facility using a contract lab? 0 • 0 0
#Is proper temperature set for sample storage(kept at less than or equal to 6.0 degrees Celsius)? ❑ 0 ■ 0
Incubator(Fecal Coliform)set to 44.5 degrees Celsius+/-0.2 degrees? 0 n E 0
Incubator(BOD)set to 20.0 degrees Celsius+/- 1.0 degrees? 0 0 E n
Comment:
Disinfection-Tablet Yes No NA NE
Page# 4

Permit: NCG550797 Owner-Facility: 1125 West Catawba Avenue
Inspection Date: 06/25/2008 Inspection Type: Compliance Evaluation
Disinfection-Tablet Yes No NA NE
Are tablet chlorinators operational? ■ ❑ ❑ ❑
Are the tablets the proper size and type? ■ ❑ ❑ ❑
Number of tubes in use? 2
Is the level of chlorine residual acceptable? ❑ ❑ ❑ •
Is the contact chamber free of growth, or sludge buildup? • ❑ ❑ ❑
Is there chlorine residual prior to de-chlorination? ❑ ❑ ■ ❑
Comment:
Effluent Sampling Yes No NA NE
Is composite sampling flow proportional? ❑ ❑ ■ ❑
Is sample collected below all treatment units? 0 ■ 0 0
Is proper volume collected? 001110
Is the tubing clean? ❑ ❑ ■ ❑
#Is proper temperature set for sample storage(kept at less than or equal to 6.0 degrees Celsius)? 001110
Is the facility sampling performed as required by the permit(frequency, sampling type representative)? 0 ■ 0 0
Comment:
Page# 5

Form 101 NC Division of Water Quality
Surface Water Protection Section
SINGLE FAMILY WASTEWATER TREATMENT/DISPOSAL SYSTEM FIELD
INSPECTION CHECKLIST
Inspector Name(s): Ron Boone Date of Inspection: 25 Arrival Time: 0933AM -Departure Time: 1015AM
June 2008
Property Owner Name: Douglas and Phone Number(s): 704-827-3515 Certificate of Coverage#:
Terresa Painter NCG550797
Physical Address of Treatment System: City: Mount Holly Zip Code: County: Gaston
1125 West Catawba Avenue 28012
Mailing Address of Property Owner: 1125 City: Mount Holly Zip Code: County: Gaston
West Catawba Avenue 28012
# Question Yes No N/A NIE Remarks:
I. Residency/Ownership =::_--------=-=-=--===-===_--::- _===_:=_::--=-_-------`--_-_- --======___=,=____>_-__:-:____=>:::-->==-~~=>>==__.-_ -----_'=-_____=-===`'===_-_-:-:_:--:__=:_
Is the Permittee the current owner of the Single Family
1 Home? (Verify current ownership of the location X
producing the discharge.)
II. System La out/Per itte s Knowledge of System = _ _- _ - _ -_- _ ___ - _ =-= = ` = = --'==-_-
1 Does permittee have a map showing the layout of the X
treatment system?
2 Does permittee know where the septic tank is located? X
3 Does permittee know where the sandfilter(s) is/are X
located?
4 Does permittee know where the Chlorinator is located? X
5 Does permittee know where chlorine tablets go? If not, X
instruct them.
Does permittee know where the dechlorination unit is?
6 (Only new facilities constructed after August 1, 2007 X
(Effective date of latest general permit)are required to
install dechlorination.)
7 Does permittee know the location of the outlet/discharge? X
III. System History = ----- ---- ----- --___- ----- --- --- - ___=------------
1 Has sewage ever backed up into the house? X
2 Have there been any other sewage problems at all? X
Monitoring --- - --- --_- ---IV. Analytical -- -------- - - ----- -
1 Has the permittee conducted the required analytical X
monitoring?
2 Does permittee have analytical monitoring results on site? X
3 Is analytical monitoring conducted by a NC certified X
laboratory?
Do analytical monitoring results show compliance with
4 permit limits? (Check for compliance with permit limits X
using Form 102.)
V. Septic Tank
1 Has the septic tank been pumped in last 3 to 5 years? If X 2007
yes, when?
Page 1 of 3 SFR Inspection Checklist Douglas Painter Mount Olive Gaston Cty NCG550797 0806 CEI.xls 6/26/2008,3:23 PM

Form 101 NC Division of Water Quality
Surface Water Protection Section
0 Question Yes No N/A N/E Remarks:
VI. Chlorination = ZZ:g _ _ __ ___ __ _
Are the chlorine tablets wastewater rated? (Inspect
1 original container for wastewater rating. If not, require X
permittee to get tablets rated for wastewater.)
©Are there chlorine tablets in the chlorinator? X _
VII. D hl rin ion : _- == _:_---------====== -__=_=::-:__-::_: =_ _:<::_<__::-::_-::_: _ --
ec o at
Are the dechlorination tablets wastewater rated? (Inspect
original container for wastewater rating. If not, require
1 permittee to get tablets rated for wastewater. Only new X
facilities constructed after August 1, 2007 {Effective date
of latest general permit}are required to install
dechlorination.)
©Are there dechlorination tablets in the dechlorinator? X
VIII. Ultraviolet(UV) -_ === -- - -- -- _ _---- --- _
Ult e ---- : _ - -
0 Is the UV disinfection system working? X
Does permittee know how to determine if the UV system g
X
is working? ■■
©Do they know how to clean and replace UV bulbs? X
4 Do they have extra UV bulbs on site? X
IX. PumpS stems ___::-:: _= ___:___`_=______ ____ _ ____ ___________=__==== - _ _---_ `___>_____;__=======_:_-__-::-__ __:___:-
0 Is/are the pump(s) working. X
©Is the high water alarm in the pump tank operational? _ X
Does the permittee know how to check the pump and 111
X
high water alarm to ensure operability? ■■
__-_-` = :=1'=:: z?_--:_ _ _______________ '_`>`:_:::= _' -- =::=:t r#_--'_``�_ :_z _'__':_
X. DetectingPossible Problems/System Failure ---_-_ --_-_-_-_____- - ---
0 Is there any evidence of sewage surfacing or ponding , ■ X ■■
anywhere on the grounds?
©Is there any overflow or soggy soils on the property? X -_
Is there any sewage on the ground near the septic tank,
3 distribution box(es), sand filters or contact chambers, X
indicating a possible failure of the system?
Does any area of the property appear to be greener with
4 vegetation growth than any where else on the property? X
(Indicates a possible sandfilter failure.)
If standing sewage or possible system failure is observed,
are there signs of human and animal traffic in the area?
5 (Need to understand if human contact/vector concerns X
are evident/prevalent.)
X . Effluenti Pipe & Discharge e
--------------------
0 Did you observe the end of the discharge pipe? X ---
©Was the outlet discharging? X
©Was the discharge clear and free of solids? -_- X
4 Is there any evidence of solids at the end of the pipe or in ■ X ■■
nearby ditches or creeks?
Page 2 of 3 SFR Inspection Checklist Douglas Painter Mount Olive Gaston Cty NCG550797 0806 CEI.xls 6/26/2008,2:03 PM

Form 101 NC Division of Water Quality
Surface Water Protection Section
Question Yes No N/A NIE Remarks:
Is the outlet submerged in stream flow, or does it appear
5 that it may become submerged under slightly higher X
stream flows? (Outlet should never be submerged.)
XII Illegal Discharges
Is all wastewater from the home connected to drain into
1
the septic tank? X
Is there any discharge of gray water(i.e. washing
machine or dishwashing machine wastewater)from the
2 residence straight into the creek, ditch, stream, etc? (If X
yes, then the discharge must be connected to drain into
the septic tank immediately. Any discharge of untreated
wastewater into the environment is illegal.)
NOTES: Owner must begin conducting annual analytical monitoring in accordance with
Part IA of the permit. Owner must begin using the correct chlorine tablets. Please refer to
the inspection summary letter for further information.
•
Page 3 of 3 SFR Inspection Checklist Douglas Painter Mount Olive Gaston Cty NCG550797 0806 CEI.xls 6/26/2008,2:03 PM

" ro Michael F. Easley,Governor
rj r William G. Ross,Jr.,Secretary
>_ North Carolina Department of Environment and Natural Resources
Coleen H.Sullins,Director
Division of Water Quality
23 May 2008
Mr. Douglas Painter
1125 West Catawba Avenue
Mount Holly,NC 28120
Subject: Single Family Residence Wastewater Treatment
System
NPDES General Wastewater Permit No./Certificate
. of Coverage NCG550797
Compliance Evaluation Inspection
Dear Mr. Painter: '
Division of Water Quality (DWQ) database records show that you currently own/opdate 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 NCG550797 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.
1 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/Cergiicate 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 Noa
hCarolina
,Naturally

V550797
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,
/----,6 6 IL--
Robert B. Krebs
Surface Water Protection Section Supervisor
Division of Water Quality
Mooresville Regional Office

AlA FILE
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory John E. Skvarla, III
Governor Secretary
August 18,2014
Mr. Douglas Painter
1125 West Catawba Avenue
Mt. Holly,NC 28120
Subject: Single Family Residence Wastewater
Treatment System
NPDES General Wastewater Permit
No./Certificate of Coverage
NCG550797
Compliance Evaluation Inspection
Dear Mr. Painter:
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 NCG550486
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 704-235-2196, between the hours of 9AM and
4PM, Monday through Friday. Please contact Ms. Sifford within the next 10 days to identify
the best possible time for her to evaluate your SFR WW system 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.
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.
Mooresville Regional Office,610 East Center Avenue,Mooresville,North Carolina 28155
Phone:[phone]\Internet:www.ncdenr.gov
An Equal Opportunity''.Affirmative Action Employer—Made in part by recycled paper

• AND NATURAL RESCE8 •
•
yr
NCDEt� ���"�r� �.
North Carolina Department of Environment and, Natural Resources
Division of Water Quality
Michael F. Easley, Governor William:6 Ross,Jr., Secretary
CGen H.Sullins, Director
July 27, 20
Douglas Painter wi4��� 4 YE
1125 W Catawba Ave
Mount Holly,NC 28120
Subject: Renewal of coverage/General Permit NCG550000
1125 West Catawba Avenue
Certificate of Coverage NCG550797
Gaston County
Dear Permittee:
In accordance with your renewal application [received on January 17, 2007],the Division is renewing
Certificate of Coverage(CoC)NCG550797 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,
for Coleen H. Sullins
cc: Central Files
NPDES file
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 NCG550797
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,
Douglas Painter
is hereby authorized to discharge domestic wastewater [360 GPD] from a facility located at
1125 West Catawba Avenue
Mount Holly
Gaston County
to receiving waters designated as Fites Creek in subbasin 03-08-34 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 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

f
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
MOORESVILLE REGIONAL OFFICE
AVA
NCDENR DIVISION OF WATER QUALITY
June 15, 1999
JAMES B.HUNT JR.
GOVERNOR Douglas Painter
220 Walnut Avenue
Mount Holly, North Carolina 28120
WAYNE MCDEv1TT Subject: Wastewater Discharge Permit
SECRETARY
Douglas Painter
NPDES Permit No. NCG550000
Cert. of Coverage No.
'` NCG550797
- Gaston County,NC
` Dear Mr. Painter:
s' Our files indicate that the subject wastewater discharge permit was issued to Mr.
E �: Douglas Painter for a wastewater discharge from the subject residence. The Mooresville
,k Regional Office requests that you contact this Office if you do not have a copy of the
_ . subject permit, if a change in property ownership has occurred, or if you have any
"` ;%� questions regarding this matter.
w
if
, Pursuant to conditions of North Carolina General Permit Number NCG550000,
E 4 1 _- the following documentation must be kept and readily available for inspection for a
f period of at least three years:
t
.` `-- . required maintenance activities relating to the wastewater treatment system
► yearly sample analyses results for the parameters listed on the effluent
_ limitation/monitoring page of the permit
rti � required inspections of disinfection apparatus and septic tanks
� _ Please do not hesitate to contact Roberto Scheller at(704) 663-1699 if you have
r ; any questions.
<' °-ma a e
`-� ,Sincerely,_
!I-4,-r „:4".7% ,: - -, 1.11. - A c--) A,,,k,
.. 1/4,-- D. Rex Gleason, P.E.
Water Quality Regional Supervisor
, ,m,.
cc: Gaston County Health Department
x.
rls 919 NORTH MAIN STREET,MOORESVILLE, NORTH CAROLINA 29115
�. PHONE [phone] FAX [phone]
6-} ''';`..,Y. 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
James B. Hunt, Jr., Governor p E H N
Wayne McDevitt, Secretary TLC. DPPT. OF
A. Preston Howard, Jr., P.E., Director ENVIRONMENT, �zr,,. July 21, 1997
&N ATOuIZI
Douglas Painter AUG 3 1 1998
220 Walnut Avenue
Mount Holly,NC 28120 DIVISIOII OF E:; ' '"°"`'''EM
MOOR S U.E REu,�, ,i O�
Subject: Certificate of Coverage No. NCG550797
Renewal of General Permit
Painter, Douglas & Teresa-Res.
Gaston 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,
1)•
11,14'. 4.
9r4r,fit___-.-
A.Preston Howard,Jr.,P.E.
cc: Central Files
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. NCG550797
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,
Douglas Painter
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
Painter, Douglas & Teresa-Res.
West Catawba Avenue
Mount Holly
Gaston County
to receiving waters designated as subbasin 30836 in the Catawba 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.
• Z..°C . 974Z14----'
(el/A. Preston Howard,Jr., P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

State of North Carolina ,,,,
i Department of Environment,
s i Health and Natural Resources S' ' • ;
', Division of Environmental Management
T-'
^�
James B. Hunt, Jr., Governor
4,iii Jonathan B. Howes, Secretary p E I—I N F1
A. Preston Howard, Jr., P.E., Director
January12, 1996 n :'IR(
NATU:'
a
Mr. Douglas Painter JA"'
220 Walnut Avenue
Mount Holly, North Carolina 28120
Subject: Permit Issuance/ "'r14
Authorization to Construct
Permit No. NCG550797
Painter Residence
Gaston County
Dear Mr. Painter:
In accordance with the application for discharge, the Division is forwarding
herewith the subject Certificate of Coverage to discharge under the subject state - NPDES
general 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 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 a demand is made, this Certificate
of Coverage shall be final and binding.
A letter of request for an Authorization to Construct was received November 13,
1995 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 360 gpd wastewater treatment system consisting of two (2) 1500 gallon septic tanks, a
distribution box, one (1) primary sand filter measuring 420 square feet, one (1) secondary
sand filter measuring 210 square feet, a tablet chlorinator, a chlorine contact tank with a 30
minute retention time, and effluent pipe with discharge of treated wastewater into Fites
Creek, a Class C water in the Catawba River Basin. In addition, the system components
must be located above the 100 year flood line on the property.
This Certificate of Coverage shall be subject to revocation unless the wastewater
treatment facilities are constructed in accordance with the conditions and limitations
specified in Permit No. NCG550000. Please take notice that this Certificate of Coverage is
not transferable except after notice to the Division of Environmental Management. The
Division of Environmental Management may require modification or revocation of the
Certificate of Coverage.
The Mooresville Regional Office, phone no. [phone], shall be notified at
least forty-eight (48) hours in advance of operation of the installed facilities so that an in-
place inspection can be made. Such notification to the regional supervisor shall be made
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

NCG550797
Painter Residence
January 12, 1996
Page 2
during normal office hours from 8:00 a.m. until 5:00 p.m. on Monday through Friday,
excluding State Holidays.
Upon completion of construction and prior to operation of this permitted facility, a
certification must be received from a professional engineer certifying that the permitted
facility has been installed in accordance with the NPDES Permit, this Certificate of
Coverage and the approved plans and specifications. Mail the Certification to the Permits
and Engineering Unit, P.O. Box 29535, Raleigh, NC 27626-0535. A copy of the
approved plans and specifications shall be maintained on file by the Permittee for the life of
the facility.
The sand media of the sand filter units must comply with the Division's sand
specifications. The engineer's certification will be evidence that this certification has been
met.
A leakage test shall be performed on the septic tank and dosing tank to insure
that any ex filtration occurs at a rate which does not exceed twenty (20) gallons per
twenty-four(24) hour per 1,000 gallons of tank capacity. The engineer's certification will
serve as proof of compliance with this condition.
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 permits that may be required.
If you have any questions or need additional information, please contact Susan
Robson, telephone number 919/733-5083, ext. 551.
Sincerely,
Original Signed By
David A Goodrich
A. Preston Howard, Jr., P.E.
cc: Central Files
Gaston Count Health De artment
Permits and Engineering Unit
Facility Assessment Unit

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
CERTIFICATE OF COVERAGE
GENERAL PERMIT NO. NCG550797
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,
Douglas Painter
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
Painter Residence
West Catawba Avenue
Mount Holly
Gaston County
to receiving waters designated as Fites Creek in 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 shall become effective January 12, 1996
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day January 12, 1996
Original Signed By
David A. Goodrich
A. Preston Howard.Jr.,P.E., Director
Division of Environmental Mana_ement
By Authority of the Environmental Management Commission

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N pigs No . 4/C8 550747
t Garin Coup

SOC PRIORITY PROJECT: Yes No X
To: Permits and Engineering Unit
Water Quality Section
Attention: Susan Robson
Date: December 13, 1995
NPDES STAFF REPORT AND RECOMMENDATION
County: Gaston
Permit No. NCG550797
PART I - GENERAL INFORMATION
1 . Facility and Address : Douglas Painter' s Residence
220 Walnut Avenue
Mount Holly, North Carolina 28120
2 . Date of Investigation: 12-13-95
3 . Report Prepared By: G. T. Chen
4 . Persons Contacted and Telephone Number: Mr. Charles E. Jones .
5 . Directions to Site: From the intersection of South Main
Street and West Catawba Avenue in the City of Mount Holly,
travel west on West Catawba Avenue approximately 1 . 70 miles .
The site of the single family dwelling is on the left (south)
side of the road.
6 . Discharge Point(s) . List for all discharge points :
Latitude: 35° 17 ' 15" Longitude: 81° 02 ' 21"
Attach a U.S.G.S. map extract and indicate treatment facility
site and discharge point on map.
USGS Quad No. : F 14 SE USGS Quad Name: Mt. Holly, NC
7 . Site size and expansion are consistent with application?
Yes X No If No, explain:
8. Topography (relationship to flood plain included) : Sloping
southeast toward receiving stream at the rate of 5 - 7% . The
site for the proposed septic tank/surface sand filter system
does not appear to be in a flood plain.
9 . Location of nearest dwelling: Approximately 100 feet.

10 . Receiving stream or affected surface waters : Fites Creek
a. Classification: C
b. River Basin and Subbasin No. : Catawba and 03-08-34
c. Describe receiving stream features and pertinent
downstream uses : The receiving stream, a segment of
Fites Creek, appeared to be 10 feet wide with a
rocky/sandy bottom. A good flow was observed at the time
of investigation. Downstream users are unknown.
PART II - DESCRIPTION OF DISCHARGE AND TREATMENT WORKS
1 . a. Volume of wastewater to be permitted: 0. 00036 MGD
(Ultimate Design Capacity)
b. What is the current permitted capacity of the wastewater
treatment facility? N/A. Proposed discharge.
c. Actual treatment capacity of the current facility
(current design capacity) ? 0 . 00145 MGD (based on the
proposed system which consists of 420 square foot sand
filter and two 1,500 gallon septic tanks in series) .
d. Date(s) and construction activities allowed by previous
Authorizations to Construct issued in the previous two
years : None.
e. Please provide a description of existing or substantially
constructed wastewater treatment facilities : N/A.
Proposed facility.
f. Please provide a description of proposed wastewater
treatment facilities: The proposed wastewater treatment
facility will consist of two (2) 1,500 gallon septic
tanks in series, dual surface sand filters (total area
420 sq. ft. ) in series, and tablet chlorinator with
contact basin.
g. Possible toxic impacts to surface waters: None.
h. Pretreatment Program (POTWs only) : N/A.
2 . Residuals handling and utilization/disposal scheme: Sludge
handling scheme is not available. The applicant needs to
submit a sludge disposal program for approval.
a. If residuals are being land applied, please specify DEM
NPDES Permit Staff Report
Version 10/92
Page 2

Permit No. : N/A
Residuals Contractor: N/A
Telephone No. : N/A
b. Residuals Stabilization: PSRP: N/A
RFRP: N/A
Other: N/A
c. Landfill: N/A
d. Other disposal/utilization scheme (specify) : N/A
3 . Treatment plant classification (attach completed rating
sheet) : Class I, see attached rating sheet.
4 . SIC Code(s) : 9999
Wastewater Code(s) :
Primary: 04 Secondary:
Main Treatment Unit Code: 44000
PART III - OTHER PERTINENT INFORMATION
1. Is this facility being constructed with Construction Grant
Funds or are any public monies involved (municipals only) ?
N/A.
2 . Special monitoring or limitations (including toxicity)
requests : None.
3 . Important SOC, JOC or Compliance Schedule dates : (please
indicate) N/A.
4 . Alternative Analysis Evaluation: Has the facility evaluated
all of the non-discharge options available. Please provide
regional perspective for each option evaluated.
Spray Irrigation: Insufficient land area available for a
spray irrigation system.
Connection to Regional Sewer System: No area-wide system
available in that area.
Subsurface: The site soil is not suitable for a subsurface
disposal system (see attached Soil and Site Report, dated
October 24, 1995, from Joe Lynn, Regional Soil Specialist,
DEH) .
NPDES Permit Staff Report
Version 10/92
Page 3

Other Disposal Options: Not evaluated.
5. Air Quality and/or Groundwater concerns or hazardous materials
utilized at this facility that may impact water quality, air
quality or groundwater? No known air quality or hazardous
materials concerns.
6 . Other Special Items: None.
PART IV - EVALUATION AND RECOMMENDATIONS
The applicants, Mr. and Mrs. Douglas Painter request an NPDES
General Permit for the discharge of 360 GPD of domestic wastewater
which will be generated from a single family dwelling that has yet
to be built. The treated wastewater is to be discharged into a
segment of Fites Creek.
Mr. Joe Lynn, Regional Soil Specialist, On-Site Wastewater
Section, Division of Environmental Health, has performed an on-site
investigation. In a report dated October 24, 1995, Mr. Lynn
indicated that the site soil is not suitable for a ground
absorption wastewater treatment and disposal system.
It is recommended that an NPDES General Permit be issued to
the applicants with conditions that the dual sand filters must be
constructed as SURFACE sand filters and that the home be connected
to an area-wide system as soon as one becomes available.
Si;nature of4teport Pr-1,1 . a:
fraA;G
k7
Water Quality Re 'onal Supervisor
jZ- 2 �/s
Date /
NPDES Permit Staff Report
Version 10/92
Page 4

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Aip s No . NC6-550797

RATING SCALE FOR CLASSIFICATION Ci WAT"7i POLL 7,0:A Cr CACL v(`(67 :A=
Name of Facility: DDUjl pdint-eic_s A `_'e C4_,
Owner or Contact Person: ,,K�ii 4 Piz nfly
Mailing Address: 22 0 / lrl/2uiL AIM, i ,./1f ,14/Jv j G -' 120
County: 64 -� y ate
Telephone: ) z S/.
Prns nt C;T, i tier,: New Facility* V Ezistinr Facility_..
NPDES.Per. No.-Ne0O jvC61 - 0 Nondisc. Per. No.WQ ar h Lam-' ear No.
Rated by: ri `r. aapL Telephone: ( ) a3-/699 Date: /z-/3-9.1--
Reviewed by: Health Dept. Telephone:
Regional Office Telephone:
Central Office Telephone:
ORC: Grade: Telephone:
a
Check Classification(s): Subsurface Spray IrrigationIV Total Points:Land Application
Wastewater Classification: (Circle One) 0 II
4PLA T PFCCFSSES AND REL ATFM CCNT riPMENTW1404 ARE AN r4Trrtut PART OF PJD_WA AL PROD.1011niN SKAI r Nor ra=
Qf7isIDEf1ED WASTE TREATMENT PCP TMe PURPOSE aF CLASSIFICATION ALSO SEPTIC TANK SYSTEMS OCWISTNG OILY OF SEPTIC TN4(
NM GRAVITY IITRIFIC ATICN LAES ARE EXEMPT FFCOM CiAWIC&1 J
SU3SUPFACEOLASSIRCATION SPRAY tPlFiIt3ATION aossrr- 1T10 4
(check ill units that apply) (shack all units that apply)
I. _ _septic tanks 1, Fnfiminazy ttaab 1 (dNb1tion no. 32 )
2_�g°°ns
2_PtmrP tanks S._ Ic tanks
3.—_siphon at PuiTc-d01i�Mims
4, sand flaws 4._____ptttrrp tanks
S. grease trap/lyderceptor S,— Pta"Ps
fi 01/water separators i, sand Mims
7_ —gravity subsudacs treatment and disposal: 7._____grease traPRnteroaptor
i._preas+ue subsurface treatment and ducal: 11.____oill/vralsr separators
e. disinfection
10, ,chemical addition for nutrierd aigas control
11, spray irrigation of der
in 'addition to the iili-OVO evAtt:fiaZ Wid, ;,;rstrmutrnort a� nt'n1Y:zC'n.tar ".. c.Iv ass of Men© 4:v:re:anent, Shall
be rated using the point rating system and trill require an operator oitn an appropriate duel certification.
ly to gem*holder)
1. ��n lion d biosotIDUALS�re duals orFICATIMI contaminated a►ed soils acre designated:Me.
1. sand+gPrKa1'
WASTEWATER TPEATL4ENT FACILITY CJLSSFCATiCN
The meowing systems shall be assigned a Class I dassif'(cation,wing,the flow is d a signroCant qutrnty or ths technciatiY is tntgtallY
=Telex.to require consideration by the Commission on a case-by-case basis: (Cured disposal:e)
1. Oihrater Separator Systams ocrtsisting only d physical separation.dosing es and dieus. pt+rtps.sat+d hers,dhNsdiort
2,_�Septic Tank/Sand Filter Systems consisting only septic
3-, arid direct discharge;
Lagoon Systems consisting only of prsiminaty trsatmsnt,lagoons,pumps.disinfection, mammary dtsrni al bstmers for
algae or reuses" control,and direct*whine; •
Systems;
&____Grourdwater Remsdiation Systems consisting only at dMratsr separators.pumps.air-stripping.=ton adsorption,disirdeabn
•
and 11,_____—Aquaculture operations with dscharge to Surface waasrE
7_ dli
sr Plant sktdge hanng and bade-wash water treatment;
•
Seafood processing consisting ofscreening and disposal.g. Singh-(amity discharging systems.wth the exception of Aerobic Treatment Units,wit classified I permttm aintained.Suit
1903 or If upon inspection by the Division.t ia found that the system is not being adequately operated
systems wilt be notrred of to dasssrtcstion or reclassification by the Commission,to wrong.

RATING SCALE FOR CLASSIFICATION OF WATER POLLUTION CONTROL SYSTEMS
Name of Facility: .v��lat fdt`nkAs ,e. '''eiiC4.
Owner or Contact Person: ,e
Mailing Address: " ` 0
County: Telephone: D z - S
Present Classification: New Facility' V Existing Facility_,_,
NPDES Per. No.-N6oO- ,.3 7f7 Nondisc. Per. No.WQ Health DeptPer No.______
Rated by: r/ Y aavt. Telephone: (7 ) a3--//99 Date: /. -/3--111--
Reviewed by: Health Dept. Telephone:
Regional Office Telephone:
Central Office Telephone:
ORC: Grade: Telephone:
Check Classification(s): Subsurface Spray Irrigation Land Application
Wastewater Classification: (Circle One) () II III IV Total Points:
f4 Pf:CFSSES AND R LATT CONTF 1 FOUPME T WFf]4 AFF AN MFT IRAL PART OF M1i L T A.t PQC I1 TON!HAi I NriT RF
g7PISIDERED WASTE TREATMENT FOR TIE PURPOSE OF CLASSiF(CATION.ALSO SEPTIC TANG SYSTEMS CONSSTP J ONLY OF SEPTIC TAM(
f.D GAAvrTY NITRIFICATION LIES ARF EXEMPT FFCOM CLASSIF K ATION '
IILBSUFFACE CLABSFICATION SPRAY IFIRGATION ISSI'FC MCP(
(check M units that apply) (check all units that apply)
1`___emetic tanks 1, preliminary treatment (definition no. 32 )
2._pump tanks 2 tagoons
3.------90011 or Ding ergo= $,_,_,septic tanks
4, sand tapers 4,___pump tanks
5, .grease trapAnterosptor Sr---PLX Ps
II sand filers
6 r separators 7_ grease traplinteroptor
7`�pavity gravily subsudaa treatment and deposal:
IL .pressure subsurface treatment and disposal: S. oi/water separators
S. disinfection
10.__d»mid addtion for nutrient/algae control
11, spray irrigation of der
In addition to the above classifications, pretreatment of wastewater In excess of these components shall
1;4 naafi zis.,.k; Zs potsa rating ayz..: l Ind wi'1 require re k•poratar with on appropriate dual certification.
LAND APPLICATIONIRESIDUALS CLASSIFICATION(Applies only to permit holder)
1. Land eppfdicn of biosolids,residuals or contaminated soils on a designated ale.
WASTEWATER STEWATER TREATMENT FACILITY O.A FCATO1
The blowing systems ah.11 bs assigned a Class I desslficstion,urdm the flow la at a sgnroant quantity or the technology is unusually
complex.to 'squint consideration by the Commission on a case-by-case basis: (Check I Apprcprks*)
1- Cli/water Separator Systems consisting only of physical separation.pumps and deposal;
3,____Septic Tank/Sand Filler Systems consisting only of septic tanks:dosing apparatus, pumps.sand tsars.daNectie"
and direst disdurgs:
3- Lagoon Systems consisting only of preiminary treatment,lagoons,pumps,disinfection.necessary chemical Immanent for
algae or nutrient oortrot,and died discharge: -
•
- �S�fk__Qrourdwater Remedlaiion System oonshding only of olI*ater separators,pumps,ak-dtrlpping,carbon a �Pt dld^isctbn
A
t_ a:ult ure operations with discharge to surface waters;
7_ er Plant sludge handlingback
-wash and ba -wash water Usatmsrt: •
s Seafood processing consisting of screening and disposal.
g. Single-family discharging systems,with the exception of Aerobic Treatment Units.wit be classified I permitted after July 1.
1903 or t upon inspection by Si.Division.it is found that the system is not being adequately operated or maintained Such
systems wit be notified at the classification or reclassification by the Commission,in writing.

(1s) El.cf oaaysls. Pecs=for removing tonged sass ern roast through me tree of ion-saleCt+n tar+-sa,ange rn.rnbrares;
(14)Flaw Press. A process operated mechanically tar partway dewwerig sMucigs.
(17) Foam Separation. The planned lrothinp of wtewrr r rastrherseer art. +3 •• means,ir a c,erek.w amaa-ert vt 4elergart m atertrie 1,:ro.gn
Mae Ytroduclbn d ale in the forth of fire bubble:era cared loam lracbor::.
(1a)Grit Removal The proles ei removing gR and other hear miners manor from wastewater,
(tit) error Tank A doe two story wessewaw tank oorreung of art upper s.drtersatbn chamber and a borer sludge digestion charter.
a0) Inarumnereed flow 1Msur.mart. A ievien rnictn rdlcats and records rat of low;
Rt)Ion f xcharg.. A oh.mhkal proms in wren Us hem two dement ri.Ui lea are esdionged:
(22) Ladd application:
sum. Disposal. A Inal sludge deposal method by which wet sedge may be applied to lard sets by spraying on the w4aeot or by subsurface iny.abn
1, sheet pica');[not appacebie tot types of sedge described It(11)of this Rub);
get Treed Effluent. The procsa d spraying tease wearewster arc a lard area or otter methods of application et wr.seaeseerpno a land area as a '
•
•
Mears ofc final depose(r iliac ert;ntin b.ak-wah.d.roaring drum fMr operating under gravty condtfors as a polishing method for rerroring
QSy kOcrarareen. A low aped,continuously
oraperdee se ids tram sabers;
04)Nerit a.iien Process The biodrmicel oonvenbn of enoziaxed nitrogen(ammonia and organic nitrogen)to waxed nitrogen (usually nitrate);
(X)PmsPnous saga. A separate stage of waste ra.r treatment designed for to ap.eftic purpose of converting ammonia nitrogen to nitrate 'nitrogen;
Wf) Phosphate Removal,SlobpicaL The removal of phosphorus from wastewater by art ab:anoxic process designed to enhance kaury uptake of phosphoruc
by R:1 the net_
hslding pore beowfmp secondary treatment.tot suflefent detention time to aloe sealing of finely wnp.nd.d solids;
Q!) Post Aeration Aeration IoNowrhg conventional.acordary treatment errile to Increase effluent 0.0.or for any other purpose:
pa) Pest Aeration. (Cascade) A pointing method by which dissolved oxygen la added to the&Nihon by a rwnmechanical. gravity means of having down a
wins d tlUps or eel% The low occurring acres the steps or weirs moves in a fairy ten layer and the operation of the cascade requires no operator
ad)ustmera;thus, zero porno an assigned even trough this Is an ssarrrlal sap to meeting the limits of the discharge permit;
(!0) Pardoned to Granular Adhered Carbon Feed. A bbot yskal carbon proces that wares biological activity and organic absorption by using powdered or
granular activated a soon; Virgin or regenerated arbon Is feed controlled into the ileum;
1) Pr re:ion. A tank constructed to words aeration prior to primary treatment; •
p2) Preliminary Unit& Urfa operaterw in the treatment process.such as screening and comrnihutbn.that prepare the liquor for autos:peni mayor operations:
(33) hdusrtal Pretreatment.
a]a) Pre-trsatmrrt Unit, Industrial The owdabning of a wso at its scheme before discharge.to remove or to neutralize
fit as s to sewers
end
flreatmart processes or to effect a partial seduction In bed on the treatment prone.s which is operated by the awe
l atmers plan being raked:
b)Pt►tr.atmeni Progamt,Irduatrisl•awes be a Stale or EPA required program to rwaslvs points on the rating sheet:
(34) Primary Clacton. Tte fiat setting tanks through which wastewater Is passed to a Iniatniers works fort.purposed removing settleable and suspended
seeds and SOD which s ssocia1ed with the.olds;
(25) Pumps. Al influent.ofikors and holm pump.:
( Radiation. Disktf.ctfon or sterilization process Wilding devices emitting prow ultraviolet w rays;
7)Rev.ree Carnes. A reatrit.nt proses Vt crash a heavy cornartinated Iould is presented though a membrane fortnlq rteariy pure liquid free from
wusp.ndati.aids: In which w.sewesr flows through tanks In which a series of pithily submerged chrwla'
(!a) Routing Biological Catra.as. A fixed blei.girai gash Proses
solaces are rotated;
pi)Sand Mars:
(a) marl ant Stabgic.L Fitrailon of effluent following septic tank& lagoons.or some other treatment prows In which further bbdeea►9altlon Ii
abased to produce desired influents;Hydraulic larding rats on these titers are corrpueed In gpatec and hays a muting low Gomel (less than one):
b) R.drwisrhg biological-the same type or sand flier as defined in Subparagraph(79)(a)of this Rue with the added capability to recycle.fluent back
trough the sand flier,
(40)Sand or Iu.d-UAsdla FMers. A polishing process by which effluent Imes are achieved though a further reduction of suspended said.,
fat)low rata—gay.hirdrauarsay base raw wan loading',ins In the one to twee ppnvtd range;
(b)high raft—a pressure,hydraulicaly loaded liar rah loafing raw in the the glom►rst nags;At any rose,to loodi+g rate el aimed throe gi.ice
(41)Secondary Clert tank iers. A ta which Wows the biological unit el treatment plant and which has the purss of removing sludges associated
Obbgkpl treatment tents; where the activated I transferred to a tank and aerated before rewrT*c a
(42) Separate Sludge Rerrgbn A part of V.cosiest atabisatlorn processsedge
Is the contact basin;
(43) Septic Tank. A angle-gory sating tank In.Mich settled sludge Is In coned wren this aast.vrw.r flowing through its tank:shall rot be applicable for
seek tank system serving aegis family residences having capacity of 2.000 gab's or less which discharge to a ntraic tba tied:
(44)Sludge isstlort The process by which organic or rotate matter and sludge is guild,ioustied,mlwal:rad or converted into more gable organic matftr
trough the activity of living organisms,which inducts aerated hoidrg tanks; *pared r dried by drainage and
(a;Sludge Drying Buds. An aria oomprlslt rest e or artifice byes d porous mortal icon which digest a.alalge sedge
ov' 0 'r • .._,ti' In„lvn• ,,r.-,-,nr Arts Ire ...-enovwt7 by sue:' -mahhr •Ymstingc with fresh over or pert.hlkort:
. :,.3 r..�..
(4a) Studgs Noidmp Tank(Aerated and Nora -in:.d). :A tank iftlr.:m'd fa irnat aastewaer twat sewn prarxs not corearning a bossier In which sludge may be
lea fresh.and supernatant withdrawn prior to a drying meted(Le.sludge drying be le);This may I.done by adding a said amount of air simply to keep the
Adige bash,but not reoessarly an amount thst would be required to achieve stablIzatbn of organic manor. A nortasrsted tank would ei rpy be used to
decant sludge prior to d.waterfng and would not allow long periods (several days Of dst.rtbn) without resulting odor problems;
(49) Sludge Incinerators. A fumes designed to bum sludge and to remove at moisture and cornbkatbie rnater ie and reduce the sludge to a serfs ash;
(0)Sludge Stabizaion(Chemical or Therm . A pros s to make tressed sludge isee odorous and putmcbs.and to educe w pathogenic organism
content;This may be done by per ad ustr ert chlorine dosing, er by feat treadmert:
(it i Sludge Thickener. A type ssdrr.rtwlon tare In iRhdn the sludge it ber e:sd to settle and thicken trough Welton and gravity:
9.62)Stt'bi$t:ation moon. A type 01 oxidation bacon In which biological oxidation of organic matter I elected by neural terser of oxygen to the weer loath
($) Starri.Dr :'agree tie ly. On site or portedil ewoarkal prorating. JVui s;
(lip Stork Screens. A stationary sown designed to romv..solds.Including roerbtdrpeadable particular(aoatabts sold&otgsndsd sole sled SOD
seduction)fy Tr municipal and f e:X tet wutersatmenu foliating
ing tern ay�h Is permit for ifs purpoaa CO snarl polishing;A seating lagoon r card or oast titer
�Tertiary Traaarrert. A stage d treatment toarnrrnp secondary
aright be employed for the purpose;
1114)Thermal Pollution Control Device. A dwvic:crooking for the ttaria&of hog from a skid flowing In tubes to another tkuid outside the tubes,err sub were;
Or afar shears of rsputasing ski trss;
�Thermal sfhedv. eaehddo A •ing peoeaaa by
whist heal Isadded for a protracted period of Sea to Mime Its da al Mudge ud s.by Vs
sokblzing and tricks :ring of the smaller and more highly hydrated sludge pan s; eAhlch edit dacinarge sled upon exposure.kgstio^. 0n
(is)Tonic Material& Those wastes r combination' waste&knekudirg dfsaaa.•cauaing Were foo6 art cause death.x osure. ,behavioral
r
err wknila4on Its are organisms,ether �fy from to srwranrn.n or rhdrslc�y by kcetion through
abrcrreultlss.carder,genetic m utaibna,physbbgIca!malfunctions (Including mdurcfbrs In reps Judith)or physical defomtsbns,In such organisms er Their
(Estprlhg;Toxic materialsInclude.byCary of■ n and rot Imitallort a �mercury.vanadium.work,f
�,Cay,Doyc�elrig.d aeiyaPCHs)arid dkiorod�h+rtylV*tctio t a( malarial that hae r may hereafter bedetermined to has
toxic properties'
gh
(50)Tricking Film. A bbbgkat teemed me oorriding d a mewled such as broken sera rock over Which
I designed to �e at Orrbone i e Ar hi perat
icking
S tar to one which operated al between 10 ara 70 mad per acre. A low rate tfiddingoperate
(a0)Trfclkirg F7tat(Peked Towerr). A plug flaw vpis of operation to Mich w s:swo&floes down through successive tams d media or fitrata material;Organic
ma:trfal Is rammed oorthually by the scars bbio growth grow In each w ty.dcess layer. Thla method may product'iaccrquayarr quy affluent.a nt. may be
adapted to produce a Hulled.fluent;
f1)Vacuum Fite.Cantrtfuget.or Fear Press.. Oates which are dsskred to remove lxase water from either dusted or undigested sludge Prior to diapala'
err turtle ttea►mwi.

State of North Carolina ,`6h
Department of Environment,
& NATURAL
Health and Natural Resources N.C. mire or
Division of Ern ironmental Manag €NI"N't'' x ,
RES'
James
Hunt, Jr., Governor
Jo ath B. B. Howes, Secretary DEC
A. Preston Howard, Jr., P.E., Director
DIZ1414 4F E!{VURONMENTAL PiA$ASEMEKIT ; , N',• } ;,,;A:,31f�flW
MUCRtSV'ILLE REMIA1 OFFICE ,,,,1+ic!Iw9u !a waft{1RGItthle'9 :1f) INISM
November 30, 1995
330
Mr. and Mrs. D. Painter
220 Walnut Ave. • .a Toiatt .j„41TnNtoNxinrrl
Mount Holly, North Carolina 28120 'a,a:ta -Nt
Subject: NOI Application
NPDES: NCG550797
Single Family Residence
Gaston County
Dear Mr. and Mrs. Painter:
This letter is to acknowledge receipt of your application received November 13,
1995 for coverage under General Permit for Single Family Residences. The permit number
highlighted above has been assigned to the subject facility. By copy of this letter, we are
requesting that our Regional Office Supervisor prepare a staff report and recommendations
regarding this discharge.
If you have questions regarding this matter,please contact Susan Robson at(919)
733-5083.
Sincerely,
Q / 1-Trt.
Dave Goodrich
Supervisor, NPDES Group •
cc: fice (with attachments)
Permits and Engineering Unit
Central Files
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

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1314VIRoNmENT, IlEALTfl ,
&NATURAL RUSOURCES
.11111-4)44- e;tZUL-- NOV 3 1995
,2.2b ZacyjeS avzfre_ . DIVISION OF EOONTITAL MANASEMINT
MOORESVILLE REGIONAL OFFIE
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State of North Carolina
Department of Environment, Health and Natural Resources
Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27611
James G. Martin, Governor A.Preston Howard,Jr.,P.E.
William W. Cobey,Jr., Secretary Acting Direct&
NOTICE OF INTENT
National Pollutant Discharge Elimination System •
Application for Coverage under General Permit NCG540000; Single Family Domestic Units '
1. Name,Address,location,and telephone number of facility requgsting Permit.
A. Official Name: Teress,; ��ou [as ra; crer
B. Mailing Address:
(1)Street Address; 2,26 LJa
(2)City; (fiun+ l�ail�
(3)State; Perth Cmrlk'4a,
(4)Zip; 110
(5)County; Gas-ror Co401+y/
C. Location. (Attach map delineating general facility location) 1
(1)Street Address; West- Co-taw be Ave. - (No street n u n bet assign ec.�,)
(2)City; , . .f, t• J
(3)State; tOort-h Ca , ,na
(4)County; Gas rvn Cat."
D. Telephone Number; (I o`f) 81-i - 3.5 t5'
2. Facility Contact:
A. Name;
B. Title;
C. Company Name;
D. Phone Number;
3. Application type (check appropriate selection):
A. New or Proposed; ✓
B. Existing; If previously permitted,provide permit number
and issue date -
C. Modification;
(Describe the nature of the modification):
4. Description of discharge.
A. Please state the number of separate discharge points. •
• 1,[, 2,[l; 3,[); 4,[]; ,[].
B. Please describe the amount of wastewater being discharged per each separate discharge point.
(Design flow is based on 120 GPD/bedroom with a minimum of 240 GPD/home)
1:3 gallons per day (gpd) 2: (gpd) 3: (gpd) 4: (gpd)
Page 1

y
C. Check the duration and frequency of the discharge,per each separate discharge point
1.Continuous: f�
2.Intermittent(please describe): V �V�'UC G ,
3.Seasonal: (check the month(s)the discharge occurs):Janu [✓;February[vi;March [14 April [
May[, June f];July['J;,August-(];September 14;October[,a;November[a;December H.
4.How many days per week is there a discharge?(check the days the discharge occurs)
Monday[], Tuesday[], Wednesday[], Thursday[],Friday[], Saturday[], Sunday[].
5.How much of the volume discharged is treated? (State in percent) 10 0 %
D. Describe the type of wastewater being discharged. (please list any known toxants being
discharged from this residence);
E. Check the appropriate type of treatment being used to treat the wastewater,
1. Septic Tank; ✓ (2)
2. Dual Sand Filters; V
3. Recirculating Sand Filters;
4. Chlorination; V.
5. Other form of disinfection(specify);
6. Aeration(specify type);
7. Other(describe, be specific);
8.Please describe in detail the information checked above. (Include specifics for each check; to
include:type,dimensions,treatment amounts,design volumes,retention times for each
system,manufacture's specifics and contractor's specifics) Existing treatment facilities
should be described in detail and design criteria or operational data should be provided
(including calculations) to ensure that the facility can comply with requirements of
the General Permit.The following are the minimum design requirements needed for each of
the treatments listed above:
a.Septic Tank; Minimum tank septic tank size shall be 750 gallons for two bedrooms and
900 gallons for three bedrooms. The Division recommends the use of a 900 gallon tank for
a two bedroom and a 1200 gallon tank for a three bedroom unit. If excavation into
bedrock is necessary for the septic tank or sand filter then a liner of at least 10 mm
thickness shall be provided for the septic tank and/or sand filter.
b.Sand Filters(dual sand and recirculating sand filters); These shall be used to provide
secondary treatment. For the dual sand filters, the first filter shall be able to handle
1.15 GPD per square foot of filter and the second filter shall be able to handle 2.3 GPD
per square foot. These dual sand filters shall be in series. The Recirculating*Sand Filter
should be able to handle 5.0 GPD per square foot with no more than a 3:1 recirculating
ratio. Sand shall conform to the Division's standards of 0.35 to 0.5 mm effective size,3.0
uniformity coefficient,and 0.5%dust content.
c. Chlorination; The chlorine contact chamber shall have at least a 30 minute detention
time. The volume should be calculated as follows: Volume(gallons)=(design flow x
0.5)/ 24 hours.. Discharge pipe from the chlorinator shall be perforated.
d.Cascade aeration should consist of a 5 step concrete trough but may also be made of rip
rap.
NOTE: Construction of any wastewater treatment facilities require submission of three(3)sets of plans
and specifications along with their application. Design of treatment facilities must comply
with requirement 15A NCAC 2H .0138. If construction applies to the discharge, include the
three sets of plans and specifications/n1 with�� � the application.
C5. Name of receiving water: ,l/t.(.I V ' Classification: i'� T
(Attach a USGS to a hicawith all discharge point(s) clearly marked) ,� � �
PogT•P map L�tiC. ,
Page 2

6. Is the discharge directly to the receiving water?(Y,N)_
If no, state specifically the discharge point. Mark clearly he pathway to the potential receiving
waters on the site map. (This includes tracing the pathway of the storm sewer to its discharge point,
if a storm sewer is the only viable means of discharge.)
7. Please address possible non-discharge alternatives for the following options:
A. Connection to a Regional Sewer Collection System; "nkilt24,'4
B. Subsurface Disposal; l9 d- ohAo.-
C. Spray Irrigation; ` t L .
8. 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.
Printed Name of Person Signing ! PS So. TJ . ictnve r
Title P Dr-r+L OtAmt° V
Date Application Signed -17 /9% 5
Signature of Applican
t _aZ59-.624.-
NORTH CAROLINA GENERAL STATUTE 143-215.6 B (i)PROVIDES THAT:
Any person who knowingly makes any false statement, representation, or certification in any
application,record,report,plan or other document filed ur 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$10,000,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$10,000 or imprisonment not more than 5 years, or both, for a
similar offense.)
Notice of Intent must be accompanied by a check or money order for$400.00 made payable to the North
Carolina Department of Environment, Health, and Natural Resources. Mail three (3) copies of entire
package to:
Division of Environmental Management
NPDES Permits Group
Post Office Box 29535
Raleigh, North Carolina 27626-0535
•
Page 3

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SURVEY BY:
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LOT 021 PRESTON R. TAYLOR. JR.
REG SUR. L-I052
• 7779 HARBOR LANE
0 DENVER. N.C. 28037 '
�EPL�NEPOP TEL [phone]
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GASTON COUN TY
CATAWBA STREET SR02044)
l . i net r: MOUNT ,HCLLY. NORTH CAROLINA
now property of:
r a� CHARLES E.JONES and wife: PAUL!NE B.
30Q k --
NEW TRACT TO BE:
s b4-2B wa_BB,5.-.,� at
ti;..' PAULA TERESSA JONES PAINTER
CITES CREEK ' and aux. •
JAMES DOUGLAS PAINTER
Di D REFERENCES: DB0 1887 PG0162

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•
&NATU ti1ry.T. xF ,r , ..
12AL 38; 1
� 7g'DEC 1iy5
1 JON OF ENVIAONMENTAI
MOORESVILLE R MANAGEMENT
f6mm OFFICE
SOIL AND SITE REPORT FOR A GROUND ABSORPTION
WASTEWATER SYSTEM FOR CHARLES JONES / TERESA PAINTER
I
by
JOE LYNN, REGIONAL SOIL SPECIALIST
ON-SITE WASTEWATER SECTION
DIVISION OF ENVIRONMENTAL HEALTH
. a
•
Submitted to :
CURTIS HOPPER, EHS
GASTON COUNTY HEALTH DEPARTMENT
4,
OCTOBER 24 , 1995
Joe Lynn
Regional Soil Specialist

SUMMARY •
This site is UNSUITABLE for a ground absorption wastewater
treatment and disposal system under current laws and rules 15A
NCAC 18A . 1900 . No ground absorption wastewater (septic tank)
system can be permitted on this site.
This report gives a brief summary of the findings , conclusions ,
and recommendations .
If you have any questions or I can be of assistance contact me at
the Mooresville Regional Office ( 704 ) 663-1699 .
INTRODUCTION
COUNTY: Gaston
OWNER/APPLICANT: Charier Jooes / Teresa Painter
LOCATION: West Catawba Ave .
TYPE OF FACILITY: Residence
DESIGN UNIT: 360 gpd
PROPOSED WATER SUPPLY: On-site well
} EVALUATED BY: Joe Lynn assisted by Curtis Hopper using hand augers
t
1 DATE OF EVALUATION: September 21 , 1995
OTHER(S) PRESENT: Mr . Jones
•
SITE INFORMATION
AREA/PRESENT USE: Two acres / wooded
TOPOGRAPHY: 1 to 5 percent
LANDSCAPE POSITION: Flood plain , linear , and foot slopes
SITE LIMITATIONS : Low wet areas , creek , depressions
SOIL INFORMATION
SOIL TEXTURE: ( surface) Sandy loam, loam, and sandy clay loam
( subsoil ) Sandy clay and clay
•
SOIL STRUCTURE:- ( subsoil ) Blocky

CLAY MINERALOGY: 10 to 23 inches to expansive mineralogy
_1 SOIL DEPTH: 25 to 38 inches to saprolite , rock , or parent material
ESAPROLITE: 25 to 38 inches to unsuitable saprolite
SOIL WETNESS: 25 inches to chromas of 2 or less
RESTRICTIVE HORIZONS: None
AREA of S or PS SOIL: None
CONCLUSIONS
• This site is Unsuitable for the installation of a conventional
ground absorption wastewater system due to :
r 1 . Unsuitable Topography and Landscape Position Section . 1940
Depressions
2 . Unsuitable Soil Characteristics Section 1941
Expansive clay mineralogy
t 3 . Unsuitable Soil Wetness Section . 1942
Chromas of 2 or less Munsell Color Book
f 4 . Insufficient Soil Depth Section . 1943
Soil depths of less than 36 inches
5 . Insufficient Available Space Section . 1945
Not enough area for an initia' sewage system and a repair if .
t needed .
4
;' The site is Unsuitable under Rule . 1956 Modifications to Septic
Tank Systems :
1 . Shallow conventional system NO
t 2 . Large Diameter Pipe system NO
3 . Prefabricated Porous Block Panel system NO
4 . Drainage will not be sufficient to reclassify the site to
provisionally suitable .
5 . The saprolite is unsuitable by this rule , the texture is to
clayey .
• The site is Unsuitable under Rule . 1957 Alternative Sewage
Systems :
1 . Low-Pressure Pipe Systems NO
2 . Fill Systems NO
3 . Aerobic Treatment Systems NO
t
i
RECOMMENDATIONS
The Owner has the following options that might allow the use of
this property as desired :
• 1 : The applicant may purchase other Suitable or Provisionally
- Suitable property to place the around absorption sewage.. system
-on . -- --

2 . The applicant may obtain an easement on a Suitable or
Provisionally Suitable property to place the ground absorption
sewage system on .
3 . The Division of Environmental Management in Mooresville , N. C .
at ( 704 ) 663-1699 may be contacted to pursue options available
through that office . The applicant should contact someone with
a demonstrated knowledge of discharge systems to evaluate the
site before contacting this office .
4 . A sewage system can be pursued under Rule . 1948 (d) . Written
documentation must be submitted to your office showing that the
•
proposed system can be expected to function properly. The data
must contain the following :
A. The effluent must be non-pathogenic , non-infectious , non-
toxic , and non-hazardous .
B . The ground water and the surface water must not be
contaminated by the effluent .
C . The effluent must not be exposed to the ground surface or
discharged to surface waters where it could come into
contact with people , animals , or vectors .
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•
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