WQ0003158_Regional Office Historical File Pre 2018

Water Resources
ENVIRONMENTAL QUALITY
KIMBERLY A. KOCIK
5311 FLINT RIDGE CHURCH ROAD
MARSHVILLE, NORTH CAROLINA 28103
Dear Ms. Kocik:
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
Secretary
S. JAY ZIMMERMAN
Director
August 5, 2016 FILE
Subject: Permit No. WQ0003158
5311 Flint Ridge Church Rd. SFR
Single -Family Residence
Wastewater Irrigation System
Union County
In accordance with your permit renewal request received May 10, 2016, we are forwarding
herewith Permit No. WQ003158 dated August 5, 2016, to Kimberly A. Kocik for the continued operation
of the subject single-family residence wastewater treatment and irrigation facilities. Please note that this
renewed permit shall become effective on January 1, 2018 (i.e. the day after the expiration date of the
existing permit).
This permit shall be effective from January 1, 2018 until December 31, 2022, shall void Permit No.
WQ0003158 issued January 30, 2009, and shall be subject to the conditions and limitations as specified
therein. An extension shall be requested at least six months prior to the expiration of this permit.
Upon receipt of the request, the Commission will review the adequacy of the facility described therein and,
if warranted, will extend the permit for such period of time and under such conditions and limitations as it
may deem appropriate.
Please pay particular attention to the operation and maintenance requirements listed in Section III.
Failure to establish an adequate system for collecting and maintaining the required operational information
shall result in future compliance problems. Also note that Condition VI.6. requires the Permittee to retain
a set of Division approved plans and specifications for the life of the facilities permitted herein.
Please note the following permit condition has been removed since the last permit issuance
dated January 30, 2009:
➢ Old Condition I.51. — The setback to swimming pools has been removed because it was
inadvertently added in a previous permit issuance.
Please note the following permit conditions are new since the last permit issuance dated
January 30, 2009:
➢ Condition II.4. — This condition includes information about the wastewater irrigation field.
➢ Condition II.6. — This condition establishes the compliance boundary at the property boundary
in accordance with 15A NCAC 02L .0107(i).
State of North Carolina I Environmental Quality I Water Resources I Water Quality Permitting I Non -Discharge Permitting
1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919 807 6464

Ms. Kimberly A. Kocik
August 5, 2016
Page 2 of 2
➢ Condition II.7. — This condition establishes the review boundary midway between the
compliance boundary and the disposal area in accordance with 15A NCAC 02L .0108.
➢ Condition II.8. — This condition requires the Permittee to apply for a permit modification to
establish a new compliance boundary if any sale or transfer of property affects the existing
compliance boundary. .
➢ Condition IV.2.c. —'This condition requires the Permittee to notify the Division any time self -
monitoring indicates the facility has gone out of compliance with its permit limitations.
➢ Condition IV.2.d. — This condition requires the Permittee to notify the Division any time there
is ponding in or runoff from the irrigation sites.
➢ Condition VI.7. — This condition requires the Permittee to maintain this permit until all
permitted facilities are properly closed or permitted under another permit.
➢ Condition VI.8. — This condition notifies the Permittee that this permit is subject to revocation
or unilateral modification upon 60 days notice from the Division Director, in whole or part for
the requirements listed in 15A NCAC 02T .0110.
➢ Condition VI.9. — This condition notifies the Permittee that unless the Division Director grants
a variance, expansion of the permitted facilities contained herein shall not be granted if the
Permittee: has been convicted of an environmental crime; has previously abandoned a
wastewater treatment facility; has not paid a civil penalty; is non -compliant with a permit
schedule; or has not paid an annual fee.
If any parts, requirements or limitations contained in this permit are unacceptable, the Permittee
has the right to request an adjudicatory hearing upon written request within 30 days following receipt of
this permit. This request shall be in the form of a written petition, conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings at 6714 Mail Service
Center, Raleigh, NC 27699-6714. Unless such demands are made, this permit shall be final and binding.
If you need additional information concerning this permit, please contact Kipp Glazier at (919)
807-6319 or kipp. lg azierQncdenr.gov.
Sincerely,
y S. Jay Zimmerman, P.G., Directo
U Division of Water Resources
cc: Union County Health Department (Electronic Copy)
Morrisville Regional Office, Water Quality Regional Operations Section (Electronic Copy)
Digital Permit Archive (Electronic Copy)
Central Files

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
RALEIGH
SINGLE-FAMILY RESIDENCE WASTEWATER IRRIGATION SYSTEM PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules and Regulations
PERMISSION IS HEREBY GRANTED TO
Kimberly A. Kocik
Union County
FOR THE
continued operation of a 750 gallon per day (GPD) single-family residence wastewater treatment and
irrigation facility consisting of:
1,200 gallon baffled septic tank; a 1,200 gallon pump tank with a 52 gallon per minute (GPM) recirculation
pump; a flow splitter; a 150 square foot (ftz) recirculating sand filter; a tablet chlorinator; a 2,000 gallon
chlorine contact storage/pump tank; a 20 GPM self -priming effluent dosing pump; a 0.16 acre spray
irrigation area with three sprinklers; and all associated piping, valves, controls, and appurtenances
to serve the single-family residence at 5311 Flint Ridge Church Rd., Marshville, NC 28103, with no
discharge of wastes to surface waters, pursuant to the application received May 10, 2016, and in conformity
with the project plans, specifications, and other supporting data subsequently filed and approved by the
Department of Environmental Quality and considered a part of this permit.
This permit shall be effective from January 1, 2018 until December 31, 2022, shall void Permit No.
WQ0003158 issued January 30, 2009, and shall be subject to the following specified conditions and
limitations:
I. SCHEDULES
1. No later than six months prior to the expiration of this permit, the Permittee shall request renewal of
this permit on official Division forms. Upon receipt of the request, the Division will review the
adequacy of the facilities described therein, and if warranted, will renew the permit for such period of
time and under such conditions and limitations as it may deem appropriate. Please note Rule 15A
NCAC 02T .0105(d) requires an updated site map to be submitted with the permit renewal application.
[15A NCAC 02T .0105, 02T .0109, 02T .0115(c)]
2. If a public or community sewage system is or becomes available, the subject single-family residence
wastewater treatment and irrigation facilities shall be closed and all wastewater shall be discharged into
the public or community sewage system within 180 days of its availability. Prior to the initiation of
these connection activities, appropriate Division approval shall be received. [15A NCAC 02T .0607]
WQ0003158 Version 4.0 Shell Version 151201 Page 1 of 6

H. PERFORMANCE STANDARDS
The subject non -discharge facilities shall be effectively maintained and operated at all times so there is
no discharge to surface waters, nor any contravention of groundwater or surface water standards. In
the event the facilities fail to perform satisfactorily, including the creation of nuisance conditions due
to improper operation and maintenance, or failure of the irrigation areas to adequately assimilate the
effluent, the Permittee shall take immediate corrective actions including Division required actions, such
as the construction of additional or replacement wastewater treatment or disposal facilities. [15A
NCAC 02T .0108(b)(1)]
2. This permit shall not relieve the Permittee of their responsibility for damages to groundwater or surface
water resulting from the operation of this facility. [ 15A NCAC 02B .0200, 02L .0100]
3. Application rates, whether hydraulic, nutrient or other pollutant, shall not exceed those specified in the
following table:
TABLE 1 —APPLICATION LIMITATIONS
Field
Parameter
Hourly Rate
Yearly Max
Units
1
01284 — Non -Discharge Application Rate
N/A
39
inches
[15A NCAC 02T .06050)]
4. The subject facility has been approved to land apply wastewater effluent on the following fields:
TABLE 2 — IRRIGATION AREA INFORMATION
Field
Owner
County
Latitude
Longitude
Net
Acrea a
Dominant
Soil Series
1
Kimberly A. Kocik
Union
34.9398910
-80.3445760
0.16
Goldston
[G. S. 143-215.1 ]
5. The Operation and Maintenance Agreement (attached) between the Permittee and the Division of Water
Resources is incorporated herein by reference and shall be a condition of this permit. Noncompliance
with the terms of the Operation and Maintenance Agreement shall subject the Permittee to all sanctions
provided by North Carolina General Statutes § 143-215.6A to § 143-215.6C for violation of or failure
to act in accordance with the terms and conditions of this permit. [15A NCAC 02T .0115 (2)]
6. The compliance boundary is established at the property boundary. Any exceedance of standards at the
compliance boundary shall require action in accordance with 15A NCAC 02L .0106. [15A NCAC 02L
.0107(i)]
7. The review boundary is established midway between the compliance boundary and the effluent disposal
area. Any exceedance of groundwater standards at the review boundary shall require action in
accordance with 15A NCAC 02L .0106. [15A NCAC 02L .0108]
8. The Permittee shall apply for a permit modification to establish a new compliance boundary prior to
any sale or transfer of property affecting a compliance boundary. [15A NCAC 02L .0107(c)]
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PV 9
The facilities permitted herein shall be constructed according to the following setbacks:
a. The setbacks for irrigation sites permitted under 15A NCAC 02H .0200 shall be as follows (all
distances in feet):
i. Any habitable residence or place of public assembly under separate ownership: 400
ii.
iii. Surface waters: 100
iv. Any well with exception of monitoring wells: 100
v. Any property line: 150
vi.
vii. Public right of way: 50
[15A NCAC 02H .02190)]
b. The setbacks for storage and treatment units permitted under 15A NCAC 02H .0200 shall be as
follows (all distances in feet):
i. Any well with exception of monitoring wells: 100
ii. Any property line: 50
[15A NCAC 02H .02190)]
III. OPERATION AND MAINTENANCE REOUHIEMENTS
1. The facilities shall be properly maintained and operated at all times. The facilities shall be effectively
maintained and operated as a non -discharge system to prevent the discharge of any wastewater resulting
from the operation of this facility. The Permittee shall maintain an Operation and Maintenance Plan
pursuant to 15A NCAC 02T .0604(f). [ 15A NCAC 02T .0604(f)]
2. Upon the Water Pollution Control System Operators Certification Commission's (WPCSOCC)
classification of the subject non -discharge facilities, in accordance with 15A NCAC 08G .0200 the
Permittee shall designate and employ a certified operator in responsible charge (ORC) and one or more
certified operator(s) as back-up ORC(s). The ORC or their back-up shall visit the facilities in
accordance with 15A NCAC 08G .0200, and shall comply with all other conditions specified in the
previously cited rules. [15A NCAC 02T .0117]
3. A suitable year round vegetative cover shall be maintained at all times, such that crop health is
optimized, allows for even distribution of effluent and allows inspection of the irrigation system. [15A
NCAC 02T .0108(b)(1)]
4. Adequate measures shall be taken to prevent effluent ponding in or runoff from the irrigation sites listed
in Condition II.4. [15A NCAC 02T .0605(o)]
5. Irrigation shall not be performed during inclement weather or when the ground is in a condition that
will cause ponding or runoff. [15A NCAC 02T .0605(o)]
6. Only effluent from the single-family residence at 5311 Flint Ridge Church Rd., Marshville, NC 28103
shall be irrigated on the sites listed in Condition II.4. [G.S. 143-215.1]
No automobiles or machinery shall be allowed on the irrigation sites except during equipment
installation or while maintenance is being performed. [15A NCAC 02T .0108(b)(1)]
8. Public access to the irrigation sites and wastewater treatment facilities shall be prohibited. Fencing
shall be provided to prevent access to the irrigation site (minimum 2-strand wire) and treatment units
shall be secured with locks on all tank accesses and control panels. [15A NCAC 02T .0605(i)]
WQ0003158 Version 4.0 Shell Version 151201 Page 3 of 6

IV.
9. The residuals generated from the wastewater treatment facilities shall be disposed or utilized in
accordance with 15A NCAC 02T .1100. [ 15A NCAC 02T .1100].
10. Diversion or bypassing of untreated or partially treated wastewater from the treatment facilities is
prohibited. [15A NCAC 02T .0605(f)]
11. Pump/dosing tanks shall have audible and visual alarms external to any structure. [15A NCAC 02T
.0605(n)]
12. The Permittee is responsible for the operation and maintenance of the entire treatment and disposal
system including, but not limited to, the following items:
a. The septic tank shall be checked annually and pumped out as needed. The septic tank effluent filter
shall be checked and cleaned at the same frequency as the septic tank. [15A NCAC 18A .1900,
02T .0605]
b. The tablet chlorinator shall be checked weekly. Wastewater grade chlorine tablets (calcium
hypochlorite) shall be added as needed to provide proper chlorination. Pool chlorine tablets shall
not be used. [15A NCAC 02T .0605(1)]
c. The storage, pump, and alarm systems shall be inspected monthly. The scum layer in the pump
tank shall be removed at the same interval as the septic tank is cleaned out. [15A NCAC 02T
.0108(b)(1)]
d. The system shall be inspected monthly to make certain of the proper operation of the spray heads,
that the system is free of leaks, that the vegetative growth allows a proper spray pattern, that the
soil is assimilating the disposed treated wastewater with no surface runoff, and that no objectionable
odors are being generated. [15A NCAC 02T .0108(bxl)]
MONITORING AND REPORTING REQUIREMENTS
1. Any Division required monitoring (including groundwater, plant tissue, soil and surface water analyses)
necessary to ensure groundwater and surface water protection shall be established, and an acceptable
sampling reporting schedule shall be followed. [15A NCAC 02T .0108(c)]
2. Noncompliance Notification:
The Permittee shall report by telephone to the Mooresville Regional Office, telephone number (704)
661-1699, as soon as possible, but in no case more than 24 hours, or on the next working day following
the occurrence or first knowledge of the occurrence of any of the following:
a. Any process unit failure (e.g., mechanical, electrical, etc.), due to known or unknown reasons,
rendering the facility incapable of adequate wastewater treatment.
b. Any facility failure resulting in a by-pass directly to receiving surface waters.
c. Any time self -monitoring indicates the facility has gone out of compliance with its permit
limitations.
d. Ponding in or runoff from the irrigation sites.
Any emergency requiring immediate reporting (e.g., discharges to surface waters, imminent failure of
a storage structure, etc.) outside normal business hours shall be reported to the Division's Emergency
Response personnel at telephone number [phone], [phone], or [phone]. Persons
reporting such occurrences by telephone shall also file a written report in letter form within five days
following first knowledge of the occurrence. This report shall outline the actions taken or proposed to
betaken to ensure the problem does not recur. [15A NCAC 02T .0105(1)]
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V. INSPECTIONS
1. The Permittee shall provide adequate inspection and maintenance to ensure proper operation of the
wastewater treatment and irrigation facilities. [ 15A NCAC 02T .0108(b)]
2. The Permittee or their designee shall inspect the wastewater treatment and irrigation facilities to prevent
malfunctions, facility deterioration and operator errors resulting in discharges, which may cause the
release of wastes to the environment, a threat to human health or a public nuisance. The Permittee shall
maintain an inspection log that includes, at a minimum, the date and time of inspection, observations
made, and any maintenance, repairs, or corrective actions taken. The Permittee shall maintain this
inspection log for a period of five years from the date of the inspection, and this log shall be made
available to the Division upon request. [15A NCAC 02T .0108(b)]
3. Any duly authorized Division representative may, upon presentation of credentials, enter and inspect
any property, premises or place on or related to the wastewater treatment and irrigation facilities
permitted herein at any reasonable time for the purpose of determining compliance with this permit;
may inspect or copy any records required to be maintained under the terms and conditions of this permit,
and may collect groundwater, surface water or leachate samples. [G.S. 143-215.3(a)(2)]
VI. GENERAL CONDITIONS
1. Failure to comply with the conditions and limitations contained herein may subject the Permittee to an
enforcement action by the Division in accordance with North Carolina General Statutes 143-215.6A to
143-215.6C. [G.S. 143-215.6A to 143-215.6C]
2. This permit shall become voidable if the permitted facilities are not constructed in accordance with the
conditions of this permit, the Division approved plans and specifications, and other supporting
documentation. [ 15A NCAC 02T .0110]
3. This permit is effective only with respect to the nature and volume of wastes described in the permit
application, Division approved plans and specifications, and other supporting documentation. No
variances to applicable rules governing the construction or operation of the permitted facilities are
granted, unless specifically requested and approved in this permit pursuant to 15A NCAC 02T .0105(n).
[G.S. 14.-215.1 ]
4. The issuance of this permit does not exempt the Permittee from complying with any and all statutes,
rules, regulations, or ordinances, which may be imposed by other jurisdictional government agencies
(e.g., local, state, and federal). Of particular concern to the Division are applicable river buffer rules in
15A NCAC 02B .0200; erosion and sedimentation control requirements in 15A NCAC Chapter 4 and
under General Permit NCGO10000; any requirements pertaining to wetlands under 15A NCAC 02B
.0200 and 02H .0500; and documentation of compliance with Article 21 Part 6 of Chapter 143 of the
General Statutes. [15A NCAC 02T .0105(c)(6)]
5. In the event the permitted facilities change ownership or the Permittee changes their name, a formal
permit modification request shall be submitted to the Division. This request shall be made on official
Division forms, and shall include appropriate property ownership documentation and other supporting
documentation as necessary. The Permittee of record shall remain fully responsible for maintaining
and operating the facilities permitted herein until a permit is issued to the new owner. [15A NCAC
02T .0104]
6. The Permittee shall retain a set of Division approved plans and specifications for the life of the facilities
permitted herein. [15A NCAC 02T .0108(b)(1)]
7. The Permittee shall maintain this permit until all permitted facilities herein are properly closed or
permitted under another permit issued by the appropriate permitting authority. [15A NCAC 02T
.01050)]
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8. This permit is subject to revocation or unilateral modification upon 60 days notice from the Division
Director, in whole or part for the requirements listed in 15A NCAC 02T .0110. [ 15A NCAC 02T .0110]
9. Unless the Division Director grants a variance, expansion of the permitted facilities contained herein
shall not be granted if the Permittee exemplifies any of the criteria in 15A NCAC 02T .0120(b). [15A
NCAC 02T .0120]
10. The Permittee shall pay the annual fee within 30 days after being billed by the Division. Failure to pay
the annual fee accordingly shall be cause for the Division to revoke this permit. [15A NCAC 02T
.0105(e)(3)]
Permit issued this the 51 day of August 2016
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
S. Jay Zimmerman, P.G., Director
Division of Water Resources
By Authority of the Environmental Management Commission
Permit Number WQ0003158
WQ0003158 Version 4.0 Shell Version 151201 Page 6 of 6

34056'23.7"N 80°20'37.5"W - Google Maps
Go gle Maps 34056'23.7"N 80020'37.5"W
WQ0003158 - 5311 Flint Ridge Church Rd. SFR
Imagery ©2016 Google, Map data Oe 2016 Google 100 ft
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31
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State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0600 - SINGLE-FAMILY RESIDENCE WASTEWATER IRRIGATION SYSTEMS
OPERATION AND MAINTENANCE AGREEMENT
Division of Water Resources FORM: SFRWWIS O&M 11-15
Permit No. 0(::� o D 6.3) 5z
Property owner(s) as appearing on the recorded deed:
County: t hi Ian
Mailing address: .531 kL4 e 64 yn,k rb h vi Z! if 2,16 �
Facility address: 5-01 /-7, a f Rid a f- 6,hC-1,A ��, f%1 Cy-ihv zM y v c, �-16 -_3
Irrigation Method: SPRAY ❑ DRIP
I / We agree to operate and maintain the single-family residence wastewater treatment and irrigation system as follows:
1. The Permittee is responsible for the operation and maintenance of the entire wastewater treatment and irrigation
system including, but not limited to, the following items:
a. The septic tank shall be checked annually and pumped out as needed.
b. The septic tank effluent filter shall be checked and cleaned annually.
c. Accessible sand filter surfaces shall be raked and leveled every six months and any vegetative growth shall be
removed manually.
d. Ill The tablet chlorinator shall be checked weekly. Wastewater grade tablets (calcium hypochlorite) shall be
added as needed to provide proper chlorination (pool chlorine tablets shall not be used), OR
❑ The ultraviolet disinfection unit shall be checked weekly. The lamp(s) and quartz sleeve(s) shall be cleaned
or replaced as needed to ensure proper disinfection.
e. All pump and alarm systems shall be inspected monthly.
f. The irrigation system shall be inspected monthly to ensure that the system is free of leaks, that all irrigation
equipment is operating as designed, that vegetative growth does not interfere with the system inspection or
operation, that the .soil is assimilating the disposed treated wastewater with no visible runoff or ponding, and
that no objectionable odors are being generated.
2. Failure to pay the annual fee shall be cause for the Division to revoke the permit pursuant to 15A NCAC 02T
.0105(e)(3).
3. The Permittee's failure to properly operate this system is subject to a penalty up to $25,000 per day.
4. Failure to meet the permit conditions or violation of the State's surface water or groundwater regulations may void
the permit.
All owners aygearing on the legally recorded property deed shall sign ft Operation & Maintenance Agreement
I ! We understand the above requir ents and agree to these terms as part of the issued permit.
Owner Signature: Date: S - o? a O 1 (o
Owner Signature: Date:

Compliance Inspection Report
Permit: WO0003158 Effective: 01/01/18 Expiration: 12/31/22 owner: Kimberly A Kocik
SOC: Effective: Expiration: Facility: 5311 Flint Ridge Church Rd. SFR
County: Union 5311 Flint Rdg Church Rd
Region: Mooresville
Marshville NC 28103
Contact Person: Kimberly A Kocik Title: Phone: [phone]
Directions to Facility:
From Mooresville take 1-77S to 1-277E, take exit 213 and follow US 74E (E. Independence Blvd) -33.8 mi turn R, take S. White Rd
(turns into Landsford Rd) -3.6 mi, turn L onto Flint Ridge Ch Rd., first driveway on Lt
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 07/04/1976 Entry Time: Exit Time:
Primary Inspector: Maria Schutte Phone: [phone]
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Single -Family Residence Wastewater Irrigation
Facility Status: ❑ Compliant ❑ Not Compliant
Question Areas:
Miscellaneous Questions Permit Status Septic Tank
Sand Filter/Treatment Pods Disinfection UV Disinfection Tablets
Pump Tank Drip or Irrigation General
(See attachment summary)
Page: 1

Permit: WQ0003158 Owner - Facility: Kimberly A Kocik
Inspection Date: 07/04/1976 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
Page: 2

Permit: W00003158 Owner - Facility: Kimberly A Kocik
Inspection Date: 07/0411976 Inspection Type: Compliance Evaluation Reason for Visit: Routine
Permit Status
Yes No NA NE
# Is the current resident in the home the Permittee? ❑ ❑ ❑ ❑
# If not, does the resident rent from the Permittee? ❑ ❑ ❑ ❑
Change of Ownership form needed? (Mail the form with the inspection letter) ❑ ❑ ❑ ❑
# Is there an inspection and maintenance agreement with a contractor? ❑ ❑ ❑ ❑
If YES, who is the contractor (include contact info)?
Comment:
Septic Tank Yes No NA NE
*** The septic tank and filters should be checked annually and pumped/cleaned as needed. ***
Is all wastewater from the home connected to the septic tank? ❑ ❑ ❑ ❑
# Does the permittee/resident know where the septic tank is located? ❑ ❑ ❑ ❑
Has the septic tank been pumped in the last 5 years? ❑ ❑ ❑ ❑
If YES, describe if known and proof (include date pumped):
# Does the septic tank have an EFFLUENT FILTER or SANITARY T? ❑ ❑ ❑ ❑
If FILTER, when was the filter cleaned and by who?
Comment:
Sand Filter/Treatment Pods Yes No NA NE
*** Accessible sand filter surfaces shall be raked/leveled every 6 months and vegetative growth shall be
removed manually. ***
# Is system something other than a sand filter? ❑ ❑ ❑ ❑
# If YES, what kind? (examples - Peat, Textile or brand name - Advantex, etc.)
# Does the permittee know where the sandfilter is located? ❑ ❑ ❑ ❑
Does the sandfilter require maintenance? ❑ ❑ ❑ ❑
If maintenace is required, explain:
Comment:
Disinfection UV Yes No NA NE
*** UV unit shall be checked weekly. Lamps/sleeves should be cleaned/replaced as needed to ensure
proper disinfection. —
Is UV working? ❑ ❑ ❑ ❑
Has the UV Unit been serviced and bulbs cleaned? ❑ 1111 ❑
# Who completes the weekly check for the UV? ( Non -Discharge)
Comment:
Disinfection Tablets Yes No NA NE
*** Tablet chlorinator unit shall be checked weekly to ensure continuous and proper operation. ***
Does the permittee have the correct chlorine tablets? (If none, mark No) ❑ ❑ ❑ ❑
Page: 3

permit: W00003158 Owner - Facility: Kimberly A Kocik
Inspection Date: 07/04/1976 Inspection Type : Compliance Evaluation Reason for Visit: Routine
# Does the Permittee know the location of the chlorinator? ❑ ❑ ❑ ❑
Were chlorine tablets observed in the chlorinator? ❑ ❑ ❑ ❑
Are tablets contacting water? (If possible, poke them to determine.) ❑ ❑ ❑ ❑
Comment:
Pump Tank Yes No NA NE
*** All pump and alarm sytems shall be inspected monthly. (Non -Discharge) ***
Is the pump working? ❑ ❑ ❑ ❑
Is the audible and visual high water alarm operational? ❑ ❑ ❑ ❑
# Does the permittee know how to check the pump & high water alarm? ❑ ❑ ❑ ❑
# Last functional test:
Comment:
Drip or Irrigation
Yes No NA NE
*** Irrigation sysetm shall be inspected monthly to ensure system is free of leaks and equipment is operating
as designed. ***
# Type of system (DRIP or IRRIGATION):
# If IRRIGATION, number of sprinkler heads:
Are buffers and setbacks adequate? ❑ ❑ ❑ ❑
Is the site free of ponding and runoff? ❑ ❑ ❑ ❑
Does the application equipment appear to be working properly? ❑ ❑ ❑ ❑
Is there a minimum two wire fence surrounding the entire irrigation area? ❑ ❑ ❑ ❑
Comment:
General
Yes No NA NE
# Are the treatment units locked and/or secured?
❑
❑ ❑ ❑
# Has resident had any sewage problems?
❑
❑ ❑ ❑
If YES. explain:
Does the system match the permit description?
❑
❑ ❑ ❑
If NO, explain:
Is the system compliant?
❑
❑ ❑ ❑
Is the system failing? (If yes, take pictures if possible)
❑
❑ ❑ ❑
If system is failing, describe any exposures to people/animals or environmental risks
Comment:
Page 4

State of North Carolina
Department of Environmental Quality
Division of Water Resources
FVDWR WATER QUALITY REGIONAL OPERATIONS SECTION
Division of Water Resources NON -DISCHARGE APPLICATION REVIEW REQUEST FORM
RECEIVEDINGUENROWK
May 11, 2016
MAY 13 2016
To:
WQROS
MQQRESVILLE REGIONAL OFFICE
From: Kipp Glazier, Water Quality Permitting Section - Non -Discharge Permitting unit
Permit Number: WQ0003158
Applicant: Kimberly A. Kocik
Owner Type: Individual
Facility Name: 5311 Flint Ridge Church Rd. SFR
Signature Authority: Kimberly A. Kocik
Permit Type: Single -Family Residence Wastewater Irrigation
Project Type: Renewal
Owner in BIMS? Yes
Facility in BIMS? Yes
Title: Owner
Address: 5311 Flint Ridge Church Rd., Marshville, North Carolina 28103 County: Union
Fee Category: Single -Family Residence Wastewater Irrigiaton Fee Amount: $0
Comments/Other Information:
Attached, you will find all information submitted in support of the above -referenced application for your review,
comment, and/or action. Within 45 calendar days, please take the following actions:
® Return this form completed.
❑ Attach an Attachment B for Certification
® Return a completed staff report.
❑ Issue an Attachment B Certification.
When you receive this request form, please write your name and dates in the spaces below, make a copy of this sheet, and
return it to the appropriate Central Office Water Quality Permitting Section contact person listed above.
RO-WQROS Reviewer:
Date: 5
FORM: WQROSNDARR 09-15 Page 1 of 1

RECEIVED/NCDENRIDWR
MAY 13 2016
Water Resources WQROS
ENVIRONMENTAL QUALITY MOORESVILLE REGIONAL OFFICE
May 11,1,U16
KIMBERLY A. KOCIK
5311 FLINT RIDGE CHURCH RD.
MARSHVILLE, NORTH CAROLINA 28103
Dear Ms. Kocik:
PAT MCCRORY
Govemor
DONALD R. VAN DER VAART
Secretary
S. JAY ZIMMERMAN
Subject: Acknowledgement of .
Application No. WQ0003158
5311 Flint Ridge Church Rd.
SFR
Single -Family Residence
Wastewater Irrigation System
Union County
The Water Quality Permitting Section acknowledges receipt of your permit application and
supporting documentation received on May 10, 2016. Your application package has been assigned the
number listed above, and the primary reviewer is Kipp Glazier.
Central and Mooresville Regional Office staff will perform a detailed review of the provided
application, and may contact you with a request for additional information. To ensure maximum efficiency
in processing permit applications, the Division of Water Resources requests your assistance in providing a
timely and complete response to any additional information requests.
Please note that processing standard review permit applications may take as long as 60 to 90 days
after receipt of a complete application. If you have any questions, please contact
Kipp Glazier at [phone] or [e-mail].
Sincerely,
Nathaniel D. Thornburg, Supervisor
Division of Water Resources
cc:
Permit File WQ0003158
Director
State of North Carolina I Environmental Quality I Water Resources I Water Quality Permitting I Non -Discharge Permitting
1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919 807 6464

Division of Water Resources
`VEDIN��E��wR
RECE
IJIAY 1 0 2p16
State of North Carolii
Department of Environmental Quali
Division of Water Resourc
NON -DISCHARGE SYSTEM RENEWY
FORM: NDSR 11-
Non'plsrna
I. PERMITTEE INFOZZ7/
: Pe�tttan9
1. Permittee's name: E'l � ���s �1l
2. Signature authority's name: per I'V Ab`Cl y Title: to e_r �29
3. Perminee's mailing address: i? l / 9,4 Ada e-l0�c`�,
City:►%f-; Vide_ State: N6 Zip: lo"-
4. Permittee's contact information: Phone number: (2�0 2Zl - l Email Address:
II. FACILITY INFORMATION:
1. Facility name:1�mb4ly
c�
2. Facility's physical address:` ��riQe�cJe.t R
City[ha f h We State: ,Nf__ Zip: Wb County: 1� � c A
III. PERMIT INFORMATION:
1. Existing permit number: WQ00 � .5' and most recent issuance date:
2. Existing permit type: Select j�'�n I. ! f�' icQ P41G e:
3_ Has the facility been constructed? XYes or 0 No
4. Demonstration of historical consideration for permit approval -
Has the Applicant or any parent, subsidiary or other affiliate exhibited the following?
a. Has been convicted of environmental crimes under Federal law or ? 0 Yes orpo
b. Has previously abandoned a wastewater treatment facility without properly closing that facility? 0 Yes or6To
c. Has unpaid civil penalty where all appeals have been abandoned or exhausted? 0 Yes oMNo
d. Is non -compliant with an existing non -discharge permit, settlement agreement or order? 0 Yes or
e. Has unpaid annual fees in accordance with
Applicant's Certification per
? 0 Yes oXNo
t, ) i�///`>✓ U �/ �- / attest that this application
j (Signature Auutho ty's name & title from Application Item 1.2.)
/
(Facility name from Application Item II.1.)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that any discharge of wastewa:
from this non -discharge system to surface waters or the land will result in an immediate enforcement action that may include ci
penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a conditi
of this permit be violated. I also understand that if all required parts of this application package are not completed and that if all requir
supporting information and attachments are not included, this application package will be returned to me as incomplete. I further cert
that the Applicant or any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility with(
proper closure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are compliant with a
active compliance schedule, and do not have any overdue annual fees per
NOTE - In accordance with General Statutes and , any person who knowingly makes any false stateme:
representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may include a fine not
exceed $10,000 as e civil enalti s to $25,00 per violation.
Signature: _ - Date: v5_- o2 LaO l 6

State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0600 — SINGLE-FAMILY RESIDENCE WASTEWATER IRRIGATION SYSTEMS
OPERATION AND MAINTENANCE AGREEMENT
Division of Water Resources FORM: SFRWWIS O&M 11-15
County: 0/116/ 1
Property owner(s) as appearing on the recorded deed:
Mailing address:
531/ F1��FJ�i�i�uc &;yak IOU 919L5h L21
TJ� cb
22210 -2'
Facility address:
P% at R► ld q e e6,,I-ch /4-� `i'1 Q -5h0 i//�
� �
a-
Irrigation Method: SPRAY ❑ DRIP
I / We agree to operate and maintain the single-family residence wastewater treatment and irrigation system as follows:
1. The Permittee is responsible for the operation and maintenance of the entire wastewater treatment and irrigation
system including, but not limited to, the following items:
a. The septic tank shall be checked annually and pumped out as needed.
b. The septic tank effluent filter shall be checked and cleaned annually.
c. Accessible sand filter surfaces shall be raked and leveled every six months and any vegetative growth shall be
removed manually.
d. X The tablet chlorinator shall be checked weekly. Wastewater grade tablets (calcium hypochlorite) shall be
added as needed to provide proper chlorination (pool chlorine tablets shall not be used), OR
❑ The ultraviolet disinfection unit shall be checked weekly. The lamp(s) and quartz sleeve(s) shall be cleaned
or replaced as needed to ensure proper disinfection.
e. All pump and alarm systems shall be inspected monthly.
f. The irrigation system shall be inspected monthly to ensure that the system is free of leaks, that all irrigation
equipment is operating as designed, that vegetative growth does not interfere with the system inspection or
operation, that the soil is assimilating the disposed treated wastewater with no visible runoff or ponding, and
that no objectionable odors are being generated.
2. Failure to pay the annual fee shall be cause for the Division to revoke the permit pursuant to 15A NCAC 02T
.0105(e)(3).
3. The Permittee's failure to properly operate this system is subject to a penalty up to $25,000 per day.
4. Failure to meet the permit conditions or violation of the State's surface water or groundwater regulations may void
the permit.
All owners appearing on the legally recorded property deed shall sign this Operation & Maintenance Agreement
I / We understand the above requir ents and agree to these terms as part of the issued permit.
Owner Signature: Date:
Owner Signature:
Date:
FORM- CFRWWIR OkM 11-15 Paee 1 of 1

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�0W A r§9 Beverly Eaves Perdue, Governor
Dee Freeman, Secretary
co p North Carolina Department of Environment and Natural Resources
G ? Coleen H. Sullins, Director
Division of Water Quality
January 30, 2009
Kimberly Kocik
5311 Flint Ridge Church Rd
Marshville, NC 28103
Dear Ms. Kocik:
Subject: Permit No. WQ0003158
Kimberly Kocik SFR
Surface Irrigation Facility
Wake County
In accordance with your permit renewal request received September 26, 2008, we are forwarding
herewith Permit No. WQ0003158, dated January 30, 2009, to Kimberly Kocik for the continued operation
of the subject single family wastewater treatment and surface irrigation facilities. The system was
designed and originally permitted in 1984 (Permit No. 10269) to serve a single family residence at 450
gallons per day. In 1985 a permit modification changed the flow to 750 gallons per day to include a
second single family -type dwelling. However, this modification did not change the capacity of the
treatment facilities designed to serve these two single family residences. The Division is assuming,
because the existing records are incomplete, that this action was taken to accommodate a family member
residing at the same location in the second house. Please be advised that this system cannot accommodate
an increase in flow if more than one person resides in this second house and therefore, a modification to
the existing facilities would be necessary prior to that occurring. A system failure could result if actual
flows exceed design capacity of the subject system. Please note Condition I(1) as well as other
conditions of this permit that require action for any type of system failure or any other problems resulting
in the operation of this system.
This permit shall be effective from the date of issuance until December 31, 2013, shall void Permit No.
WQ0003158 issued August 9, 2004, and shall be subject to the conditions and limitations as specified
therein. Please pay particular attention to the monitoring requirements in this permit. Failure to establish
an adequate system for collecting and maintaining the required operational information will result in
future compliance problems.
An extension shall be requested at least six (6) months prior to the expiration of this permit. Upon receipt
of the request the Commission will review the adequacy of the facility described therein and, if warranted,
will extend the permit for such period of time and under such conditions and limitations as it may deem
appropriate.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to
request an adjudicatory hearing upon written request within thirty (30) days following receipt of this
permit. This request must be in the form of a written petition, conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service
Center, Raleigh, NC 27699-6714. Unless such demands are made this permit shall be final and binding.
•
Please contact John McCray at [phone] if you need additional information concerning this matter.
Nov` Carolina
Na AWAY
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Phone [phone] Customer Service
Internet: http://h2o.enr.state.nc.us 2728 Capital Boulevard Raleigh, NC 27604 Fax [phone]
Fax [phone]
n Equal UpportunlWffirmalive Acton Lmployer— o Recycle Flost Gonsumer Paper

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH
SINGLE FAMILY RESIDENCE SURFACE IRRIGATION PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Kimberly Kocik
Union County
FOR THE
continued operation of a ?50 gallon per day (GPD) surface irrigation wastewater treatment and disposal
system consisting of a 1,200 gallon baffled septic tank, a I,200 gallon pump tank With a 52 tallow per
minute (GPM) recirculation pump, a flow splitter, a 150 square foot recirculating sand filter, a tablet
chlorinator, a 2,00U gallon chlorine contact suorageipump tank, a 20 GPM sell -priming effluent dosing
pu171p. a 6,969 square foot spray irrigation area with three sprinklers, and all associated piping and
appurtenances, to serve the Kimberly Kocik residence with no discharge of wastes to the surface waters,
pursuant to the application received September 26, 2008, and in conformity with the project plan,
specifications, and other supporting data subsequently filed and approved by the Department of
Environment and Natural Resources and considered a part of this permit.
This permit shall be effective from the date of issuance until December 31, 2013, shall void Permit No.
WQ0003158 issued August 9, 2004, and shall be subject to the following specified conditions and
limitations:
I. PERFORMANCE STANDARDS
1. The surface irrigation facilities shall be effectively maintained and operated at all times so °that
there is no discharge to surface waters, nor any contamination of ground waters, which will
render them unsatisfactory for normal use. In the event that the facilities fail to perform
satisfactorily, including the creation of nuisance conditions or failure of the irrigation area to
adequately assimilate the wastewater, the Permittee shall take immediate corrective actions
including those actions that may be required by the Division of Water Quality, such as the
construction of additional or replacement wastewater treatment and disposal facilities.
2. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to
surface or ground waters resulting from the operation of this facility.
3. The residuals generated from these treatment facilities must be disposed in accordance with
General Statute 143-215.1 and in a manner approved by the Division.
4. Diversion or bypassing of the untreated wastewater from the treatment facilities is prohibited.

PV
5. The following set -backs shall be maintained:
a. 40() feet between wetted area and any residence or places of public assembly under separate
ownership,
b. 1 * (O feel between wetted area and property lines,
c. 100 feet between wetted area and wells,
d. 100 feet between wetted area and drainage ways or surface water bodies,
e. 50 feet between wetted area and public right of ways,
f. 100 feet between treatment/storage units and any wells,
g. 50 feet between treatment units and property lines, and
h. 100 feet between wetted area and swimming pools.
Some of the set -backs specified above may not have been included in previous pennits for this
waste treatment and disposal system. These set -backs are not intended to prohibit or prevent
modifications, which are required by the Division, to improve performance of the existing
treatment facility. These set -backs do, however, apply to modifications of the treatment and
disposal facilities that are for the purpose of increasing the flow that is tributary to the facility.
These set -backs do apply to any expansion or modification of the surface irrigation areas and
apply in instances in which the sale of property would cause any of the set -backs now complied
with, for the treatment and disposal facilities, to be violated. The applicant is advised that any
modifications to the existing facilities will require a permit modification.
6. The pump tank(s) shall have functional audible and visual high water alarms that are external to
any structure.
II. OPERATION AND MAINTENANCE REOUIREMENTS
1. The facilities shall be properly maintained and operated at all times.
2. Upon classification of the wastewater treatment and surface irrigation facilities by the Water
Pollution Control System Operators Certification Commission (WPCSOCC), the Permittee
shall designate and employ a certified operator to be in responsible charge (ORC) and one or
more certified operator(s) to be back-up ORC(s) of the facilities in accordance with 15A NCAC
8G .0201. The ORC shall visit the facilities in accordance with 15A NCAC 8G .0204 or as
specified in this permit and shall comply with all other conditions specified in these rules.
3. A suitable year round veLetativc cover shall be maintained over the irrigation area.
4. Irrigation shall not be performed during inclement weather or when the ground is in a condition
that will cause runoff.
5. Adequate measures shall be taken to prevent wastewater runoff from the irrigation field.
6. The application rate shall not exceed a cumulative loading of 3 9.0 inches over any twelve (12)
month period at an instantaneous application rate not to create any ponding or run-off.
7. The facilities shall be effectively maintained and operated as a non -discharge system to prevent
the discharge of any wastewater resulting from the operation of this facility.
8. No type of wastewater other than that from the hocik residences shall be sprayed onto the
irrigation area.
9. No traffic or equipment shall be allowed on the disposal area except while installation occurs or
while normal maintenance is being performed.
10. The irrigation field shall be fenced with at least a two -strand wire fence.

11. Wastewater treatment units open to the atmosphere shall have restricted access and pump
control panels shall be locked.
12. The Permittee is responsible for the operation and maintenance of the entire treatment and
disposal system including, but not limited to, the following items:
a. The septic tank shall be checked annually and pumped out as needed. The septic tank
effluent filter shall be checked and cleaned at the same frequency of the septic tank.
b. The tablet chlorinator shall be checked every week. Tablets shall be added to provide
proper chlorination.
c. The storage, pump, and alarm systems shall be inspected monthly. The scum layer shall be
removed at the same interval as the septic tank is cleaned out.
d. The system shall be inspected monthly to make certain of the proper operation of the spray
head(s), that the vegetative growth allows a proper spray pattern, that the soil is
assimilating the disposed treated wastewater with no surface runoff, and that no
objectionable odors are being generated.
III. MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring deemed necessary by the Division to insure surface and ground water
protection will be established and an acceptable sampling reporting schedule shall be followed.
2. The Permittee shall maintain records of all maintenance performed on the system and irrigation
area, as required in Condition II(12) for a minimum of five years. This information shall be
provided to the Division upon request.
3. Noncompliance Notification:
MY
The Permittee shall report by telephone to the Mooresville Regional Office, telephone number
[phone], as soon as possible, but in no case more than 24 hours or on the next working
day following the occurrence or first knowledge of the occurrence of any of the following:
a. Any process unit failure, due to known or unknown reasons, that renders the facility
incapable of adequate wastewater treatment, such as mechanical or electrical failures of
pumps, spray heads, etc.; or
b. Any failure of a pumping station or treatment facility resulting in a by-pass directly to
receiving waters without treatment of all or any portion of the influent to such station or
facility.
Occurrences outside normal business hours may also be reported to the Division's Emergency
Response personnel at telephone number [phone] or [phone]. Persons reporting
such occurrences by telephone shall also file a written report in letterform within five (5) days
following first knowledge of the occurrence. This report must outline the actions taken or
proposed to be taken to ensure that the problem does not recur.
1. Adequate inspection, maintenance, and cleaning shall be provided by the Permittee to insure
proper operation of the subject facilities.

Permit issued this the 30d' day of January, 2009
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
0-'Y�6
Colee H. Sullins, Director
ivision of Water Quality
By Authority of the Environmental Management Commission
Permit Number WQ0003158

W F` T�� Beverly Eaves Perdue, Governor
pG Dee Freeman, Secretary
/J North Carolina Department of Environment and Natural Resources
tr
=l
.� Coleen H. Sullins, Director
IF Division of Water Quality
Kimberly Kocik
5311 Flint Ridge Church Rd
Marshville, NC 28103
Dear Ms. Kocik:
January 30, 2009
2p C�C�C0dC
FF 9 - 4 2009
NC DENR MRO
DWQ - Aquifer Protection
Subject: Permit No. WQ0003158
Kimberly Kocik SFR
Surface Irrigation Facility
Wake County
In accordance with your permit renewal request received September 26, 2008, we are forwarding
herewith Permit No. WQ0003158, dated January 30. 2009, to Kimberly Kocik for the continued operation
of the subject single family wastewater treatment and surface irrigation facilities. The system was
designed and originally permitted in 1984 (Permit No. 10269) to serve a single family residence at 450
gallons per day. In 1985 a permit modification changed the flow to 750 gallons per day to include a
second single family -type dwelling. However, this modification did not change the capacity of the
treatment facilities designed to serve these two single family residences. The Division is assuming,
because the existing records are incomplete, that this action was taken to accommodate a family member
residing at the same location in the second house. Please be advised that this system cannot accommodate
an increase in flow if more than one person resides in this second house and therefore, a modification to
the existing facilities would be necessary prior to that occurring. A system failure could result if actual
flows exceed design capacity of the subject system. Please note Condition I(1) as well as other
conditions of this permit that require action for any type of system failure or any other problems resulting
in the operation of this system. zot 7
-3
This permit shall be effective from the date of issuance until December 31,2443, shall void Permit No.
WQ0003158 issued August 9, 2004, and shall be subject to the conditions and limitations as specified
therein. Please pay particular attention to the monitoring requirements in this permit. Failure to establish
an adequate system for collecting and maintaining the required operational information will result in
future compliance problems.
An extension shall be requested at least six (6) months prior to the expiration of this permit. Upon receipt
of the request the Commission will review the adequacy of the facility described therein and, if warranted,
will extend the permit for such period of time and under such conditions and limitations as it may deem
appropriate.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to
request an adjudicatory hearing upon written request within thirty (30) days following receipt of this
permit. This request must be in the form of a written petition, conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service
Center, Raleigh, NC 27699-6714. Unless such demands are made this permit shall be final and binding.
Please contact John McCray at [phone] if you need additional information concerning this matter.
Nam` hCarolina
Naturally
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Phone [phone] Customer Service
Internet: http://h2o.enr.state.nc.us 2728 Capital Boulevard Raleigh, NC 27604 Fax [phone]
Fax [phone]
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper

cc: Union County Health Department
ona1 Office -,Aquifer Protection
ec c-
Tssistance and Certification Unit
APS Central Files (WQ0003158) j
Notebook Files
r
Sincerely,
Col en H. Sullins
Section""
G�
q?a 1 LJ
.s.
rho.•

Pr
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH
SINGLE FAMILY RESIDENCE SURFACE IRRIGATION PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Kimberly Kocik
Union County
FOR THE
continued operation of a 750 gallon per day (GPD) surface irrigation wastewater treatment and disposal
system consisting of a 1.200 gallon baffled septic tank, a 1,200 gallon pump tank with a 52 gallon per
minute (GPM) recirculation pump, a flow splitter, a 150 square foot recirculating sand filter, a tablet
chlorinator, a 2,000 gallon chlorine contact storage/pump tank, a 20 GPM. self -priming effluent dosing
pump, a 6,969 square foot spray irrigation area with three sprinklers, and all associated piping and
appurtenances, to serve the Kimberly Kocik residence with no discharge of wastes to the surface waters,
pursuant to the application received September 26, 2008, and in conformity with the project plan,
specifications, and other supporting data subsequently filed and approved by the Department of
Environment and Natural Resources and considered a part of this permit.
This permit shall be effective from the date of issuance until December 31, 2013, shall void Permit No.
WQ0003158 issued August 9, 2004, and shall be subject to the following specified conditions and
limitations:
I. PERFORMANCE STANDARDS
The surface irrigation facilities shall be effectively maintained and operated at all times so that
there is no discharge to surface waters, nor any contamination of ground waters, which will
render them unsatisfactory for normal use. In the event that the facilities fail to perform
satisfactorily, including the creation of nuisance conditions or failure of the irrigation area to
adequately assimilate the wastewater, the Permittee shall take immediate corrective actions
including those actions that may be required by the Division of Water Quality, such as the
construction of additional or replacement wastewater treatment and disposal facilities.
2. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to
surface or ground waters resulting from the operation of this facility.
3. The residuals generated from these treatment facilities must be disposed in accordance with
General Statute 143-215.1 and in a manner approved by the Division.
4. Diversion or bypassing of the untreated wastewater from the treatment facilities is prohibited.

5. The following set -backs shall be maintained:
'I%
I®
a. 400 feet between wetted area and any residence or places of public assembly under separate
ownership,
b. 150 feet between wetted area and property lines,
c. 100 feet between wetted area and wells,
d. 100 feet between wetted area and drainage ways or surface water bodies,
e. 50 feet between wetted area and public right of ways,
f. 100 feet between treatment/storage units and any wells,
g. 50 feet between treatment units and property lines, and
h. 100 feet between wetted area and swimming pools.
Some of the set -backs specified above may not have been included in previous permits for this
waste treatment and disposal system. These set -backs are not intended to prohibit or prevent
modifications, which are required by the Division, to improve performance of the existing
treatment facility. These set -backs do, however, apply to modifications of the treatment and
disposal facilities that are for the purpose of increasing the flow that is tributary to the facility.
These set -backs do apply to any expansion or modification of the surface irrigation areas and
apply in instances in which the sale of property would cause any of the set -backs now complied
with, for the treatment and disposal facilities, to be violated. The applicant is advised that any
modifications to the existing facilities will require a permit modification.
6. The pump tank(s) shall have functional audible and visual high water alarms that are external to
any structure.
OPERATION AND MAINTENANCE REQUIREMENTS
1. The facilities shall be properly maintained and operated at all times.
2. Upon classification of the wastewater treatment and surface irrigation facilities by the Water
Pollution Control System Operators Certification Commission (WPCSOCC), the Permittee
shall designate and employ a certified operator to be in responsible charge (ORC) and one or
more certified operator(s) to be back-up ORC(s) of the facilities in accordance with 15A NCAC
8G .0201. The ORC shall visit the facilities in accordance with 15A NCAC 8G .0204 or as
specified in this permit and shall comply with all other conditions specified in these rules.
3. A suitable year round vegetative cover shall be maintained over the irrigation area.
4. Irrigation shall not be performed during inclement weather or when the ground is in a condition
that will cause runoff.
5. Adequate measures shall be taken to prevent wastewater runoff from the irrigation field.
6. The application rate shall not exceed a cumulative loading of 39.0 inches over any twelve (12)
month period at an instantaneous application rate not to create any ponding or run-off.
7. The facilities shall be effectively maintained and operated as a non -discharge system to prevent
the discharge of any wastewater resulting from the operation of this facility.
No type of wastewater other than that from the Kocik residences shall be sprayed onto the
irrigation area.
9. No traffic or equipment shall be allowed on the disposal area except while installation occurs or
while normal maintenance is being performed.
10. The irrigation field shall be fenced with at least a two -strand wire fence.

Pr
11. Wastewater treatment units open to the atmosphere shall have restricted access and pump
control panels shall be locked.
12. The Permittee is responsible for the operation and maintenance of the entire treatment and
disposal system including, but not limited to, the following items:
a. The septic tank shall be checked annually and pumped out as needed. The septic tank
effluent filter shall be checked and cleaned at the same frequency of the septic tank.
b. The tablet chlorinator shall be checked every week. Tablets shall be added to provide
proper chlorination.
c. The storage, pump, and alarm systems shall be inspected monthly. The scum layer shall be
removed at the same interval as the septic tank is cleaned out.
d. The system shall be inspected monthly to make certain of the proper operation of the spraN
head(s), that the vegetative growth allows a proper sprav pattern, that the soil is
assimilating the disposed treated wastewater with no surface runoff, and that no
objectionable odors are being generated.
III. MONITORING AND REPORTING REOUIREMENTS
1. Any monitoring deemed necessary by the Division to insure surface and ground water
protection will be established and an acceptable sampling reporting schedule shall be followed.
2. The Permittee shall maintain records of all maintenance performed on the system and irrigation
area, as required in Condition II(12) for a minimum of five years. This information shall be
provided to the Division upon request.
3. Noncompliance Notification:
The Permittee shall report by telephone to the Mooresville Regional Office, telephone number
[phone], as soon as possible, but in no case more than 24 hours or on the next working
day following the occurrence or first knowledge of the occurrence of any of the following:
a. Any process unit failure, due to known or unknown reasons, that renders the facility
incapable of adequate wastewater treatment, such as mechanical or electrical failures of
pumps, spray heads, etc.; or
b. Any failure of a pumping station or treatment facility resulting in a by-pass directly to
receiving waters without treatment of all or any portion of the influent to such station or
facility.
Occurrences outside normal business hours may also be reported to the Division's Emergency
Response personnel at telephone number [phone] or [phone]. Persons reporting
such occurrences by telephone shall also file a written report in letterform within five (5) days
following first knowledge of the occurrence. This report must outline the actions taken or
proposed to be taken to ensure that the problem does not recur.
IV. INSPECTIONS
1. Adequate inspection, maintenance, and cleaning shall be provided by the Permittee 'to insure
proper operation of the subject facilities.
3

2. Any duly authorized officer, employee, or representative of the Division may, upon
presentation of credentials, enter and inspect any property, premises or place on or related to
the disposal site or facility at any reasonable time for the purpose of determining compliance
with this permit, may inspect or copy any records that must be maintained under the terms and
conditions of this permit, and may obtain samples of groundwater, surface water, or leachate.
V. GENERAL CONDITIONS
This permit shall become void unless the facilities are constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data.
2. This permit is effective only with respect to the nature and volume of wastes described in the
application and other supporting data.
This permit is not transferable. In the event there is a desire for the facilities to change
ownership, or there is a name change of the Permittee, a formal permit request must be
submitted to the Division accompanied by documentation from the parties involved, and other
supporting materials as may be appropriate. The approval of this request will be considered on
its merits and may or may not be approved.
4. Upon the availability of a municipal or regional sewerage collection system, the subject
wastewater treatment facilities shall be abandoned with guidance from the Division and all
wastewater discharged into the municipal or regional sewerage system.
5. Failure to abide by the conditions and limitations contained in this permit may subject the
Permittee to an enforcement action by the Division in accordance with North Carolina General
Statute 143-215.6A to 143-215.6C.
6. The issuance of this permit does not preclude the Permittee from complying with any and all
statutes, rules, regulations, or ordinances, which may be imposed by other government agencies
(local, state, and federal), which have jurisdiction.
7. This permit may be revoked if the Permittee fails to abide by the conditions of the "Operation
and Maintenance Agreement" previously signed by the Permittee.
8. The Permittee shall retain a set of approved plans, specifications of the subject facility for the
life of the project.
9. The Permittee shall pay the annual administering and compliance fee within 30 days of being
billed by the Division. Failure to pay the fee accordingly may cause the Division to initiate
action to revoke this permit as specified by 15A NCAC 2T .0105(e)(3).
10. The Permittee, at least six (6) months prior to the expiration of this permit, shall request its
extension. Upon receipt of the request, the Commission will review the adequacy of the
facilities described therein, and if warranted, will extend the Permit for such period of time and
under such conditions and limitations, as it may deem appropriate.
4

Permit issued this the 30t" day of January, 2009
pr NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
ru�
eBy
ole H. Sullins, Director
ivision of Water Quality
Authority of the Environmental Management Commission
Permit Number WQ0003158

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IrOPERATION AND MAINTENANCE AGREEMF'�':- pa�C i 104 SEC-
SINGLE FAMILY RESIDENCE SURFACE IRRIGATION SYSTEM
DIVISION OF WATER QUALITY
as sPF 26 PH 2= 21
Property Owner(s) (as appearing on the property deed): ' / -4,c
Mailing Address: ; �c C P !�t=L`% ���1 Div '' �� I xfQS11U( Yw,%��Z�� 3
Facility Address (if different than above):
Disposal Method: <:- v SPRAY IRRIGATION'S
County: I hcan
o DRIP IRRIGATION (Check One)
Permit No. �J CQ Do 315 r
UWe agree to operate and maintain the wastewater treatment system as follows:
1. The Permittee is responsible for the operation and maintenance of the entire treatment and disposal
system including, but not limited to, the following items:
a. The septic tank shall be checked annually and pumped out as needed. The effluent filter shall be
checked and cleaned at the same frequency of the septic tank.
b. The sand filter surface shall be raked and leveled every six (6) months and any vegetative growth
shall be removed by hand [accessible sand filters only).
c. Check one:
o. .,The tablet chlorinator shall be checked every week. Tablets shall be added so as to provide
(/ proper chlorination.
o The ultraviolet disinfection unit shall be checked every week. The lamp shall be cleaned
and/or replaced to ensure proper disinfection.
d. The storage, pump, and alarm systems shall be inspected monthly. The scum laver shall be
removed at the same time interval as the septic tank is pumped out.
e. The irrigation system shall be inspected monthly to make certain of proper operation, that
vegetative growth does not interfere with the system inspection or operation, that the soil is
assimilating the disposed treated wastewater with no surface runoff, and that no objectionable
odors are being generated.
2. Failure of the Permittee to properly operate this system is subject to a penalty up to $25,000 per day.
3. Failure to meet the permit conditions or violation of the State's surface or groundwater regulations
will require evacuating the dwelling and may void the permit.
NOTE: All persons (owners) appearing on the legally registered property deed must sign this O&M
Agreement
UWe understand the above requ�ents and agree to ese terms as part of the issued permit.
Owner(s) Signature(s): Date:
Owner(s) Signature(s):
Date:
SFR O&M (version 07/07)

January-1 9, 2009
Kimberly Kocik
5311 Flint Ridge Church Rd
Marshville, NC 28103
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
7006 2150 0003 5466 8377
Subject: Notice of Expiration (NOE)
Kimberly Kocik SFR
Permit No. WQ0003158
Union County
Dear Ms. Kocik:
Beverly Eaves Perdue, Governor
Dee Freeman, Secretary
North Carolina Department of Enviromnent and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
2
3
J-7:5 "RE
F E B — 2 2009
D Q-Surfs - J
. ion
The Aquifer Protection Section (APS) of the North Carolina Division of Water Quality (DWQ) is entrusted to
protect the groundwater quality and resources of the State of North Carolina. Our records indicate that the above -
referenced permit, which was issued on 8/9/2004, and expires on 7/31/2009, has not been renewed.
This permit was issued for the operation of the surface waste irrigation system on your property located at the above
referenced address. As the property owner, you are responsible for maintaining this permit. Failure to do so may
result in the revocation of the permit per 15A NCAC 2T .0110 or assessment of civil penalties in accordance with
North Carolina General Statute § 143-215.6A. Therefore, it is important that you submit a renewal application form
and an Operations and &Maintenance Agreement (O&M) within 30 days of receipt of this letter. For your
convenience, a renewal application and an O&M form are attached along with a self-addressed envelope. These
forms are also available on-line at the DWQ website at http://h2o.enr.state.nc.us/lau/Lapplications.htm] under Single
Family Residence Wastewater Irrigation System.
Please respond to this notice within 30 calendar days of its receipt by selecting one of the following options:
1. APPLY FOR PERMIT RENEWAL. When you apply for and receive a renewal, operation
of your surface irrigation system will be permitted to continue. As such, all sampling
requirements, the payment of annual fees, and any operation and maintenance procedures
specified in your previous permit will be required. If you choose to renew your surface
irrigation system you must submit the following information:
a) a completed SINGLE FAMILY RESIDENCE PERMITRENEWAL APPLICA 77ON (form WWR 09-
06) (Enclosure 1). This form must be signed by each property/permit owner.
b) a completed SINGLE FAMILY RESIDENT OPERATION AND MAINTENANCE A GREEMENT (form
SFR O&M 07/07) (Enclosure 2). This form must be signed by each property/permit
owner.
1
Aquifer Protection Section 1636 Mail Service Center
Internet: www.ncwatgAualit�.org Location: 2728 Capital Boulevard
An Equal Opportunity/Affirmative Action Employer- 50% Recycledl10% Post Consumer Paper
Noe Carolina
Ntura!!y
Raleigh, NC 27699-1636 Telephone: [phone]
Raleigh, NC 27604 Fax 1: [phone]
Fax 2: [phone]
Customer Service: [phone]

2. APPLY FOR PERMIT RESCISSION. If the surface irrigation system has not been
constructed, or if it is no longer active, you may choose to rescind your permit by submitting
the following information:
a) a completed Single Family Residence Permit Renewal Application (form WWR 09-06)
(Enclosure 1). This form must be signed by each property/permit owner. Please indicate
your wish to rescind this permit in Part H, Item 4 of this form.
Please submit the completed forms within 30 days receipt of this letter to the following address:
Division of Water Quality
Aquifer Protection Section
Groundwater Protection Unit
1636 Mail Service Center
Raleigh, NC 27699-1636
Thank you in advance for yb4i looperation and timely response. If you have any questions, please call Michael
Rogers me at [phone], or email him at Michael.Roeers(a!ncmail.net.
Sincerely,
OWAJ
Olita Boone
Office Assistant
Aquifer Protection Section
Enclosures
1. WWR 09-06
2. SFR O&M 07/07
cc:
APS Central Files - Permit o. WQ0003158 w/o enclosures
WQ0003158 Page 2

f
Affln-EXA
RCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
KIMBERLY KOCIK, OWNER
5311 FLINT RIDGE CHURCH ROAD
MARSHVILLE, NORTH CAROLINA
Dear Ms. Kocik:
Alan W. Klimek, P.E., Director
August 9, 2004
NC DEPT OF ENVIRONMENT
AND NATURAL RESOURCES
28103 RECEIVED
Subject
SEP 14 2004
MOORESVILLE REGIONAL OFFICE
DWQ-GROUNDWATER SECTION
William G. Ross, Jr., Secretary
Permit No. WQ0003158
Single Family Residence
Surface Irrigation Facility
Union County
In accordance with your renewal request received December 11, 2003 and additional information
received March 8, 2004, we are forwarding herewith Permit No. WQ0003158, dated August 9, 2004, to
Kimberly Kocik for the continued operation of the subject single family wastewater treatment and surface
irrigation facilities. The system was designed and originally permitted in 1984 (Permit No. 10269) to serve a
single family at 450 gallons per day. In 1985, a permit modification changed the flow to 750 gallons per day
to include a second single-family type dwelling. However, this modification did not change the capacity of
the treatment facilities designed to serve these two single-family residences. The Division is assuming,
although records are incomplete, that this action was taken to accommodate a family member residing at the
same location in the second house. Please be advised that this system cannot accommodate an increase in
flow if more than one person resides in this second house and therefore, a modification to the existing
facilities would be necessary prior to that occurring. A system failure may result if actual flows exceed
design capacity of the subject system. Please note Condition I(1) and other permit conditions in this permit
that require action for any type of system failure or any other problems resulting in the operation of this
system.
This permit shall be effective to the date of issuance until July 31, 2009, shall void Permit No.
WQ0003158 issued July 1, 1999, and shall be subject to the conditions and limitations as specified therein.
Please pay particular attention to the monitoring requirements in this permit. Failure to establish an adequate
system for collecting and maintaining the required operational information will result in future compliance
problems. Please also pay particular attention to Conditions V(3) and V(10) of this permit.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the
right to request an adjudicatory hearing upon written request within thirty (30) days following receipt of this
permit. This request must be in the form of a written petition, conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service Center,
Raleigh, NC 27699-6714. Unless such demands are made this permit shall be final and binding.
Aquifer Protection Section — Land Application Permitting and Compliance Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
512 N. Salisbury St., Raleigh, North Carolina 27604
Phone: [phone] / FAX: [phone] / Internet: h2o.enr.state.nc.us
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper
NorthCarolina
AWmally

If you need additional information concerning this matter, please contact Toni Wyche at (919) 733-
5083 extension 546. 1
Sincerely,
Alan W. Klimek, P. E.
cc: Union County Health Department
Mooresville Regional Office, Water Quality Section
Technical Assistance and Certification Unit
Water Quality Central Files
NDPU Files

w
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH
SINGLE FAMILY RESIDENCE SURFACE IRRIGATION PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Kimberly Kocik
Union County
FOR THE
continued operation of a 750 gallon per day (GPD) surface spray irrigation wastewater treatment and
disposal system consisting of a 1,200 gallon baffled septic tank, a 1,200 gallon pump tank with a 52 GPM
recirculation pump, a flow splitter, a 150 square foot recirculating sand filter, a tablet chlorinator, a 2,000
gallon chlorine contact storage/pump tank, a 20 GPM self priming effluent dosing pump, a 6,969 square
foot spray irrigation area with three (3) sprinklers, and all associated piping and appurtenances to serve
the Kimberly Kocik Residence and the second single-family type dwelling, with no discharge of wastes to
the surface waters, pursuant to the application received December 11, 2003, and in conformity with the
project plan, specifications, and other supporting data subsequently filed and approved by the Department
of Environment and Natural Resources and considered a part of this permit.
This permit shall be effective from the date of issuance until July 31, 2009, shall void Permit No.
WQ0003158 issued July 1, 1999 and shall be subject to the following specified conditions and
limitations:
I. PERFORMANCE STANDARDS
The surface irrigation facilities shall be effectively maintained and operated at all times so
that there is no discharge to surface waters, nor any contamination of ground waters which
will render them unsatisfactory for normal use. In the event that the facilities fail to perform
satisfactorily, including the creation of nuisance conditions or failure of the irrigation area to
adequately assimilate the wastewater, the Permittee shall take immediate corrective actions
including those actions that may be required by the Division of Water Quality (Division),
such as the construction of additional or replacement wastewater treatment and disposal
facilities.
2. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to
surface or ground waters resulting from the operation of this facility.

A.
3. The residuals generated from these treatment facilities must be disposed in accordance with
General Statute 143-215.1 and in a manner approved by the Division.
4. Diversion or bypassing of the untreated wastewater from the treatment facilities is prohibited.
5. The following buffers shall be maintained:
a. 400 feet between wetted area and any residence or places of public assembly under
separate ownership,
b. 150 feet between wetted area and property lines,
c. 100 feet between wetted area and wells,
d. 100 feet between wetted area and drainage ways or surface water bodies,
e. 50 feet between wetted area and public right of ways,
f. 100 feet between treatment/storage units and any wells, and
g. 50 feet between treatment units and property lines.
Some of the buffers specified above may not have been included in previous permits for this
waste treatment and disposal system. These buffers are not intended to prohibit or prevent
modifications, which are required by the Division, to improve performance of the existing
treatment facility. These buffers do, however, apply to modifications of the treatment and
disposal facilities that are for the purpose of increasing the flow that is tributary to the
facility. These buffers do apply to any expansion or modification of the surface irrigation
areas and apply in instances in which the sale of property would cause any of the buffers now
complied with, for the treatment and disposal facilities, to be violated. The applicant is
advised that any modifications to the existing facilities will require a permit modification.
6. The pump tank(s) shall have functional audible and visual high water alarms that are external
to any structure.
II. OPERATION AND MAINTENANCE REQUIREMENTS
The facilities shall be properly maintained and operated at all times.
2. Upon classification of the wastewater treatment and surface irrigation facilities by the Water
Pollution Control System Operators Certification Commission (WPCSOCC), the Permittee
shall designate and employ a certified operator to be in responsible charge (ORC) and one or
more certified operator(s) to be back-up ORC(s) of the facilities in accordance with 15A
NCAC 8G .0201. The ORC shall visit the facilities in accordance with 15A NCAC 8G .0204
or as specified in this permit and shall comply with all other conditions specified in these
rules.
3. A suitable year round vegetative cover shall be maintained.
4. Irrigation shall not be performed during inclement weather or when the ground is in a
condition that will cause runoff.
Adequate measures shall be taken to prevent wastewater runoff from the irrigation field.
6. The application rate shall not exceed a cumulative loading of 39.0 inches over any twelve
(12) month period at an instantaneous application rate not to create any ponding or runoff.
4

7. The facilities shall be effectively maintained and operated as a non -discharge system to
prevent the discharge of any wastewater resulting from the operation of this facility.
8. No type of wastewater other than that from the Kimberly Kocik Residence and the second
single-family type dwelling shall be sprayed onto the irrigation area.
9. In the event that the sprinkler heads fail to achieve the design diameter, to cover all the
designed wetted area, the obstructions shall be removed or the sprinkler heads shall be raised
and supported to such height that the design diameter is achieved.
10. No traffic or equipment shall be allowed on the disposal area except while installation occurs
or while normal maintenance is being performed.
11. The irrigation field shall be fenced with at least a two -strand wire fence.
12. Wastewater treatment units open to the atmosphere shall have restricted access and pump
control panels shall be locked.
13. The Permittee is responsible for the operation and maintenance of the entire treatment and
disposal system including, but not limited to, the following items:
a. The septic tank shall be checked annually and pumped out as needed. The septic tank
effluent filter shall be checked and cleaned at the same frequency of the septic tank.
b. The tablet chlorinator shall be checked every week. Tablets shall be added to provide
proper chlorination.
c. The storage, pump, and alarm systems shall be inspected monthly. The scum layer shall
be removed at the same interval as the septic tank is cleaned out.
d. The system shall be inspected monthly to make certain of the proper operation of the
spray head(s), that the vegetative growth allows a proper spray pattern, that the soil is
assimilating the disposed treated wastewater with no surface runoff, and that no
objectionable odors are being generated.
III. MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring deemed necessary by the Division to insure surface and ground water protection will
be established and an acceptable sampling reporting schedule shall be followed.
2. The Permittee shall maintain records of all maintenance performed on the system and irrigation area,
as required in Condition II(12) for a minimum of five years. This information shall be provided to the
Division upon request.
3. Noncompliance Notification:
The Permittee shall report by telephone to the Mooresville Regional Office, telephone
number [phone], as soon as possible, but in no case more than 24 hours or on the next
working day following the occurrence or first knowledge of the occurrence of any of the
following:
5

Any process unit failure, due to known or unknown reasons, that renders the facility
incapable of adequate wastewater treatment, such as mechanical or electrical failures of
pumps, spray heads, etc.; or
b. Any failure of a pumping station or treatment facility resulting in a by-pass directly to
receiving waters without treatment of all or any portion of the influent to such station or
facility.
Occurrences outside normal business hours may also be reported to the Division's
Emergency Response personnel at telephone number [phone] or [phone].
Persons reporting such occurrences by telephone shall also file a written report in letterform
within five (5) days following first knowledge of the occurrence. This report must outline the
actions taken or proposed to be taken to ensure that the problem does not recur.
IV. INSPECTIONS
Adequate inspection, maintenance, and cleaning shall be provided by the Permittee to insure
proper operation of the subject facilities.
Any duly authorized officer, employee, or representative of the Division may, upon
presentation of credentials, enter and inspect any property, premises or place on or related to
the disposal site or facility at any reasonable time for the purpose of determining compliance
with this permit, may inspect or copy any records that must be maintained under the terms
and conditions of this permit, and may obtain samples of groundwater, surface water, or
leachate.
V. GENERAL CONDITIONS
This permit shall become void unless the facilities are constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data.
2. This permit is effective only with respect to the nature and volume of wastes described in the
application and other supporting data.
This permit is not transferable. In the event there is a desire for the facilities to change
ownership, or there is a name change of the Permittee, a formal permit request must be
submitted to the Division accompanied by documentation from the parties involved, and
other supporting materials as may be appropriate. The approval of this request will be
considered on its merits and may or may not be approved.
4. Upon the availability of a municipal or regional sewerage collection system, the subject
wastewater treatment facilities shall be abandoned and all wastewater discharged into the
municipal or regional sewerage system.
Failure to abide by the conditions and limitations contained in this permit may subject the
Permittee to an enforcement action by the Division in accordance with North Carolina
General Statute 143-215.6A to 143-215.6C.
Cel

The issuance of this permit does not preclude the Permittee from complying with any and all
statutes, rules, regulations, or ordinances which may be imposed by other government
agencies (local, state, and federal) which have jurisdiction.
7. This permit may be revoked if the Permittee fails to abide by the conditions of the "Operation
and Maintenance Agreement" previously signed by the Permittee.
8. A set of approved plans, specifications for the subject project must be retained by the
Permittee for the life of the project.
9. The annual administering and compliance fee must be paid by the Permittee within 30 days
after being billed by the Division. Failure to pay the fee accordingly may cause the Division
to initiate action to revoke this permit as specified by 15A NCAC 2H .0205 (c)(4).
10. The Permittee, at least six (6) months prior to the expiration of this permit, shall request its
extension. Upon receipt of the request, the Commission will review the adequacy of the
facilities described therein, and if warranted, will extend the Permit for such period of time
and under such conditions and limitations, as it may deem appropriate.
Permit issued this the 9t' day of August, 2004
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
!Z).
--Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number WQ0003158
7

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OPERATION AND MAINTENANCE AGREEMENT
QEL S%WE FAMILY RESIDENCE WASTEWATER TREATMENT SYSTEM
tgzVe� DIVISION OF WATER QUALITY �o�g15
Owner:
Address: 5 ---� 1 ` T I k r4 kkJ� �-'kvv COS M a U51 �l� (1 e � �2�65�5
Disposal Method: SPRAY IRRIGATION J DRIP IRRIGATION (Circle One)
County: L>n v n
Permit No. C)o 3 1 ,6
I agree to operate and maintain the wastewater treatment system as follows:
1) The Permittee is responsible for the operation and maintenance of the entire treatment and disposal
system including, but not limited to, the following items:
a) The septic tank shall be checked annually and pumped out as needed. The effluent filter shall be
checked and cleaned at the same frequency of the septic tank.
b) [Open access sand filters only] The sand filter surface shall be raked and leveled every six (6)
months and any vegetative growth shall be removed by hand.
c) Check one:
;A The tablet chlorinator shall be checked every week. Tablets shall be added so as to provide
proper chlorination.
❑ The ultraviolet disinfection unit shall be checked every week. The lamp shall be cleaned
and/or replaced to ensure proper disinfection.
d) The storage, pump, and alarm systems shall be inspected monthly. The scum layer shall be
removed at the same time interval as the septic tank is pumped out.
e) The irrigation system shall be inspected monthly to make certain of proper operation, that
vegetative growth does not interfere with the system inspection or operation, that the soil is
assimilating the disposed treated wastewater with no surface runoff, and that no objectionable
odors are being generated.
2) Failure of the Permittee to properly operate this system is subject to a penalty up to $25,000 per day.
3) Failure to meet the permit conditions or violation of the State's surface or groundwater regulations
will require evacuating the dwelling and may void the permit.
I understand the above requirements and agree to these terms as part of the issued permit.
Owner Signature:
Notary Signature:
Date:
/02 — M 'a005 Commission Expiration:
Date
Seal:
SFR O&M 03/03

Fr
+wn
RCDENR
Ir-r,-nIC C_-C'If 7
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
Alan W. Klimek, P.E., Director
August 9, 2004
KIMBERLY KOCIK, OWNER
5311 FLINT RIDGE CHURCH ROAD
MARSHVILLE, NORTH CAROLINA 28103
Dear Ms. Kocik:
William G. Ross, Jr., Secretary
Subject: Permit No. WQ0003158
Single Family Residence
Surface Irrigation Facility
Union County
In accordance with your renewal request received December 11, 2003 and additional information
received March 8, 2004, we are forwarding herewith Permit No. WQ0003158, dated August 9, 2004, to
Kimberly Kocik for the continued operation of the subject single family wastewater treatment and surface
irrigation facilities. The system was designed and originally permitted in 1984 (Permit No. 10269) to serve a
single family at 450 gallons per day. In 1985, a permit modification changed the flow to 750 gallons per day
to include a second single-family type dwelling. However, this modification did not change the capacity of
the treatment facilities designed to serve these two single-family residences. The Division is assuming,
although records are incomplete, that this action was taken to accommodate a family member residing at the
same location in the second house. Please be advised that this system cannot accommodate an increase in
flow if more than one person resides in this second house and therefore, a modification to the existing
facilities would be necessary prior to that occurring. A system failure may result if actual flows exceed
design capacity of the subject system. Please note Condition I(1) and other permit conditions in this permit
that require action for any type of system failure or any other problems resulting in the operation of this
system.
This permit shall be effective to the date of issuance until July 31, 2009, shall void Permit No.
WQ0003158 issued July 1, 1999, and shall be subject to the conditions and limitations as specified therein.
Please pay particular attention to the monitoring requirements in this permit. Failure to establish an adequate
system for collecting and maintaining the required operational information will result in future compliance
problems. Please also pay particular attention to Conditions V(3) and V(10) of this permit.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the
right to request an adjudicatory hearing upon written request within thirty (30) days following receipt of this
permit. This request must be in the form of a written petition, conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service Center,
Raleigh, NC 27699-6714. Unless such demands are made this permit shall be final and binding.
Aquifer Protection Section — Land Application Permitting and Compliance Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
512 N. Salisbury St., Raleigh, North Carolina 27604
Phone: [phone] / FAX: [phone] / Internet: h2o.enr.state.nc.us
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper
None
ahCarolina
Vaturallty

If you need additional information concerning this matter, please contact Toni Wyche at (919) 7337
5083 extension 546.
Sincerely,
Alan W. Klimek, P. E.
cc: Union County Health Department
Mooresville Regional Office, Water Quality Section
Technical Assistance and Certification Unit
Water Quality Central Files
NDPU Files
2

NORTH CAROLINA
1 TOM I MCI MR 013 _._ alu i
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH
SINGLE FAMILY RESIDENCE SURFACE IRRIGATION PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Kimberly Kocik
Union County
FOR THE
continued operation of a 750 gallon per day (GPD) surface spray irrigation wastewater treatment and
disposal system consisting of a 1,200 gallon baffled septic tank, a 1,200 gallon pump tank with a 52 GPM
recirculation pump, a flow splitter, a 150 square foot recirculating sand filter, a tablet chlorinator, a 2,000
gallon chlorine contact storage/pump tank, a 20 GPM self priming effluent dosing pump, a 6,969 square
foot spray irrigation area with three (3) sprinklers, and all associated piping and appurtenances to serve
the Kimberly Kocik Residence and the second single-family type dwelling, with no discharge of wastes to
the surface waters, pursuant to the application received December 11, 2003, and in conformity with the
project plan, specifications, and other supporting data subsequently fled and approved by the Department
of Environment and Natural Resources and considered a part of this permit.
This permit shall be effective from the date of issuance until July 31, 2009, shall void Permit No.
WQ0003158 issued July 1, 1999 and shall be subject to the following specified conditions and
limitations:
I. PERFORMANCE STANDARDS
The surface irrigation facilities shall be effectively maintained and operated at all times so
that there is no discharge to surface waters, nor any contamination of ground waters which
will render them unsatisfactory for normal use. In the event that the facilities fail to perform
satisfactorily, including the creation of nuisance conditions or failure of the irrigation area to
adequately assimilate the wastewater, the Permittee shall take immediate corrective actions
including those actions that may be required by the Division of Water Quality (Division),
such as the construction of additional or replacement wastewater treatment and disposal
facilities.
2. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to
surface or ground waters resulting from the operation of this facility.

II1
3
4
5.
6.
The residuals generated from these treatment facilities must be disposed in accordance with
General Statute 143-215.1 and in a manner approved by the Division.
Diversion or bypassing of the untreated wastewater from the treatment facilities is prohibited.
The following buffers shall be maintained:
a. 400 feet between wetted area and any residence or places of public assembly under
separate ownership,
b. 150 feet between wetted area and property lines,
c. 100 feet between wetted area and wells,
d. 100 feet between wetted area and drainage ways or surface water bodies,
e. 50 feet between wetted area and public right of ways,
f. 100 feet between treatment/storage units and any wells, and
g. 50 feet between treatment units and property lines.
Some of the buffers specified above may not have been included in previous permits for this
waste treatment and disposal system. These buffers are not intended to prohibit or prevent
modifications, which are required by the Division, to improve performance of the existing
treatment facility. These buffers do, however, apply to modifications of the treatment and
disposal facilities that are for the purpose of increasing the flow that is tributary to the
facility. These buffers do apply to any expansion or modification of the surface irrigation
areas and apply in instances in which the sale of property would cause any of the buffers now
complied with, for the treatment and disposal facilities, to be violated. The applicant is
advised that any modifications to the existing facilities will require a permit modification.
The pump tank(s) shall have functional audible and visual high water alarms that are external
to any structure.
OPERATION AND MAINTENANCE REQUIREMENTS
1. The facilities shall be properly maintained and operated at all times.
2. Upon classification of the wastewater treatment and surface irrigation facilities by the Water
Pollution Control System Operators Certification Commission (WPCSOCC), the Permittee
shall designate and employ a certified operator to be in responsible charge (ORC) and one or
more certified operator(s) to be back-up ORC(s) of the facilities in accordance with 15A
NCAC 8G .0201. The ORC shall visit the facilities in accordance with 15A NCAC 8G .0204
or as specified in this permit and shall comply with all other conditions specified in these
rules.
A suitable year round vegetative cover shall be maintained.
4. Irrigation shall not be performed during inclement weather or when the ground is in a
condition that will cause runoff.
5. Adequate measures shall be taken to prevent wastewater runoff from the irrigation field.
6. The application rate shall not exceed a cumulative loading of 39.0 inches over any twelve
(12) month period at an instantaneous application rate not to create any ponding or runoff.
4

7. The facilities shall be effectively maintained and operated as a non -discharge system to
prevent the discharge of any wastewater resulting from the operation of this facility.
8. No type of wastewater other than that from the Kimberly Kocik Residence and the second
single-family type dwelling shall be sprayed onto the irrigation area.
9. In the event that the sprinkler heads fail to achieve the design diameter, to cover all the
designed wetted area, the obstructions shall be removed or the sprinkler heads shall be raised
and supported to such height that the design diameter is achieved.
10. No traffic or equipment shall be allowed on the disposal area except while installation occurs
or while normal maintenance is being performed.
11. The irrigation field shall be fenced with at least a two -strand wire fence.
12. Wastewater treatment units open to the atmosphere shall have restricted access and pump
control panels shall be locked.
13. The Permittee is responsible for the operation and maintenance of the entire treatment and
disposal system including, but not limited to, the following items:
a. The septic tank shall be checked annually and pumped out as needed. The septic tank
effluent filter shall be checked and cleaned at the same frequency of the septic tank.
b. The tablet chlorinator shall be checked every week. Tablets shall be added to provide
proper chlorination.
c. The storage, pump, and alarm systems shall be inspected monthly. The scum layer shall
be removed at the same interval as the septic tank is cleaned out.
d. The system shall be inspected monthly to make certain of the proper operation of the
spray head(s), that the vegetative growth allows a proper spray pattern, that the soil is
assimilating the disposed treated wastewater with no surface runoff, and that no
objectionable odors are being generated.
M. MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring deemed necessary by the Division to insure surface and ground water protection will
be established and an acceptable sampling reporting schedule shall be followed.
2. The Permittee shall maintain records of all maintenance performed on the system and irrigation area,
as required in Condition H(12) for a minimum of five years. This information shall be provided to the
Division upon request.
3. Noncompliance Notification:
The Permittee shall report by telephone to the Mooresville Regional Office, telephone
number [phone], as soon as possible, but in no case more than 24 hours or on the next
working day following the occurrence or first knowledge of the occurrence of any of the
following:

IV.
V.
a. Any process unit failure, due to known or unknown reasons, that renders the facility
incapable of adequate wastewater treatment, such as mechanical or electrical failures of
pumps, spray heads, etc.; or
b. Any failure of a pumping station or treatment facility resulting in a by-pass directly to
receiving waters without treatment of all or any portion of the influent to such station or
facility.
Occurrences outside normal business hours may also be reported to the Division's
Emergency Response personnel at telephone number [phone] or [phone].
Persons reporting such occurrences by telephone shall also file a written report in letterform
within five (5) days following first knowledge of the occurrence. This report must outline the
actions taken or proposed to be taken to ensure that the problem does not recur.
1. Adequate inspection, maintenance, and cleaning shall be provided by the Permittee to insure
proper operation of the subject facilities.
2. Any duly authorized officer, employee, or representative of the Division may, upon
presentation of credentials, enter and inspect any property, premises or place on or related to
the disposal site or facility at any reasonable time for the purpose of determining compliance
with this permit, may inspect or copy any records that must be maintained under the terms
and conditions of this permit, and may obtain samples of groundwater, surface water, or
leachate.
GENERAL CONDITIONS
1. This permit shall become void unless the facilities are constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data.
2. This permit is effective only with respect to the nature and volume of wastes described in the
application and other supporting data.
3. This permit is not transferable. In the event there is a desire for the facilities to change
ownership, or there is a name change of the Permittee, a formal permit request must be
submitted to the Division accompanied by documentation from the parties involved, and
other supporting materials as may be appropriate. The approval of this request will be
considered on its merits and may or may not be approved.
4. Upon the availability of a municipal or regional sewerage collection system, the subject
wastewater treatment facilities shall be abandoned and all wastewater discharged into the
municipal or regional sewerage system.
Failure to abide by the conditions and limitations contained in this permit may subject the
Permittee to an enforcement action by the Division in accordance with North Carolina
General Statute 143-215.6A to 143-215.6C.
2

6. The issuance of this permit does not preclude the Permittee from complying with any and all
statutes, rules, regulations, or ordinances which may be imposed by other government
agencies (local, state, and federal) which have jurisdiction.
7. This permit may be revoked if the Permittee fails to abide by the conditions of the "Operation
and Maintenance Agreement" previously signed by the Permittee.
8. A set of approved plans, specifications for the subject project must be retained by the
Permittee for the life of the project.
9. The annual administering and compliance fee must be paid by the Permittee within 30 days
after being billed by the Division. Failure to pay the fee accordingly may cause the Division
to initiate action to revoke this permit as specified by 15A NCAC 2H .0205 (c)(4).
10. The Permittee, at least six (6) months prior to the expiration of this permit, shall request its
extension. Upon receipt of the request, the Commission will review the adequacy of the
facilities described therein, and if warranted, will extend the Permit for such period of time
and under such conditions and limitations, as it may deem appropriate.
Permit issued this the 9t' day of August, 2004
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number WQ0003158
fd

0 f W A TF9 ) • Michael F. Easley, Governor
O� QG ^+. William G. Ross Jr., Secretary
0 7 I North Carolina Department of Environment and Natural Resources
r
> 1 Alan W. Klimek, P.E., Director
p I Division of Water Quality
DEPYOF -
�p Np jUp,t, IESOURCES
February 24, 2004 �,,, . gym_ OWC'.
KIMBERLY KOEIK WOREd,
5311 FLINT RIDGE CHURCH ROAD
MARSHVILLE, NC 28103
Dear Ms. Koeik:
MAR 0 3 2004
Subject: Application No. WQ0003158
Additional Information Request
SFR Surface Irrigation
Union County
The Non -Discharge Permitting Unit has conducted a preliminary review of the subject permit application
package. Additional information is required before we may continue our review. Please address the
following item(s) no later than March 26, 2004:
✓ 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 permit, the approved plans and
specifications, and other supporting materials. To date, our records show that no
certification has been received for the subject permit. If the permitted facility has been
constructed and placed into operation, please submit the required certification immediately.
The consulting engineering firm is not listed in our database for this project.
Please be aware that you are responsible for meeting all requirements set forth in North Carolina rules
and regulations. Any oversights that occurred in the review of the subject application package are still
the responsibility of the applicant. In addition, any omissions made in responding to the above items may
result in future requests for additional information.
Please reference the subject application number when providing the requested information. Three copies
of all revised and/or additional documentation should be signed, sealed, dated, and submitted to my
attention at the address below. Please note that failure to provide this additional information on or before
the above requested date may result in your application being denied.
If you have any questions regarding this request, please do not hesitate to contact me at [phone],
extension 546. You may also check the future status of this project online at
http://h2o.enr.state.nc.us/bims/Reports/reportsPermits.html. Thank you for your cooperation.
Cc: n
Permit Application File WQ0003158
Non -Discharge Permitting Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
DENR Customer Service Center
An Equal Opportunity Action Employer
Sinc ely,tToni
he
Non -Discharge Permitting Unit
Internet http://h2o.enr.state.nc.us/ndpu
Telephone [phone] Fax [phone]
Telephone [phone]
50% recycled/10% post -consumer paper

wArk- Michael F. Easley, Governor o f
William G. Ross Jr., Secretary
y North Carolina Department of Environment and Natural Resources
CO
>` r
Alan W. Klimek, P.E., Director
Coleen H. Sullins, Deputy Director
Division of Water Quality
January 14, 2004
Kimberly Ann Koeik
5311 Flint Ridge Church Road
Marshville, NC 28103
Subject: Acknowledgement of Application No. WQ0003158
SFR
Single Famiy Residence Surface Irrigation System
Union County
Dear Ms. Koeik:
The Non -Discharge Permitting Unit of the Division of Water Quality (Division) acknowledges receipt of
your permit application and supporting materials on December 11, 2003. This application package has
been assigned the number listed above and will be reviewed by Toni Wyche.
The reviewer will perform a detailed review and contact you with a request for additional information if
necessary. To ensure the maximum efficiency in processing permit applications, the Division requests
your assistance in providing a timely and complete response to any additional information requests.
Please be aware that the Division's Regional Office, copied below, must provide recommendations prior to
final action by the Division. Please also note at this time, processing permit applications can take as long
as 60 - 90 days after receipt of a complete application.
If you have any questions, please contact Toni Wyche at 919-733-5083, extension 546, or via e-mail at
[e-mail]. If the reviewer is unavailable, you may leave a message, and they will respond
promptly.
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAKING INQUIRIES ON THIS
PROJECT.
Sincerely,
M041M M��
Kim H. Colson, P.E.
Supervisor
cc:
Permit Application File WQ0003158
Non -Discharge Permitting Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
WX
Internet http://h2o.enr.state.nc.us/ndpu NCDEN
Telephone [phone] Fax [phone]
DENR Customer Service Center
An Equal Opportunity Action Employer
Telephone [phone]
50% recycled/10% post -consumer paper

F WATF
O R Michael F. Easley, Governor
O� pG William G. Ross Jr., Secretary
y North Carolina Department of Environment and Natural Resources
r
� Alan W. Klimek, P.E. Director
0 Coleen H. Sullins, Deputy Director
Division of Water Quality
November 25, 2003
KIMBERLY KOCIK
OWNER/PERMITTEE
5311 FLINT RIDGE CHURCH RD
MARSHVILLE, NC 28103
Subject: Request for Permit Renewal
Surface Irrigation - Single Family Residence
Kocik SFR
Permit Number WQ0003158
Union County
Dear Ms. Kocik,
As of this date, our records indicate that the above -referenced permit, which was issued on 07/01/99 and
expires on 06/30/04, has not been renewed. It is both a condition of your permit and required by 15A NCAC 2H
.0211 to request a renewal of your permit at least 180 calendar days prior to its expiration date.
Failure to apply for permit renewal, and operation of your facility without an active permit may result in
the assessment of civil penalties of up to $25,000 per violation per day, in accordance with North Carolina
General Statute § 143-215.6A. Therefore, it is imperative that you submit a permit renewal application package
for review as soon as possible.
Please respond to this notice within sixty (60) calendar days of its receipt. Please submit, in triplicate, the
completed Single Family Residence Surface Irrigation System Permit Application, a notarized Operation and
Maintenance Agreement and the completed Permit Name/Ownership Change Form (if necessary) to the following
contact person:
Mr. Nathaniel Thornburg
NCDENR-DWQ
1617 Mail Service Center
Raleigh, NC 27699-1617
[phone], extension 533
[e-mail]
Please note that if the facility has never been constructed or if the residence has been connected to sewer service,
an option to rescind the permit is located in the application. Thank you in advance for your cooperation and
timely response.
Sincerely,
Nathaniel Thornburg
Environmental Engineer I
cc: Daryl Merritt — Non -Discharge Compliance/Enforcement Unit
— Water Quality Section ,r,
Water Quality Central Files
Non -Discharge Permitting Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
DENR Customer Service Center
An Equal Opportunity Action Employer
Internet http://h2o.enr.state.nc.us/ndpu
Telephone [phone] Fax [phone]
Telephone [phone]
50% recycled/10% post -consumer paper

Ne
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
MOORESVILLE REGIONAL OFFICE
DIVISION OF WATER QUALITY
July 9, 1999
Ms. Kimberly A Kocik
5311 Flint Ridge Church Road
Marshville, North Carolina 28103
Subject: Permit No. WQ003158
Two Single Family Residences
Single Family Wastewater
Spray Irrigation Facility
Union County, NC
Dear Ms. Kocik:
Our records show that Permit No. WQ003158 was issued on July 1, 1999 for your non -
discharge wastewater treatment facility. The purpose of this letter is to advise you of the
importance of the Permit and the liabilities in the event of failure to comply with the terms and
conditions of the Permit. If you have not already done so, it is requested that you and other
appropriate persons thoroughly read the Permit.
The Permit sets forth specific performance standards, operation and maintenance
requirements, monitoring requirements, plus general conditions applicable to non -discharge
permits. Failure to comply with the terms and conditions of the Permit subject the Permittee to
enforcement action pursuant to Section 143-215.6 of the North Carolina General Statutes in the
form of civil or criminal penalties.
Please note that the subject Permit expires on June 30, 2004. Part V, Condition No. 9
of the Permit requires that a renewal request be submitted at least six (6) months prior to
expiration Also, the Permit is non -transferable until such time that the Perri ttee has requested
a name change to the new Permittee.
As mentioned previously, the purpose of this letter is to advise you of the importance of
your Permit. Please read the permit and contact this Office at 704/663-1699 in Mooresville if
you have any questions or need clarification. We look forward to providing any assistance.
DRG: de
Sincerely,
4-&" &x
Rex Gleason, P. E.
Water Quality Regional Supervisor
919 NORTH MAIN STREET, MOORESVILLE, NORTH CAROLINA 28115
PHONE [phone] FAX [phone]
AN EQUAL OPPORTUNITY / AFFIRMATIVE ACTION EMPLOYER - 50`Yo RECYCLED/1 Oq POST -CONSUMER PAPER

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
I
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
Kerr T. Stevens, Director
Ms. Kimberly A. Kocik
5311 Flint Ridge Church Road
Marshville, North Carolina 28103
Dear Ms. Kocik:
JUL 9 1999
July 1, 1999
IT ilk
0A&4;1 • �
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: Permit No. WQ003158
Two Single Family Residences
Single Family Wastewater
Spray Irrigation Facility
Union County
In accordance with your application received February 2, 1999 we are forwarding herewith Permit No.
WQ0003158, dated July 1, 1999 to Ms. Kimberly A. Kocik for the continued operation of the subject two
single family wastewater treatment and spray irrigation facilities. The system was designed and originally
permitted in 1984 (Permit No. 10269) to serve a single family at 450 gallons per day. In 1985, a permit
modification changed the flow to 750 gallons per day to include a second single family type dwelling.
However, this modification did not change the capacity of the treatment facilities designed to serve these two
single family residences. The Division is assuming, although records are incomplete, that this action was
taken to accommodate a family member residing at the same location in the second house. Please be advised
that this system cannot accommodate an increase in flow if more than one person resides in this second house
and therefore, a modification to the existing facilities would be necessary prior to that occurring. A system
failure may result if actual flows exceed design capacity of your system. Please note, condition I.1 and other
permit conditions in this permit that require action for any type of system failure or any other problems
resulting in the operation of this system.
This permit shall be effective from the date of issuance until Jun3 30, 2004 shall void Permit No.
WQ0003158 issued November 30, 1994, and shall be subject to the conditions and limitations as specified
therein. Please pay particular attention to the monitoring requirements in this permit. Failure to establish an
adequate system for collecting and maintaining the required operational information will result in future
compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right
to request an adjudicatory hearing upon written request within thirty (30) days following receipt of this permit.
This request must be in the form of a written petition, conforming to Chapter 150B of the North Carolina
General Statutes, and filed with the Office of Administrative Hearings, P.O. Drawer 27447, Raleigh, NC
27611-7447. Unless such demands are made this permit shall be final and binding.
PO Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post -consumer paper

If you need additional information concerning this matter, please contact Ron Palumbo at (919) 733-
5083 extension 533.
SZel
/.Kerr T. Stevens
cc: Union County Health De art nt
echnical Assistance and Certification Unit
Non -Discharge Compliance/Enforcement Unit

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH
SINGLE FAMILY SPRAY IRRIGATION PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Ms. Kimberly A. Kocik
Union County
FOR THE
continued operation of a 750 GPD spray irrigation wastewater treatment and disposal system consisting of a
1,200 gallon baffled septic tank, a 1,200 gallon pump tank with a 52 gpm recirculation pump, a flow splitter, a
150 square foot recirculating sand filter, a tablet chlorinator, a 2,000 gallon chlorine contact storage/pump
tank, a 20 gpm self priming effluent dosing pump, a 6,969 square foot spray irrigation area with three (3)
sprinklers and all associated piping, valves, controls, meters and appurtenances to serve the two related single
family residence (One being the Kimberly A. Kocik Residence and the other being her mother's residence),
with no discharge of wastes to the surface waters, pursuant to the application received February 6, 1999, and in
conformity with the project plan, specifications, and other supporting data subsequently filed and approved by
the Department of Environment and Natural Resources and considered a part of this permit.
This permit shall be effective from the date of issuance until June 30, 2004 shall void Permit No.
WQ0003158 issued November 30, 1994, and shall be subject to the following specified conditions and
limitations:
I. PERFORMANCE STANDARDS
The spray irrigation facilities shall be effectively maintained and operated at all times so that there
is no discharge to the surface waters, nor any contamination of ground waters which will render
them unsatisfactory for normal use. In the event that the facilities fail to perform satisfactorily,
including the creation of nuisance conditions or failure of the irrigation area to adequately
assimilate the wastewater, the Permittee shall take immediate corrective actions including those
actions that may be required by the Division of Water Quality (Division), such as the construction
of additional or replacement wastewater treatment and disposal facilities.
4. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to
surface or groundwaters resulting from the operation of this facility.
The sand media of the sand filter must comply with the Division's sand specifications. The
engineer's certification will serve as evidence that these specifications have been met.

6. The residuals generated from these treatment facilities must be disposed in accordance with
General Statute 143-215.1 and in a manner approved by the Division.
7. Diversion or bypassing of the untreated wastewater from the treatment facilities is prohibited.
The following buffers shall be maintained:
a) 400 feet between wetted area and any residence or places of public assembly under separate
ownership,
b) 150 feet between wetted area and property lines,
c) 100 feet between wetted area and wells,
d) 100 feet between wetted area and drainageways or surface water bodies.
e) 50 feet between wetted area and public right of ways,
f) 100 feet between treatment/storage units and any wells, and
g) 50 feet between treatment units and property lines.
Some of the buffers specified above may not have been included in previous permits for this waste
treatment and disposal system. These buffers are not intended to prohibit or prevent
modifications, which are required by the Division, to improve performance of the existing
treatment facility. These buffers do, however, apply to modifications of the treatment and disposal
facilities which are for the purpose of increasing the flow that is tributary to the facility. These
buffers do apply to any expansion or modification of the spray irrigation areas and apply in
instances in which the sale of property would cause any of the buffers now complied with, for the
treatment and disposal facilities, to be violated. The applicant is advised that any modifications to
the existing facilities will require a permit modification.
II. OPERATION AND MAINTENANCE REQUIREMENTS
1. The facilities shall be properly maintained and operated at all times.
2. Upon classification of the facility by the Water Pollution Control System Operators Certification
Commission (WPCSOCC), the Permittee shall employ a certified wastewater treatment plant
operator to be in responsible charge (ORC) of the wastewater treatment facilities. The operator
must hold a certificate of the type and grade at least equivalent to or greater than the classification
assigned to the wastewater treatment facilities by the WPCSOCC. The Permittee must also
employ a certified back-up operator of the appropriate type and grade to comply with the
conditions of 15A NCAC 8A .0202. The ORC of the facility must visit each Class I facility at
least weekly and each Class II, III, and IV facility at least daily, excluding weekends and holidays,
and must properly manage and document daily operation and maintenance of the facility and must
comply with all other conditions of 15A NCAC 8A .0202.
3. A suitable year round vegetative cover shall be maintained.
4. Irrigation shall not be performed during inclement weather or when the ground is in a condition
that will cause runoff.
5. Adequate measures shall be taken to prevent wastewater runoff from the spray field.
6. The application rate shall not exceed a cumulative loading of 39 inches over any twelve (12)
month period at an instantaneous application rate that does not allow any runoff.
7. The facilities shall be effectively maintained and operated as a non -discharge system to prevent
the discharge of any wastewater resulting from the operation of this facility.
2

8. No type of wastewater other than that from the two single-family Kocik Residences shall be
sprayed onto the irrigation area.
9. In the event that the sprinkler heads fail to achieve the design diameter, to cover all the designed
wetted area, the obstructions shall be removed or the sprinkler heads shall be raised and supported
to such height that the design diameter is achieved.
10. No traffic or equipment shall be allowed on the disposal area except while installation occurs or
while normal maintenance is being performed.
11. The spray irrigation field shall be fenced with at least a two strand wire fence.
12. The Permittee is responsible for the operation and maintenance of the entire treatment and disposal
system including, but not limited to, the following items:
a. The septic tank shall be checked annually and pumped out as needed.
b. The tablet chlorinator shall be checked every week. Tablets shall be added so as to provide
proper chlorination.
c. The storage, pump, and alarm systems shall be inspected weekly. The scum layer shall be
removed at the same interval as the septic tank is cleaned out.
d. The spray system shall be inspected weekly to make certain of the sprayers proper operation,
that the vegetative growth allows a proper spray pattern, that the soil is assimilating the
disposed treated wastewater with no surface runoff, and that no objectionable odors are being
generated.
III. MONITORING AND REPORTING REQUIREMENTS
Any monitoring deemed necessary by the Division to insure surface and ground water protection
will be established and an acceptable sampling reporting schedule shall be followed.
2. The Permittee shall maintain records of all maintenance performed on the system and irrigation
area, as required in Condition II 12 for a minimum of five years. This information shall be
provided to the Division upon request.
3. Noncompliance Notification:
The Permittee shall report by telephone to the Mooresville Regional Office, telephone number
704-663-1699, as soon as possible, but in no case more than 24 hours or on the next working day
following the occurrence or first knowledge of the occurrence of any of the following:
a. Any process unit failure, due to known or unknown reasons, that renders the facility incapable
of adequate wastewater treatment, such as mechanical or electrical failures of pumps, spray
heads, etc.; or
b. Any failure of a pumping station or treatment facility resulting in a by-pass directly to
receiving waters without treatment of all or any portion of the influent to such station or
facility.
Persons reporting such occurrences by telephone shall also file a written report in letter form
within five (5) days following first knowledge of the occurrence. This report must outline the
actions taken or proposed to be taken to ensure that the problem does not recur.
3

IV. INSPECTIONS
1. Adequate inspection, maintenance, and cleaning shall be provided by the Permittee to insure
proper operation of the subject facilities.
2. Any duly authorized officer, employee, or representative of the Division may, upon presentation
of credentials, enter and inspect any property, premises or place on or related to the disposal site or
facility at any reasonable time for the purpose of determining compliance with this permit, may
inspect or copy any records that must be maintained under the terms and conditions of this permit,
and may obtain samples of groundwater, surface water, or leachate.
V. GENERAL CONDITIONS
1. This permit shall become voidable unless the facilities are constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data.
2. This permit is effective only with respect to the nature and volume of wastes described in the
application and other supporting data.
3. This permit is not transferable. In the event there is a desire for the facilities to change ownership,
or there is a name change of the Permittee, a formal permit request must be submitted to the
Division accompanied by an application fee, documentation from the parties involved, and other
supporting materials as may be appropriate. The approval of this request will be considered on its
merits and may or may not be approved.
4. Upon the availability of a municipal or regional sewerage collection system, the subject
wastewater treatment facilities shall be abandoned and all wastewater discharged into the
municipal or regional sewerage system.
5. Failure to abide by the conditions and limitations contained in this permit may subject the
Permittee to an enforcement action by the Division in accordance with North Carolina General
Statute 143-215.6A to 143-215.6C.
6. The issuance of this permit does not preclude the Permittee from complying with any and all
statutes, rules, regulations, or ordinances which may be imposed by other government agencies
(local, state, and federal) which have jurisdiction.
7. This permit may be revoked if the Permittee fails to abide by the conditions of the "Operation and
Maintenance Agreement" previously signed by the Permittee.
8. A set of approved plans and specifications for the subject project must be retained by the Pennittee
for the life of the project.
4

9. The Permittee, at least six (6) months prior to the expiration of this permit, shall request its
extension. Upon receipt of the request, the Commission will review the adequacy of the facilities
described therein, and if warranted, will extend the Permit for such period of time and under such
conditions and limitations as it may deem appropriate.
Permit issued this t irst day of July, 1999
NORTH OL E O AL MANAGEMENT COMMISSION
Kerr T. Stevens, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number WQ0003158

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State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
January 27, 1999
KIMBERLY KOCIK
KOCIK, KIMBERLY-KOCIK SFR SPR
5311 FLINT RIDGE CHURCH ROAD
MARSHVILLE, NC 28103
L71.5;TA
� E N FI
Subject: PERMIT NO. WQ0003158
KOCIK, KIMBERLY-KOCIK SFR SPR
UNION COUNTY
Dear Permittee:
Our files indicate that the subject permit issued on 11/30/94 expires on 10/31/99. We have not
received a request for renewal from you as of this date.
A renewal request shall consist of a letter asking for permit renewal and four (4) copies of a
completed application. For permitted facilities with treatment works, a narrative description of the
residuals management plan, which is in effect at the permitted facility, must also be submitted with the
renewal application. Applications may be returned to the applicant if incomplete.
The General Assembly passed legislation incorporating renewal fees into the annual fee.
Please be advised that this permit must not be allowed to expire. You must submit the renewal
request at least 180 days prior to the permit's expiration date, as required by the 15 NCAC 2H .0211.
Failure to request a renewal at least 180 days prior to the permit expiration date and/or operation of a
facility without a valid permit may result in the assessment of civil penalties. NCGS 143-215.6A allows
for the assessment of Civil penalties up to $10,000 per violation per day.
The letter requesting renewal, along with the completed Non -Discharge Permit Application must
be sent to:
Division of Water Quality
Non -Discharge Permitting Unit
P. O. Box 29535
Raleigh, North Carolina 27626-0535
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

If you have any questions concerning this matter, please contact Ms. Kimberly Young at
919 733-5083 extension 574.
Sincerely,
�:1'I�IQ�,ti Li
�Kim H. Colson, P.E., Supervisor
Non -Discharge Permitting Unit
cc: Mooresville Regional Office
Central Files

State of North Carolina
Department of Environment,
Health and Natural Resources
Mooresville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Linda Diane Long, Regional Manager
DEHNR
DIVISION OF ENVIRONMENTAL MANAGEMENT
December 28, 1994
Ms. Kimberly A. Kocik
5311 Flint Ridge Church Road
Marshville, North Carolina 28103
Subject: Permit No. WQ0003158
Two Single Family Residences
Union County, NC
Dear Ms. Kocik:
Our records show that Permit No. WQ0003158 was issued on
November 30, 1994 for your non -discharge wastewater treatment
facility. The purpose of this letter is to advise you of the
importance of the Permit and the liabilities in the event of
failure to comply with the terms and conditions of the Permit.
If you have not already done so, it is requested that you and
other appropriate employees thoroughly read the Permit.
The Permit sets forth specific performance standards,
operation and maintenance requirements, monitoring requirements,
plus general conditions applicable to non -discharge permits.
Failure to comply with the terms and conditions of the Permit
subjects the Permittee to enforcement action pursuant to Section
143-215.6 of the North Carolina General Statutes in the form of
civil or criminal penalties.
Please note that the subject Permit expires on October 31,
1999. Part V, No. 10 of the Permit requires that a renewal
request be submitted at least six (6) months prior to
expiration. Also the Permit is non -transferable until such time
that the Permittee has requested a name change to the new
Permittee.
919 North Main Street, Mooresville, North Carolina 28115 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

Ms. Kimberly
Page Two
December 28,
A. Kocik
1994
As mentioned previously, the purpose of this letter is to
advise you of the importance of your Permit. Please read the
Permit and contact this Office at 704/663-1699 in Mooresville if
you have any questions or need clarification. We look forward
to providing any assistance.
Sincerely,
� e-- G'/� �/— —
-I/z D. Rex Gleason, P. E.
Water Quality Regional Supervisor

State of North Carolina - LOS
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
Ms. Kimberly A. Kocik
5311 Flint Ridge Church Road
Marshville, North Carolina 28103
Dear Ms. Kocik:
November 30, 1994
LT1.5WAFA,
ENT
Subject: Permit
Two Single Family Residences
Wastewater Spray Irrigation Facility
Union County
In accordance with your application received September 19, 1994, we are forwarding herewith
Permit No. WQ0003158 dated November 30, 1994, to Kimberly A. Kocik for the continued operation of
the subject single family wastewater treatment and spray irrigation facilities. The subject system was
designed and originally permitted in 1984 (Permit No. 10269) to serve a single family at 450 gallons per
day. In 1985, a permit modification changed the flow to 750 gallons per day (to include a second single
family type dwelling) however, this modification did not change the capacity of the treatment facilities
designed to serve these two single family residences. The Division is assuming, although records are
incomplete, that this action was taken to accommodate a family member residing at this same location in
the second home. Please be advised that this system cannot accommodate an increase in flow if more than
one person resides in this second home and therefore, modification to the existing facilities would be
necessary prior to that occurring. A system failure may result if actual flows exceed design capacity of
your system. Please note, condition I.1 and other permit conditions in this permit that require action for
any type of system failure or any other problems resulting in the operation of this system.
This permit shall be effective from the date of issuance until October 31, 1999, and shall be subject
to the conditions and limitations as specified therein. Please pay particular attention to the monitoring
requirements in this permit. Failure to establish an adequate system for collecting and maintaining the
required operational information will result in future compliance problems. Issuance of this permit hereby
voids Permit No. WQ0003158 issued May 3, 1990.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the
right to request an adjudicatory hearing upon written request within thirty (30) days following receipt of
this permit. This request must be in the form of a written petition, conforming to Chapter 150B of the
North Carolina General Statutes, and filed with the Office of Administrative Hearings, P.O. Drawer
27447, Raleigh, NC 27611-7447. Unless such demands are made this permit shall be final and binding.
If you need additional information concerning this matter, please contact Mr. John Seymour at
[phone].
Sincerely, t'nn • �-
- A. Prest Howard, Jr., P.E.
cc: Union County Health Department
Facilities Assessment Unit
Training and Certification Unit
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT, HEALTH AND NATURAL RESOURCES
RALEIGH
SINGLE FAMILY SPRAY IRRIGATION PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Kimberly A. Kocik
Union County
1067:i1:1�!
continued operation of a 750 GPD spray irrigation wastewater treatment and disposal system consisting of
a 1,200 gallon baffled septic tank, a 1,200 gallon pump tank with a 52 gpm recirculation pump, a flow
splitter, a 150 ft2 recirculating sand filter, a tablet chlorinator, a 2,000 gallon chlorine contact
storage/pump tank,a 20 gpm self priming effluent dosing pump, a 6,969 ft2 spray irrigation area with three
(3) sprinklers, and all associated piping, valves, controls, meters, and appurtenances to serve the two
related single family residences (one being the Kimberly A. Kocik Residence and the other being her
mother's residence), with no discharge of wastes to the surface waters, pursuant to the application
received September 19, 1994, and in conformity with the project plan, specifications, and other supporting
data subsequently filed and approved by the Department of Environment, Health and Natural Resources
and considered a part of this permit.
This permit shall be effective from the date of issuance until October 31, 1999, and shall be subject
to the following specified conditions and limitations:
I. PERFORMANCE STANDARDS
The spray irrigation facilities shall be effectively maintained and operated at all times so that
there is no discharge to the surface waters, nor any contamination of ground waters which
will render them unsatisfactory for normal use. In the event that the facilities fail to
perform satisfactorily, including the creation of nuisance conditions or failure of the
irrigation area to adequately assimilate the wastewater, the Permittee shall take immediate
corrective actions including those actions that may be required by the Division of
Environmental Management, such as the construction of additional or replacement
wastewater treatment and disposal facilities.
2. The issuance of this permit shall not relieve the Permittee of the responsibility for damages
to surface or groundwaters resulting from the operation of this facility.
3. The sand media of the sand filter must comply with the Division's sand specifications. The
engineer's certification will serve as evidence that these specifications have been met.

4. The residuals generated from these treatment facilities must be disposed in accordance with
General Statute 143-215.1 and in a manner approved by the North Carolina Division of
Environmental Management.
5. Diversion or bypassing of the untreated wastewater from the treatment facilities is
prohibited.
6. The following buffers shall be maintained:
a) 400 feet between wetted area and any residence or places of public assembly under
separate ownership,
b) 150 feet between wetted area and property lines,
c) 100 feet between wetted area and wells,
d) 100 feet between wetted area and drainageways or surface water bodies,
e) 50 feet between wetted area and public right of ways,
f) 100 feet between treatment/storage units and any wells, and
g) 50 feet between treatment units and property lines.
Some of the buffers specified above may not have been included in previous permits for
this waste treatment and disposal system. These buffers are not intended to prohibit or
prevent modifications, which are required by the Division, to improve performance of the
existing treatment facility. These buffers do, however, apply to modifications of the
treatment and disposal facilities which are for the purpose of increasing the flow that is
tributary to the facility. These buffers do apply to any expansion or modification of the
spray irrigation areas and apply in instances in which the sale of property would cause any
of the buffers now complied with, for the treatment and disposal facilities, to be violated.
The applicant is advised that any modifications to the existing facilities will require a permit
modification.
H. OPERATION AND MAINTENANCE REQUIREMENTS
1. The facilities shall be properly maintained and operated at all times.
2. A suitable vegetative cover of the spray field shall be maintained.
3. Irrigation shall not be performed during inclement weather or when the ground is in a
condition that will cause runoff.
4. Adequate measures shall be taken to prevent wastewater runoff from the spray field.
5. The application rate shall not exceed 39 inches per acre per year at an instantaneous
application rate that does not allow any runoff.
6. The facilities shall be effectively maintained and operated as a non -discharge system to
prevent the discharge of any wastewater resulting from the operation of this facility.
7. No type of wastewater other than that from the two single family Kocik Residences shall be
sprayed onto the irrigation area.
8. In the event that the sprinkler heads fail to achieve the design diameter, to cover all the
designed wetted area, due to obstructions, the obstructions shall be removed or the
sprinkler heads shall be raised and supported to such height that the design diameter is
achieved.
9. No traffic or equipment shall be allowed on the disposal area except while installation
occurs or while normal maintenance is being performed.
2

10. The Permittee is responsible for the operation and maintenance of the entire treatment and
disposal system including, but not limited to, the following items:
a. The septic tank shall be checked annually and pumped out as needed.
b. The tablet chlorinator shall be checked every week. Tablets shall be added so as to
provide proper chlorination.
c. The storage, pump, and alarm systems shall be inspected weekly. The scum layer shall
be removed at the same interval as the septic tank is cleaned out.
d. The spray system shall be inspected weekly to make certain of the sprayers proper
operation, that the vegetative growth allows a proper spray pattern, that the soil is
assimilating the disposed treated wastewater with no surface runoff, and that no
objectionable odors are being generated.
III. MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring deemed necessary by the Division of Environmental Management to insure
surface and ground water protection will be established and an acceptable sampling
reporting schedule shall be followed.
2. The Permittee shall maintain records of all maintenance performed on the system and
irrigation area, as required in Condition II.10 for a minimum of five years. This
information shall be provided to the Division of Environmental Management upon request.
3. Noncompliance Notification:
The Permittee shall report by telephone to the Mooresville Regional Office, telephone
number 704/ 663-1699 as soon as possible, but in no case more than 24 hours or on the
next working day following the occurrence or first knowledge of the occurrence of any of
the following:
a. Any process unit failure, due to known or unknown reasons, that renders the facility
incapable of adequate wastewater treatment, such as mechanical or electrical failures of
pumps, spray heads, etc.; or
b. Any failure of a pumping station or treatment facility resulting in a by-pass directly to
receiving waters without treatment of all or any portion of the influent to such station or
facility.
Persons reporting such occurrences by telephone shall also file a written report in letter
form within 15 days following first knowledge of the occurrence. This report must outline
the actions taken or proposed to be taken to ensure that the problem does not recur.
IV. INSPECTIONS
1. Adequate inspection, maintenance, and cleaning shall be provided by the Permittee to
insure proper operation of the subject facilities.
2. Any duly authorized officer, employee, or representative of the Division of Environmental
Management may, upon presentation of credentials, enter and inspect any property,
premises or place on or related to the disposal site or facility at any reasonable time for the
purpose of determining compliance with this permit, may inspect or copy any records that
must be maintained under the terms and conditions of this permit, and may obtain samples
of groundwater, surface water, or leachate.
3

F V.
GENERAL CONDITIONS
1. This permit shall become voidable unless the facilities are constructed in accordance with
the conditions of this permit, the approved plans and specifications, and other supporting
data.
2. This permit is effective only with respect to the nature and volume of wastes described in
the application and other supporting data.
3. This permit is not transferable. In the event there is a desire for the facilities to change
ownership, or there is a name change of the Permittee, a formal permit request must be
submitted to the Division of Environmental Management accompanied by an application
fee, documentation from the parties involved, and other supporting materials as may be
appropriate. The approval of this request will be considered on its merits and may or may
not be approved.
4. Upon the availability of a municipal or regional sewerage collection system, the subject
wastewater treatment facilities shall be abandoned and all wastewater discharged into the
municipal or regional sewerage system.
5. The spray irrigation field shall be fenced with at least a two strand wire fence.
6. Failure to abide by the conditions and limitations contained in this permit may subject the
Permittee to an enforcement action by the Division of Environmental Management in
accordance with North Carolina General Statute 143-215.6(a) to 143-215.6(c).
7. The issuance of this permit does not preclude the Permittee from complying with any and
all statutes, rules, regulations, or ordinances which may be imposed by other government
agencies (local, state, and federal) which have jurisdiction.
8. This permit may be revoked if the Permittee fails to abide by the conditions of the
"Operation and Maintenance Agreement" previously signed by the Permittee.
9. A set of approved plans and specifications for the subject project must be retained by the
Permittee for the life of the project, if available upon issuance of this permit.
10. The Permittee, at least six (6) months prior to the expiration of this permit, shall request its
extension. Upon receipt of the request, the Commission will review the adequacy of the
facilities described therein, and if warranted, will extend the Permit for such period of time
and under such conditions and limitations as it may deem appropriate.
11. Issuance of this permit hereby voids Permit No. WQ0003158 issued May 3, 1990.
Permit issued this the 30th day of November, 1994
NORTH CAROLINA ENVIRONMENTAL MANAQEMENT COMMISSION
A. Preston oward, Jr., P., Director I
Division of Vnvironmental Management
By Authority of the Environmental Management Commission
Permit Number WQ0003158
4

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OPERATION AND MAINTENANCE AGREEMENT FOR THE
DIVISION OF ENVIRONMENTAL MANAGEMENT
Ms. Kimberly A. Kocik
5311 Flint Ridge Church Road
Marshville, North Carolina 28103
Single Family Residence Wastewater Treatment System
Final Disposal by Spray Irrigation
Permit No. WQ0003158
Union County
I agree to operate and maintain the wastewater treatment system as follows:
1. The Permittee is responsible for the operation and maintenance of the entire treatment and
disposal system including, but not limited to, the following items:
a. The septic tank shall be checked every six (6) months and pumped out as required.
b. The tablet chlorinator shall be checked every week until the actual usage rate is
established and thence on a monthly basis. Tablets shall be added so as to provide
proper chlorination.
C. The storage system, pump system, and alarm system shall be inspected monthly.
The scum layer shall be removed at the same interval as the septic tank is cleaned
out.
d. The spray system shall be inspected monthly to make certain of the sprayers proper
operation, that the vegetative growth allows proper spray patterns, that the soil is
absorbing the disposed treated wastewater with no surface runoff, and that no
objectionable odors are being generated.
2. Failure of the Permittee to properly operate this system is subject to a penalty up to $10,000
per day.
3. Failure to meet permit conditions or violation of the State's surface or groundwater
regulations will require cessation of occupancy of the residence.
I understand that failure to comply with these conditions along with the permit conditions may result in
voiding the permit.
Signature: Date:
Kimberly A o
1-11
Notary Sea.1
Notary rySignature: Date: "F �!
�� ,3 z) I y

Fte of North Carolinaartmenof Environment,ealth and Natural Resources /✓ 5����n
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary 13 FE
A. Preston Howard, Jr., P.E., Director R vr, �ALH,
NATURAL RESOURCES
Ms. Kimberly A. Kocik
5311 Flint Ridge Church Road
Marshville, North Carolina 28103
Dear Ms Kocik:
November 4, 1994 NOV 7 199d
DIVISION OF ENVIROUBTAL '" ';:1 E`.IENT
MOORESVILLE REGIuiAL O, riCE
Subject: Operation and Maintenance Agreement
for Permit No. WQ0003158
Kimberly A. Kocik and Mother
Two Single Family Residences
Wastewater Treatment System
Final Disposal by Spray Irrigation
Union County
With reference to the above mentioned project, the attached Operation and Maintenance Agreement
must be signed and returned by the Permittee within Sixty (60) days or sub' ct the project application to
being returned as incomplete in accordances with 15 NCAC 2H .0208. hou his is a permit renewal a
current operational agreement is needed, per state regulation. Please note the agreement signature should
be notarized.
If you have any questions on this matter, please call me at 919/ 733-5083.
Sincerely,
John Seymour
Environmental Engineer
State Engineering Review Group
cc: Mooresville Regional Office
Permit File WQ0003158
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

OPERATION AND MAINTENANCE AGREEMENT FOR THE
DIVISION OF ENVIRONMENTAL MANAGEMENT
Ms. Kimberly A. Kocik
5311 Flint Ridge Church Road
Marshville, North Carolina 28103
Single Family Residence Wastewater Treatment System
Final Disposal by Spray In7gation
Permit No. WQ0003158
Union County
I agree to operate and maintain the wastewater treatment system as follows:
The Permittee is responsible for the operation and maintenance of the entire treatment and
disposal system including, but not limited to, the following items:
a. The septic tank shall be checked every six (6) months and pumped out as required.
b. The tablet chlorinator shall be checked every week until the actual usage rate is
established and thence on a monthly basis. Tablets shall be added so as to provide
proper chlorination.
C. The storage system, pump system, and alarm system shall be inspected monthly.
The scum layer shall be removed at the same interval as the septic tank is cleaned
out.
d. The spray system shall be inspected monthly to make certain of the sprayers proper
operation, that the vegetative growth allows proper spray patterns. that the soil is
absorbing the disposed treated wastewater with no surface runoff, and that no
objectionable odors are being generated.
2. Failure of the Permittee to properly operate this system is subject to a penalty up to $10,000
per day.
3. Failure to meet permit conditions or violation of the State's surface or groundwater
regulations will require cessation of occupancy of the residence.
I understand that failure to comply with these conditions along with the permit conditions may result in
voiding the pen -nit.
Signature:
Kimberly A. Kocik
Notary Seal
Date:
Notary Signature: t--.

PFV
N NCDEPT.
RE OF ai()A,�
C��f11ZUNjtYlt, ri 'J"'
41AY08
la :�• 1990
O/VIS/�N Of fh.�
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
William W. Cobey, Jr., Secretary
Ms. Kimberly C. Kocik, Owner
Route 1 Box 25
Marshville, North Carolina 28103
Dear Ms. Kocik:
George T. Everett, Ph.D.
Director
May 3, 1990
Subject: Permit No. WQ0003158
Kimberly C. Kocik
Two Single Family Residences
Wastewater Treatment and Spray
Irrigation Disposal
Union County
In accordance with your application received February 27, 1990, we are forwarding
herewith Permit No. WQ0003158, dated May 3, 1990, to Kimberly C. Kocik for the continued
operation of the single family wastewater treatment and spray irrigation disposal system.
This permit shall be effective from the date of issuance until April 30, 1995, and shall
supersede Permit No. 10269R1 issued May 8, 1985, and shall be subject to the conditions and
limitations as specified therein. Please pay particular attention to the monitoring requirements in
this permit. Failure to establish an adequate system for collecting and maintaining the required
operational information will result in future compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable to you,
you have the right to request an adjudicatory hearing upon written request within 30 days
following receipt of this permit. This request must be in the form of a written petition, conforming
to Chapter 150B of North Carolina General Statutes, and filed with the Office of Administrative
Hearings, P.O. Box 11666, Raleigh, NC 27604. Unless such demands are made this permit shall
be final and binding.
If you need additional information concerning this matter, please contact Mr. Mark Hawes
at 919/ 733-5083.
Sinc1 erely,
George T. Everett.
cc: Union e artment
Pollution Prevention Pays
P.O. Box 27687, Raleigh, North Carolina 27611-7687 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

PPV
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT, HEALTH AND NATURAL RESOURCES
RALEIGH
SINGLE FAMILY SPRAY IRRIGATION PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North
Carolina as amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
KIMBERLY C. KOCIK
Union County
FOR THE
continued operation of a 750 gpd single family wastewater treatment and spray irrigation disposal
system consisting of a 1,200 gallon septic tank, a 1,200 gallon pump tank with a 52 gpm
recirculation pump, flow splitter, a recirculating sand filter of 150 square feet, tablet type
chlorinator, a 2,000 gallon capacity chlorine contact/storage tank, 20 gpm self priming effluent
dosing pump, 0.16 acre spray irrigation field with three (3) sprinklers, automatic pumping and
recirculation controls, high water alarms, and associated piping, valves, and appurtenances to
serve two single family residences , with no discharge of wastes to the surface waters, pursuant
to the application received February 27, 1990 and in conformity with the project plan,
specifications, and other supporting data subsequently filed and approved by the Department of
Environment, Health and Natural Resources and considered a part of this permit.
This permit shall be effective from the date of issuance until April 30, 1995, and shall
supersede Permit No. 10269R1 issued May 8, 1985, and shall be subject to the following
specified conditions and limitations:
PERFORMANCE STANDARDS
1. The spray irrigation facilities shall be effectively maintained and operated at all times so
that there is no discharge to the surface waters, nor any contamination of ground waters
which will render them unsatisfactory for normal use. In the event that the facilities fail
to perform satisfactorily, including the creation of nuisance conditions or failure of the
irrigation area to adequately absorb the wastewater, the Permittee shall take
immediate corrective action to correct the problem, including those as may be required
by the Division of Environmental Management.
2. The issuance of this permit shall not relieve the Permittee of the responsibility for
damages to surface or groundwaters resulting from the operation of this facility.
3. The sludge generated from these treatment facilities must be disposed of in accordance
with General Statute 143-215.1 and in a manner approved by the North Carolina
Division of Environmental Management.

PV
4. Diversion or bypassing of the untreated wastewater from the treatment facilities is
prohibited.
5. The following buffers shall be maintained:
a) 400 feet between wetted area and any residence under separate ownership,
b) 150 feet between wetted area and property lines for any new spray fields otherwise
100 feet shall be maintained for the existing spray field,
c) 100 feet between wetted area and wells,
d) 100 feet between wetted area and drainageways or surface water bodies,
e) 50 feet between wetted area and public right of ways,
f) 100 feet between treatment/storage units and any wells,
g) 50 feet between treatment units and property lines.
II. OPERATION AND MAINTENANCE REQUIREMENTS
1. The facilities shall be properly maintained and operated at all times.
2. A suitable vegetative cover shall be maintained.
3. Irrigation shall not be performed during inclement weather or when the ground is in a
condition that will cause runoff.
4. Adequate measures shall be taken to prevent wastewater runoff from the spray field.
5. The application rate shall not exceed 0.75 inches per acre per week.
6. The facilities shall be effectively maintained and operated as a non -discharge system to
prevent the discharge of any wastewater resulting from the operation of this facility.
7. No type of wastewater other than that from two single family residences shall be sprayed
onto the irrigation area.
8. No traffic or equipment shall be allowed on the disposal area except while installation
occurs or while normal maintenance is being performed.
9. The Permittee is responsible for the operation and maintenance of the entire treatment
and disposal system including, but not limited to, the following items:
a. The septic tank shall be checked annually and pumped out as needed.
b. The tablet chlorinator shall be checked every week. Tablets shall be added so as to
provide proper chlorination.
c. The storage, pump, and alarm systems shall be inspected weekly. The scum layer
shall be removed at the same interval as the septic tank is cleaned out.
d. The spray system shall be inspected weekly to make certain of the sprayers proper
operation, that the vegetative growth allows proper spray pattern, that the soil is
absorbing the disposed treated wastewater with no surface runoff, and that no
objectionable odors are being generated.
104

MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring deemed necessary by the Division of Environmental Management to
insure surface and ground water protection will be established and an acceptable
sampling reporting schedule shall be followed.
2. The Permittee shall maintain records of all maintenance performed on the system
and irrigation area as required in Condition II.9 for a minimum of five years. This
information shali be provided to the Division of Environmental Management upon
request.
3. Noncompliance Notification:
The Permittee shall report by telephone to the Mooresville Regional Office,
telephone no. [phone], as soon as possible, but in no case more than 24 hours
or on the next working day following the occurrence or first knowledge of the
occurrence of any of the following:
a. Any process unit failure, due to known or unknown reasons, that render the facility
incapable of adequate wastewater treatment such as mechanical or electrical failures
of pumps, spray heads, etc.
b. Any failure of a pumping station or treatment facility resulting in a
by-pass directly to receiving waters without treatment of all or any portion of the
influent to such station or facility.
Persons reporting such occurrences by telephone shall also file a written report in letter
form within 15 days following first knowledge of the occurrence. This report must
outline the actions taken or proposed to be taken to ensure that the problem does not
recur.
IV. INSPECTIONS
1. Adequate inspection, maintenance, and cleaning shall be provided by the Permittee to
insure proper operation of the subject facilities.
2. Any duly authorized officer, employee, or representative of the Division of
Environmental Management may, upon presentation of credentials, enter and inspect
any property, premises or place on or related to the disposal site and facility at any
reasonable time for the purpose of determining compliance with this permit; may inspect
or copy any records that must be kept under the terms and conditions of this permit; or
may obtain samples of groundwater, surface water, or leachate.
V. GENERAL CONDITIONS
This permit shall become voidable unless the facilities are constructed in accordance with
the conditions of this permit, the approved plans, specifications, and other supporting
data.
2. This permit is effective only with respect to the nature and volume of wastes described in
the application and other supporting data.
3

PV
3. This permit is not transferable. In the event there is a desire for the facilities to change
ownership, or there is a name change of the Permittee, a formal permit request must be
submitted to the Division of Environmental Management accompanied by an application
fee, documentation from the parties involved, and other supporting materials as may be
appropriate. The approval of this request will be considered on its merits and may or
may not be approved.
4. Upon the availability of a municipal or regional sewerage collection system, the subject
wastewater treatment facilities shall be abandoned and all wastewater discharged into the
municipal or regional sewerage system.
5. The spray irrigation field shall be fenced with at least a two strand wire fence.
6. Failure to abide by the conditions and limitations contained in this permit may subject the
Permittee to an enforcement action by the Division of Environmental Management in
accordance with North Carolina General Statute 143-215.6.
7. The issuance of this permit does not preclude the Permittee from complying with any
and all statutes, rules, regulations, or ordinances which may be imposed by other
government agencies (local, state, and federal) which have jurisdiction.
Prior to any transfer of this land, a notice shall be given to the new owner that gives
full details of the materials applied at this site.
9. This permit may be revoked if the Permittee fails to abide by the conditions of the
operation and maintenance agreement previously signed by the Permittee.
10. The Permittee, at least six (6) months prior to the expiration of this permit, shall request
its extension. Upon receipt of the request, the Commission will review the adequacy of
the facilities described therein, and if warranted, will extend the Permit for such period
of time and under such conditions and limitations as it may deem appropriate.
Permit issued this the 3rd day of May, 1990
N RT l CAROLINA
AL MANAGEMENT COMMIS VON
George T. Everett, c or
Division of Environment anagement
By Authority of the Environmental Management Commission
Permit No. WQ0003158
El

KI. sria�' 4
State of North Carolina
Department of Environment, Health, and Natural Resources
Mooresville Regional Office
James G. Martin, Governor
William W. Cobey, Jr., Secretary
Ms. Kimberly Kocik
Route 1, Box 25
Marshville, North
Dear Ms. Kocik:
Albert F. Hilton, Regional Manager
DIVISION OF ENVIRONMENTAL MANAGEMENT
April 12, 1990
Carolina 28103
Subject: Land Application/Spray
Irrigation System
Permit No. WQ 0003158
Union County, NC
This letter concerns the uneven application of treated
wastewater in your permitted spray irrigation field. The
sprinkler heads were installed at varying elevations. The lowest
sprinkler head appears to be carrying a greater amount of flow.
Some slight ponding is occurring around this sprinkler.
To correct this situation, it is recommended that the
sprinkler heads be lowered or raised so that they are all at the
same elevation and/or provide for equal distribution. Also, it
is recommended that the sprinkler heads be cleaned periodically
to prevent clogging.
If you have any questions, please feel free to contact Kim
H. Colson or me at this Office.
KHC:se
Sincerely,
Z), D. Rex Gleason, P. E.
Water Quality Regional Supervisor
919 North Main Street, Mooresville, N.C. 28115 • Telephone [phone] • FAX [phone]
An Equal Opportunity Affirmative Action Employer

Pr
M
RECEIVED
WMION Of ENVIRONMENTAL MANASEME06 -
��
FEB 20 1990
V"ESVILLE State: of North Carolina
Department oTEnviron'#nent, Health, and Natural Resources
Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27611
James G. Martin, Governor
William W. Cobey, Jr., Secretary
Certified Mail
Return Receipt Requested
KIMBERLY C. KOCIK
KOCIK, KIMBERLY-AMD#10269
RT. 1, BOX 25
MARSHVILLE, NC 28103
Dear Permittee:
February 16, 1990
R. Paul Wilms
Director
SUBJECT: NOTICE OF VIOLATION
NON -DISCHARGE PERMIT NO. 10269R
UNION COUNTY
The Division of Environmental Management issued the subject permit on 5/08/85
and according to our records, the permit expired on 5/31/89.
North Carolina General Statute 143-215.1(a)(2) requires that a permit be obtained
for the construction or operation of any sewer system, treatment works, or disposal
system within the State. The Division will inspect this facility in the near future
to determine its compliance status with regard to this regulatory requirement. If
operation of a wastewater treatment system is occurring or is subject to occur from
this facility, the Division will prepare an enforcement action for violations of North
Carolina General Statute 143-215.1 et. seq. North Carolina General Statute
143-215.6(a)(1) states that a civil penalty of up to ten thousand dollars ($10,000)
may be assessed by the Environmental Management Commission against any person who
violates General Statute 143.21.5.1.
If you are operating this facility or plan to operate at some future date, you
should submit a reissuance request within fifteen (15) days of receipt of this
letter. The letter requesting reissuance, along with a completed Non -Discharge Permit
application and appropriate standard fee, should be sent to:
Permits and Engineering Unit
Division of Environmental Management
P. 0. Box 27687
Raleigh, North Carolina. 27611-7687
The check should be made payable to the North Carolina Department of Environment.,
Health, and Natural Resources (DEHNR).
P.O. Box 27687, Raleigh, North Carolina 27611-7687 Telephone [phone]

F'r
If you have any questions or need any additional information regarding this
matter, please contact Mr.. Rex Gleason, Water Quality Regional Supervisor, of
the Mooresville Regional Office at [phone], or Mr. Donald Safrit,
Supervisor of the Permits and Engineering Unit at [phone].
Si.nc rely,
George . Everett, Ph.D,
Director
cc: Mooresville Regional Office
Permits and Engineering Unit

STATE
M
pprpp,
'r rJ? Z'3x
!f '
I / a.
C, •
Ir
State of North Carolina
Department of Natural Resources ar q Community Development
512 North Salisbury Street • Raleigh, North Carolina 27611
©4
James G. Martin, Governor �,V6- OXr Aay 8, 1985 S. Thomas Rhodes, Secretary
1�' G•5� 1t`I 9� DIV.IS- ION OF ENVIRONMENTAL MANAGEMENT
co R1W
�g C"`
Ms. Kimberly Kocik
Route 1, Box 25
Marshville, North Carolina 28103
Subject: Permit No. 10269R1
Kimberly C. Kocik, Owner
Land Application/Spray Irrigation
Wastewater Treatment Facility
Union County, North Carolina
Dear Ms. Kocik:
In accordance with your application received April.10,''.1985, we are
forwarding herewith Permit No. 10269R1, dated May 8, 1985, to Kimberly
C. Kocik for the construction and operation of the subject wastewater
collection and treatment facilities.
This Permit shall be effective from the date of issnauce until May 31,
1989, and shall be subject to the conditions and limitations as specified
therein.
If any parts, requirements, or limitations contained in this Permit are
unacceptable to you, you have the right to an adjudicatory hearing before a
hearing officer upon written demand to the Director within thirty (30) days
following receipt of this Permit, identifying the specific issues to be con-
tended. Unless such demand is made, this Permit shall be final and binding.
Please be aware that any future transfer of ownership and maintenance
responsibility of these facilities must be approved by this Division by
requesting permit reissuance, since this Permit is non -transferable.
P.O. Box 27687, Raleigh, North Carolina 27611.7687 Telephone [phone]
An Equal Opportunity / Affirmative Action Employer

Ms. Kimberly Kocik
Page Two
If you have any questions or need any additional information concerning
this matter, please contact Mr. Gil Vinzani, telephone number 919/733-5083.
Sincerely yours,
Original Signed By
ARTHUR MOUBERRY
P&R Wilms
Director
cc: Union County Health Department
Mooresville Regional Supervisor

PPP'FP'
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF NATURAL RESOURCES & COMMUNITY DEVELOPMENT
RALEIGH
P E R M I T
For the Discharge of Sewage, Industrial Wastes, or Other Wastes
In accordance with the provisions of Article 21 of Chapter 143, General
Statutes of North Carolina as amended, and other applicable Laws, Rules, and
Regulations
PERMISSION IS HEREBY GRANTED TO
Kimberly C. Kocik
Union County
FOR THE
construction and operation of a 750 gpd non -discharge land application/
spray irrigation type wastewater treatment and disposal facility consisting
of a 1,200-gallon capacity baffled septic tank, 1,200-gallon capacity pump
tank with 52 GPM submersible recirculation pump, flow splitter, 150 S. F.
recirculating surface sand filter, tablet -type chlorinator, 2,000-gallon
capacity chlorine contact/storage tank, 20 GPM self -priming effluent dosing
pump, 0.16 acre spray irrigation field with three sprinklers, automatic
recirculation and dosing pump controls and high water alarms, and associated
piping valves and appurtenances to serve two (2) residences in Union County
with no discharge of wastewater to the surface waters of the State,
pursuant to the application received April 10, 1985, and in conformity
with the project plans, specifications, and other supporting data, previously
filed and approved by the Department of Natural Resources and Community
Development and considered a part of this Permit.
This Permit shall be effective from the date of issuance until May 31,
1989, and shall be subject to the following specified conditions and limitations:
1. This Permit shall become voidable unless the facilities are constructed
in accordance with the approved plans, specifications and other
supporting data.
2. This Permit is effective only with respect to the nature and volume
of wastes described in the application and other supporting data.
3. The facilities shall be properly maintained and operated at all times.

Pop
Permit No. 10269R1
Page Two
4. The sewage and wastewater collected by this system shall be adequately
treated in the pretreatment facilities prior to being sprayed onto
the receiving irrigation field.
5. This Permit is not transferable.
6. This Permit shall become voidable in the event of failure of the soil
to adequately absorb the wastes, and may be rescinded unless the
facilities are installed, maintained and operated in a manner which
will protect the assigned water quality standards of the surface
waters and groundwaters.
7. Inievent the facilities fail to perform satisfactorily including the
creation of nuisance conditions, the Permittee shall take such
immediate corrective action as may be required by this Division,
including the construction of additional or replacement wastewater
treatment or disposal facilities.
8. Diversion or bypassing of the untreated wastewater from the treatment
and disposal facilities is prohibited.
9. Upon the availability of a municipal or regional sewerage collection
system, the subject wastewater treatment facilities shall be abandoned,
and all wastewater discharged into the municipal or regional sewerage
system.
10. Any monitoring deemed necessary by the Division of Environmental
Management to insure surface and ground water protection will be
established and an acceptable sampling reporting schedule shall be
followed.
11. The sludge generated from these treatment facilities must be disposed
of in accordance with General Statute 143-215.1 and in a manner
approvable by the North Carolina Division of Environmental Management.
12. A suitable year round vegetative cover shall be maintained on the
spray field.
13. Irrigation shall not be performed during inclement weather or when
the ground is in a condition that will cause runoff.
14. The Permittee, at least six (6) months prior to the expiration of this
Permit, shall request its extension. Upon receipt of the request,
the Commission will review the adequacy of the facilities described
therein, and if indicated, will extend the Permit for such period of
time and under such conditions and limitations as it may deem
appropriate.
15. The application rates shall not exceed 0.75 inch/acre/week.
16. The issuance of this Permit shall not relieve Ms. Kimberly C. Kocik
of the responsibility for damages to surface or ground waters
resulting from the operations of this facility.

ppr
Permit No. 10269R1
Page Three
17. The facilities shall be effectively maintained and operated as a non -
discharge system to prevent the discharge of any wastewater into the
surface waters of the State.
18. No type of wastewater other than that from the two (2) single-family
residences served shall be sprayed on the irrigation area.
19. No traffic or equipment shall be allowed on the disposal area except
while installation occurs or while normal maintenance is being performed.
20. No root or leaf crops for public consumption shall be raised on the spray
field.
21. Adequate inspection, maintenance, and cleaning shall be provided by the
Permittee to insure proper operation of the subject facilities.
22. The following minimum buffer distances shall be maintained between the
wetted perimeter of the spray field and the indicated facilities:
a. 200 feet from the on -site residence
b. 100 feet from property lines
C. 400 feet from any existing off -site residence or place or public
assembly
d. 100 feet from any potable water supply well
23. Dikes shall be constructed as necessary to prevent surface water run-off
from the spray field.
Permit issued this the 8th day of May, 1985.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
AR rH inal Signed 8Y
For. R M()UBFRRY
Paul Wilms, Director
Division of Environmental Management
By Authority of the Environmental Management Commission
Permit No. 10269R1

P�
State of North Carolina
Department of Natural Resources and Community Development
Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27611
James G. Martin, Governor r' S. Thomas Rhodes, Secretary
Dear
We acknowledge receipts of the following documents: 19
-gl,
permit application - APN ) �'>
eng"ering plans
specifications
`dtNi�r
Your project has been assigned to, zV K /''., A,, / for a detailed engineering review.
All project documents will be reviewed with respect to the proposed wastewater facilities. This review will not commit
this Division to approving any expansion of these treatment facilities or increase of flowrate in the future.
Prior to the issuance of the permit, you will be advised of the recommendations any comments of this Division.
You will also be informed of any matter which needs to be resolved.
Our reviews are scheduled based on receipt date of complete informations. The items checked below are needed
before your project can be reviewed.
permit application (copies enclosed)
engineering plans (signed and sealed by N.C.P.E.)
specifications (signed and sealed by N.C.P.E.)
other additional information detailed on attachment
The above checked information is needed by fi�/ If not received, your application
package will be returned as incomplete. Please be aware that the Division's Regional Office
must provide RECOMMENDATIONS from the Regional Supervisor or a Procedure Four Evaluation for this project,
prior to final action by the Division.
cc:
If you have any questions, please call the review engineer at this telephone number 919/733-5083.
Sincerely,
P.O. Box 27687, Raleigh, North Carolina 27611-7687 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

r A
DIVISION OF ENVIRONMENTAL MANAGEMENT
April 30, 1985
MEMORANDUM TO: Gil Vinzani
THROUGH: D. Rex Gleason
FROM: J. Thurman Horne.
SUBJECT: Request for \P(erm Revision
Kimberly Kocik
Spray Irrigation/Land Application System
Permit No. 10269
Union County, North Carolina
As per our telephone conversation a couple of weeks ago, I have attached
a copy of a suggested revised permit affecting a revision as requested in
Ms. Kocik's letter dated April 9, 1985 (letter attached).
Ms. Kocik has requested that the permit be revised to allow the addition
of one (1) additional residence to the existing system. Therefore, the
facilities should be permitted to serve two (2) residences. The proposed
additional residence will be that of Ms. Kocik's mother.
I visited the site on March 18, 1985, and observed that all existing
facilities appeared to be operating properly and are being well maintained.
I have reviewed the sizing of the existing facilities and it appears
that the facilities were designed to accommodate the additional residence
as Ms. Kocik reported during our investigation.
The Mooresville Regional Office recommends that the permit be revised
as requested.
If additional information is needed, please advise. If not, please
consider this memo to be our Staff Report and Recommedations.
Attachments
JTH:se

rGDAVO
Feb.' 15, 198!0.` ISPN
To whom it ip y,150pern:
OP11111
I am interested in putting my trailer on my daughters property on the corner of 1005
rI ,n t
road and Ghurchridge rd. I would like a permit to hook up to her septic tank.
I plan to put on a double wide trailer Vith 3 bedrooms and I batbs. Their will
be 2 people living in the trailer., myself and my son. I plan on having my own
well.
Thank you,

1 rim illm- -
I t! 1*4
ma C� 7 10
T 7' 18100
3-9
UkA Q �j UYjL
1,41aOvQd Xvw 41 woq(-;g

Borth Carolina Department of Natural
=.s resources &Community Development
James B. Hunt, Jr., Governor James A. Summers, Secretary
DIVISION OF ENVIRONMENTAL MANAGEMENT
June 27, 1984
Ms. Kimberly C. Kocik
c/o CMO Associates, Inc.
402 Willowbrook Drive
Cary, N. C. 27511
Subject: Permit No. 10269
Kimberly C. Kocik Residence
Land Application/Spray Irrigation
Wastewater Treatment Facility
Union County, N. C.
Dear Ms. Kocik:
This letter is to document that a final construction inspection was conducted
on June 26, 1984 by the staff of this Office.
Our inspection revealed that construction is essentially complete and that
the facilities appear to be in general conformity with the approved plans and
specifications and are approved for use in accordance with the terms and
conditions of the subject Permit.
If you have any questions or need any assistance, please contact Mr. Thurman
Horne or me [phone].
Sincerely,
D.. Rex Gleason, P. E.
Water Quality Regional Engineer
cc: Union County Inspection Department
Union County Health Department
Colonial Mobile Homes
Mr. Bill Mills
J�TH:sju
J I''
Mooresville Regional Office R 0. Box 950, 919 North Main Street, Mooresville, N.C. 28115-0950 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

"4 North Carolina Department of Natural
- Resources &Community Development
.� James B. Hunt, Jr., Governor James A. Summers, Secretary
DIVISION OF ENVIRONMENTAL MANAGEMENT
June 22, 1984
Union County Inspection Department
Union County Courthouse
Monroe, North Carolina 28110
Attention: Mr. Steve Morton
Subject: In -Progress Inspection
Kimberly C. Kocik Residence
Land Application/Spray Irrigation
Wastewater Treatment Facility
Permit No. 10269
Union County, North Carolina
Dear Mr. Morton:
This Office has received a request from Mr. Mack Flowe, Colonial Mobile
Homes, that we provide you with a report of our in -progress construction
inspection of the subject facilities performed June 21, 1984.
Our inspection revealed that construction is underway on the proposed
facilities and that a substantial portion of the facilities are in basic
conformity with approved plans and specifications although there has been some
variation from approved design.
At present the facilities are not completed to a degree that would allow
their use as intended by the subject Permit. 'The facilities are lacking
necessary pumps, spray equipment, etc. which will be needed to complete the
project.
In summary, construction is not complete but appears to be progressing
in a generally satisfactory manner.
If you have any questions or need any additional information, please call
(704/663-1699).
Si cer
J. Thurman Horne, P. E.
Acting Regional Water Quality Engineer
cc: Union County Health Department
Colonial Mobile Homes
CMO Associates
JTH:se
Mooresville Regional Office R 0. Box 950,919 North Main Street, Mooresville, N.C. 28115-0950 Telephone [phone]

GOLOYIAL
MOI3I LF, HOMES
Sales and Seroce
Qcrulit.v lvohile Ilomes
1 301 Roo sevel t Blvd. P.O. Box 366
Monroe, North CFro1_in. 28110
1-704-283-282�
June 22, 1984
Mr. Rex Gleason
N. C. Dept. of Natural Resources
& Community Development
Post Office Box 950
Mooresville, North Carolina 28115
Dear Mr. Gleason:
This letter is being written to certify that Coloni?1 Mobile
Homes has requested nn Interim Inspection Letter from your
office regarding the wastewater collection and treatment
facilities at Kimberly C. Kocik's property. (Permit #10269)
The letter should be addressed to Union County Inspection
Department, attention Steve Morton, Union County Courthouse,
Monroe, N. C. 28110.
Your courtesy in this matter will be greatly appreciated.
Upon completion of this system, Colonial Mobile Homes will
also need a letter to the same person stPting that your
office has inspected system and hpve approved the installation.
Sincerely yours,
COLONIAL MOBILE HOMES
MONROE, NOR H CAROLINA
Mac Flowe, M nager
MF:leh

e ST
North Carolina Department of Natural
Resources & Community Development
James B. Hunt, Jr., Govefgf r OF NATURAL es A. Summers, Secretary
t,,;• -.,. f,�s AND
COl► ',;, :,.;Ty DL`ELOPA 1984
Mr. J. Kent Messick,
CMO Associates, Inc.
402 Willowbrook Drive
Cary, North Carolina
Dear Mr. Messick:
i4i% Nij 1964.
Agent
DIVISION CF RVIPWVYINTAL MANAGENEV
27511MOGRESYILLE RE6101M OFFICE
DIVISION OF
ENVIRONMENTAL
MANAGEMENT
Robert F. Helms
Director
Telephone [phone]
SUBJECT: Permit No. 10269
Kimberly C. Kocik, Owner
Single Family Residence
Land Application/Spray Irrigation
Wastewater Treatment Facility
Union County
In accordance with your application received March 8, 1984, we are for-
warding herewith Permit No. 10264, dated May 17, 1984, to Kimberly C. Kocik,
Owner for the construction and operation of the subject wastewater collection and
treatment facilities.
This permit shall be effective from the date of issuance until May 31, 1989,
and shall be subject to the conditions and limitations as specified therein.
If any parts, requirements, or limitations contained in this permit are
unacceptable to you, you have the right to an adjudicatory hearing before a
hearing officer upon written demand to the Director within thirty (30) days
following receipt of this permit, identifying the specific issues to be con-
tended. Unless such demand is made, this permit shall be final and binding.
Please be aware that any future transfer of ownership and maintenance
responsibility of these facilities must be approved by this Division by requesting
permit reissuance, since this permit is non -transferable.
One (1) set of approved plans and specifications is being forwarded to
you. If you have any questions or need additional information concerning this
matter, please contact Mr. Robert P. Teulings, telephone No. 919/733-5083,
ext. 101.
Sincerely yours,
Original Siumed By
Bolo Dk;,,;;,E!SJe
obert R. Helms
cc: Union County Health Department
Mr. Herbert C. Klose, P.E. j
Mr. Forrest R. Westall
Mooresville Regional Supervisor
RPT/cgc
P. 0. Box 27687 Raleigh, N. C. 27611-7687
An Equal Opportunity Affirmative Action Employer

PPPPPPP' -
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION /1D
DEPARTMENT OF NATURAL RESOURCES AND COMMUNITY DEVELOPMENT
i7
RALEIGH
P E R M I T
For the Discharge of Sewage, Industrial Wastes, or Other Wastes
In accordance with the provisions of Article 21 of Chapter 143, General
Statutes of North Carolina as amended, and other applicable Laws, Rules, and
Regulations
PERMISSION IS HEREBY GRANTED TO
Kimberly C. Kocik, Owner
Union County
FOR THE
construction and operation of a 450-GPD non -discharge land application/spray irrigation
type wastewater treatment and disposal facility consisting of a 1,200-gallon capacity
baffled septic tank, 1,200-gallon capacity pump tank with 52-GPM submersible recircula-
tion pump, flow splitter, 150 S. F. recirculating surface sand filter, tablet -type
chlorinator, 2,000-gallon capacity chlorine contact/storage tank, 20-GPM self -priming
effluent dosing pump, 0.16-acre spray irrigation field with three sprinklers, automatic
recirculation and dosing pump controls and high water alarms, and associated piping,
valves and appurtenances to serve the Kimberly C. Kocik Residence in Union County with
no discharge of wastewater to the surface waters of the State,
pursuant to the application received March 8, 1984, and in conformity with the project
plans, specifications, and other supporting data, subsequently filed and approved
by the Department of Natural Resources and Community Development and considered a
part of this permit.
This Permit shall be effective from the date of issuance until May 31, 1989, and
shall be subject to the following specified conditions and limitations:
1. This Permit shall become voidable unless the facilities are constructed in
accordance with the approved plans, specifications and other supporting data.
2. This Permit is effective only with respect to the nature and volume of wastes
described in the application and other supporting data.
3. The facilities shall be properly maintained and operated at all times.
4. The sewage and wastewater collected by this system shall be adequately treated
in the pretreatment facilities prior to being sprayed onto the receiving irrigation
field.

ppppppp- -
Permit No. 10269
Page Two
5. This Permit is not transferble.
6. This permit shall become voidable in the event of failure of the soil to adequately
absorb the wastes, and may be rescinded unless the facilities are installed,
maintained and operated in a manner which will protect the assigned water quality
standards of the surface waters and groundwaters.
7. In event the facilities fail to perform satisfactorily including the creation
of nuisance conditions, the Permittee shall take such immediate corrective action
as may be required by this Division, including the construction of additional
or replacement wastewater treatment or disposal facilities.
8. Diversion or bypassing of the untreated wastewater from the treatment and disposal
facilities is prohibited.
9. Upon the availability of a municipal or regional sewerage collection system,
the subject wastewater treatment facilities shall be abandoned, and all wastewater
discharged into the municipal or regional sewerage system.
10. The Division's Mooresville Regional Office, Phone No. 704/663-1699 shall be
notified at least twenty-four (24) hours in advance of backfilling of the installed
surface filter system so that an in -place inspection can be made of said system
prior to backf illing. Such notification to the Regional Supervisor shall be
made during normal office hours from 8:00 A.M. until 5:00 P.M. on Monday through
Friday, excluding State Holidays.
11. Any monitoring deemed necessary by the Division of Environmental Management
to insure surface and ground water protection will be established and an acceptable
sampling reporting schedule shall be followed.
12. The sludge generated from these treatment facilities must be disposed of in
accordance with G.S. 143-215.1 and in a manner approvable by the North Carolina
Division of Environmental Management.
13. A suitable year round vegetative cover shall be maintained on the spray field.
14. Irrigation shall not be performed during inclement weather or when the ground
is in a condition that will cause runoff.
15. The Permittee, at least six (6) months prior to the expiration of this Perit,
shall request its extension. Upon receipt of the request, the Commission will
review the adequacy of the facilities described therein, and if indicated, will
extend the Permit for such period of time and under such conditions and limita-
tions as it may deem appropriate.
16. The application rates shall not exceed 0.75 inch/acre/week.
17. The issuance of this permit shall not relieve Ms. Kimberly C. Kocik, Owner,
of the responsibility for damages to surface or ground waters resulting from
the operations of this facility.

PPPPPP'_
Permit No. 10269
Page Three
18. The facilities shall be effectively maintained and operated as a non -discharge
system to prevent the discharge of any wastewater into the surface waters of
the State.
19. No type of wastewater other than that from the single-family residence served
shall be sprayed on the irrigation area.
20. No traffic or equipment shall be allowed on the disposal area except while instal-
lation occurs or while normal maintenance is being performed.
21. No root or leaf crops for public consumption shall be raised on the spray field.
22. Adequate inspection, maintenance, and cleaning shall be provided by the Permittee
to insure proper operation of the subject facilities.
23— The following minimum buffer distances shall be maintained between the wetted
perimeter of the spray field and the indicated facilities:
a. 200 feet from the on -site residence
b. 100 feet from property lines.
C. 400 feet from any existing off -site residence or place or public assembly
d. 100 feet from any potable water supply well
24. Dikes shall be constructed as necessary to prevent surface water run-off from
the spray field.
Permit issued this the 17th day of May, 1984.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Original Signed By
Bob DeV eese
Robert F. Helms, Director
Division of Environmental Management
iI By Authority of the Environmental Management Commission
U,
Permit No. 10269

Dear
North Carolina Department of Natural
Resources &Community Development
James B. Hunt, Jr., Governor Joseph W. Grimsley, Secretary
DIVISION OF ENVIRONMENTAL MANAGEMENT
PROJECT:
We acknowledge receipt of the following documents:
permit application - APN
engineering plans
specifications
other
19
..Your project has been assigned to for a detailed
engineering review. All project documents will be reviewed with respect to the
proposed wastewater facilities. This review will not commit this Division to
approving any expansion of these treatment facilities or increase of flowrate in
the future.
Prior to the issuance of the permit, you will be advised of the recommendations
and comments of this Division. You will also be informed of any matter which needs
to be resolved.
Our reviews are scheduled based on receipt date of complete informations. The
items checked below are needed before your project can be reviewed.
permit application (copies enclosed)
engineering plans (signed and sealed by N.C.P.E.)
specifications (signed and sealed by N.C.P.E.)
other additional information detailed on attachment
The above checked information is needed by If not received,
your application package will be returned as incomplete. Please be aware that the
Division's Regional Office must provide RECOMMENDATIONS from
the Regional Supervisor or a Procedure Four Evaluation for this project, prior to final
action by the Division.
If you have any questions, please call the review engineer at this telephone number
919/733-5083.
Sincerely,
H. Dale Crisp, P.E., Supervisor
State Engineering Review Group
cc: Permits and Engineering Unit
P. 0. Box 27687 Raleigh, N. C. 27611-7687
HDC/meb An Equal Opportunity Affirmative Action Employer

POMr. J. Kent Messick, Vice -President
Attachment
March 16, 1984
1. Please submit a letter signed by Mr. Kocik stating that you are his authorized
agent in submitting the subject non -discharge permit application.
2. Review of the plans, specifications and other information received has been
initiated. You will be notified by this office if any additional information
is needed.
ipw
t. it
r
10:

North Carolina Department of Natural Resources and Community Development
Environmental Management Commission
�o
D E M USE ONLY
Permit Number.
NUN-1)1Jl.tlAtil,t, rt.nmr t Arr1.ti.n 1 ivl1 ,,
County:
* in accordance with N.C. General Statutes Chapter 143, Article 21 87 31 �'r�'.p'.
Union
1 Applicant (name of board, individual, or others):
5z'
Application Date:
Mailez 5, 1934
Kimberly C. Kocik
Project (name of city, village, town, sanitary district, establishment): MAR I?.— 1984
Kimberly C. Kocik residential .spray irrigation, Monroe, Union Co., N.C.
FOR:
Bpt(RW &f_NQWfEfV ftGon
0 Non -Discharge Treatment/DisposalFacilities
'Lot of 11.5 acres with individual water supply.
❑ Pretreatment Facilities
One mobile home with septic tank for solids
❑ Sewer Collection System (private)
removal flowing to irrigation cank with
❑ Extend Sewer and Sewer Systems (public)
chlorination. Irrigation onto 30' X 85' spray fie
NATURE OF WASTEWATER:
❑ Sewagie
❑ Sludge/Industrial Waste
Other Waste
From (sewers, pretreatment facilities, treatment plants): Serving (city, institution, industry):
I Individual home
Pretreatment. facility
Into (name of treatment plant): Tributary To (name of water course):
t
Septic tank/spray field
At (location of treatment plant): i
Individual lot
Name and Complete Address of Engineering Firm:
i
040 Associates, Inc. 402 Willowbrook Drive, Cary, NC 27511
Treatment Works Capacity to Serve (name of project): For (no. yrs.) Average Daily Gallons Sewage or Waste Flow:
One lot Kimberly C. Kocik 20 mrs 1 100 04
Affect Overall Reduction in Pollution (not applicable for sewer projects):
Estimated Costs:
Toxic Materials (specify % each, add pages ii needed)
B. 0. D. (5-day 2T C) N / A %
NIA %
Sewers 8 200
Pumping
Suspended Solids N / A %
N l'A %
Station $ ti00
Treatment
TOTAL SOLIDS N/A %
NSA %
Plant �16i)0
%
Other (specify)
f
• r,.
Ja s i n l Oo
,ftiVr
Estimated Completion Date:
Coliform Bacteria N/A %
M/A TOTAL TOXIC MATERIALS %
ril L984
Applicant assures that proposed works will be constructed, supervised, operated and maintained in accordance with approved plans and
specifications or approved changes thereto.
Print Name: T i�eY'L rr( fpjt `LK Title: v� �t - I.1,e_5 evl"lrMailingAddress:1��� �i�/�t /10;,J YOC/✓ %✓t
T�
.l r' Q .r " A/
J
Signature: K t-4,_ rn per„
INSTRUCTIONS:
1. Fill-in ALL spaces. If noloapplicable, enter N/A.
2. Secure appropriate signature (mayor/city manager for municipality; chairman for sanitary district board; owner/proper official of corporal
or legally co,pitituted board or commission in charge of proposed works). A letter of authorization is required from proper official i
design engi6eer or o r agent signs application.
3. Submit to N.C. Depa ent of Natural Resources and Community Development, Environmental Management, Raleigh, NC, th
original and first copy lication, 2 sets of finalized plans, specifications and other supporting data as required by Commission Rules.
NOTE: fo?plication reviewi cheduled on receipt of COMPLETE information. Generally, 30 days are required for pollution abatement projects; 90 days
other p oje
For Assistance, call the State Central Office 919/733-5083, P.O. Box 27687, Raleigh, N.C. t
'Asheville [phone] 'Mooresville [phone] 'Washington [phone] *Winston-Salem [phone]
159 Woodfin Street 919 N4th Main Street 1502 North Market Street 8003 Silas Creek Parkway'Extensio
Asheville, NC 28801 Mooresville, NC 28115 Washington, NC 27889 Winston-Salem, NC 27106
It 'Fayetteville [phone]
Suite 714 Wachovia Building
Fayetteville, NC 28301
'Raleigh [phone] 'Wilmington [phone]
Box 27687 7225 Wrightsville Avenue
Raleigh, NC 27611 Wilmington, NC 284QJ�, r •

. O it
'Fib

DIVISION OF ENVIRONMENTAL MANAGEMENT
M E M O R A N D U M
TO:
FROM:
THRU:
GROUNDWATER SECTION
March 23, 1984
Dale Cris
L.L. Laymoni'.�-
Arthur Mouberry, Head
Operations Branch.___— ___
N. C. DEPT. OF NATURAL
RESOURCES AND
COMMUNITY DEVELOPMENT
MAR 27 1984
DIVISION OF ENVIROKKKTAL MANAGEMENT
MOORESVILLE REGAMUAL OFFICE
SUBJECT •Kimberly C. Kocik, Single-Family(Resxdence
Land Application System
Union County
The Groundwater Section has no objections to issuance of a
Permit for the subject facility.
LLL/ce
cc: ce
Permit Issuance Files

Sy
C:MQ Associates, Inc.
a
402 WILLOWBROOK DRIVE -:- CARY, N.C. 27511 -:- TELEPHONE [phone]
March 2, 1984
Mr. Rex Gleason
Mooresville, Regional Office, DNRCD
119 N. Main Street
Mooresville, NC 28115
Dear Mr. Gleason:
Enclosed are blueprints, permit applications, and supporting
information prepared as a permit request for Ms. Kimberly Kocik.
Ms. Kocik proposes a single mobile home on 11.6 acres. She
wishes to use a two —compartment septic tank for solids removal and
a separate pump tank for spray irrigation. We appreciate your
consideration of this proposal.
If we can help by submitting more information, please call
US.
Sincerely.
K
J. Kent Messick, C.P.Ag.
Dennis J. Osboine, CCP.S.S.
JKM/jmf
Enclosures

North Carolina Department of '.Natural Resources and Community Development
Environmental Management Commission
D E M USE ONLY
Permit Number:
:vviv-utoi,nA1AUr� . C,[IMu, .-., , _r...-, t I� I, X7
()
County
* in accordance with N.C. General Statutes Chapter 143, Article 21
Union
Applicant (name of board, individual, or others):
Application Date:
Kimberly C. Kocik
March 5, 1984
Project (name of city, village, town, sanitary district, establishment):
Kimberly C. Kocik residential spray irrigation, Monroe, Union Co., N.C.
FOR:
Brief Project Description
Non -Discharge Treatment/Disposal Facilities
Lot of 11.6 acres with individual water supply.
❑ Pretreatment Facilities
One mobile home with septic tank for solids
❑ Sewer Collection System (private)
removal flowing to irrigation tank with
❑ Extend Sewer and Sewer Systems (public)
chlorination. Irrigation onto 80' x 85' spray fie-
, ATURE OF WASTEWATER:
❑ Sewage
❑ Sludge/Industrial Waste
Other Waste
From (sewers, pretreatment facilities, treatment plants): Serving (city, institution, industry):
Pretreatment facility I Individual home
Into (name of treatment plant): To (name of water course):
(Tributary
Septic tank/spray field _
At (location of treatment plant):
Individual lot
Name and Complete Address of Engineering Firm:
CMO Associates, Inc. 402 Willowbrook Drive Cary, NC 27511
Treatment Works Capacity to Serve (name of project): For (no. yrs.) Average Daily Gallons Sewage or Waste Flow:
f
One lot Kimberly C. Kocik 20 Yrs 1 10
Affect Overall Reduction in Pollution (not applicable for sewer projects):
Estimated Costs:
Toxic Materials (specify o ench, add pages if needed)
B. 0. D. (5-day 2Cf C) N/A %
N/A %
Sewers S, 200
Pumping
Suspended Solids N/A %
N %
Station S 600
Treatment
TOTAL SOLIDS N/A %
N/A %
Plant �1600
}{ X.•
Yr•'r,'•fr'f;}.{ :• f� :�:; f�;:;•fj f• •
0 the r (specify)
f ;.; f• :..•:; ;.;�, f. ;r,:`.;.:f.:•: ••••x .
Design 100
Estimated Completion Date:
Coliform Bacteria N/A %
N/A TOTAL TOXIC MATERIALS
April 1984
Applicant assures that proposed works will be constructed, supervised, operated and maintained in accordance with approved plans and
specifications or approved changes thereto.
{.
Print Name: �4e�'� r'I..LS51-C--•\ Title: �� 1`�— �e,,L.tMailingAddress: /JOB/ WolPLa b, %�.
C.C�,ry / of Z7511
/� P.O+pt.ef �
Signature: K� m
t
d
INSTRUCTIONS:
1. Fill-in ALL spaces. If not applicable, enter N/A.
2. Secure appropriate signature (mayor/city manager for municipality; chairman for sanitary district board; owner/proper official of corporatior
or legally constituted board or commission in charge of proposed works). A letter of authorization is required from proper official if
design engineer or other agent signs application.
3. Submit to N.C. Department of Natural Resources and Community Development, Environmental Management, Raleigh, NC, the
original and first copy of application, 2 sets of finalized plans, specifications and other supporting data as required by Commission Rules.
NOTE: Application reviews are scheduled on receipt of COMPLETE information. Generally, 30 days are required for pollution abatement projects; 90 days
for other projects
For Assistance, call the State Central Office 919/733-5083, P.O. Box 27687, Raleigh, N.C. or
`Asheville [phone] *Mooresville [phone] *Washington [phone] *Winston-Salem [phone]
159 Woodfin Street 919 North Main Street 1502 North Market Street 8003 Silas Creek Parkway Extension
Asheville, NC 28801 Mooresville, NC 28115 Washington, NC 27889 Winston-Salem, NC 27106
*Fayetteville [phone] *Raleigh [phone] *Wilmington [phone]
Suite 714 Wachovio Building Box 27687 7225 Wrightsville Avenue
Fayetteville, NC 28301 Raleigh, NC 27611 Wilmington, NC 28403

Report of Site Investigation
Property of Kimberly A. Kocik
Union County, NC
Background
Mr. Dick Dietrich, R.S. of Monroe, N.C. requested a soil and site survey
of approximately 12—acre tract in Union County, N.C. Mr. Dietrich contacted
CMO Associates, Inc. of Raleigh, N.C. knowing that company specialized in
design and construction of alternative waste disposal systems. The tract
of interest would not pass NCDHS regulations for on —site subsurface waste
disposal systems, Mr. Dietrich recognized that while the site was not suited
for subsurface disposal, it might be well —suited for a non —discharge appli—
cation site. CMO Associates, Inc. requested Mr. Dennis J. Osborne, Certified
Professional Soil Scientist, to make a soil and site survey of the tract with
view to recommendation of loading rate and suitability of the site for use
as a receiver of chlorinated spray irrigated, effluent from a single family
house.
Methods
Mr. Dick Dietrich, R.S., Mr. J. Kent Messick, Certified Professional
Agronomist, and Mr. Dennis Osborne visited the property on the morning of
19 December 1983. The property is an 11.6 acre tract, more or less, north of
and at the intersection of Flint Ridge Church Road (SR 1991) and Landsford
Road (SR 1005) just south of Monroe, Union County, N.C. (See attached map
and deed extract).
The soil survey was performed in the standard USDA—SCS fashion with hand
auger to rock.or saprolite. The survey was performed in more detail than
in the standard published soil survey because of the specialized nature of
the proposed use. Depth to seasonal high water table was estimated from soil
morphology and soil texture classed by the hand field method. Infiltration
capacity, permeability, CEC, and available water capacity were estimated from
soil physical properties and morphology, correlated with published data from
similar pedons.
The survey was also performed with a view to location of a sprayfield
with respect to buffers, drainageways, areas of steep slope (>8%), and direction
to nearest dwelling.
Findings
This tract comprises a swale between and includes the sideslopes of two
ridges in the Slate Belt. The site is quite topographically characteristic
of the region, with slopes ranging from 2 to 6%. Soils are representative
of the region, being thin on ridgetops and deepening in the swale. Cobbles
and platy fragments of slate rock litter the soil surface, which is covered
with a healthy and well —established stand of tall fescue grass. The site is
fenced on three sides and cleared as pasture land except for about a 3—acre
portion on the west -boundary.

Soil series on -site are Badin, Herndon, Tatum, Nason, and Goldston.
From these series the selection of optimal micro -site for the proposed
small sprayfield had to be made. The soils listed differ primarily in depth
to rock, ranging from 10 inches to more than 3 feet. For the proposed use,
one would wish to choose an area at least 300 feet from a drainageway,
house, boundary, etc. Fortunately for the owner, a soil body of Herndon and
Badin soils is located on a high rise to the east -center of the property.
These soils well -drained, i.e., have a water table below three feet, and
ranged from 32 to 38 inches to rock. Surface texture was very fine sandy
loam to very find sandy clay loam. Surface thickness ranged from 4 to 6
inches. B-horizons were clay, and exhibited well -developed moderate medium
subangular blocky structure. Depth to rock may well have been deeper than
32 to 38 inches, but rock fragments at that depth prevented further excavation
by hand auger.
Infiltration capacity of the soils is moderate; permeability will range
from 0.6 to 2.0 in/hr; available water capacity ranges from 0.14 to 0.20 in/in.
CEC is between 5 and 10 meg/100 g. What this means is that in the small area
selected, the soil is one of the more stable types in the Piedmont. The partic-
ular unit is quite well suited to use as a receiver of secondarily -treated
chlorinated effluent from a septic tank because it has sufficient depth of
topsoil to readily store applied effluent, and sufficient thickness of structured
subsoil to pass and treat the effluent.
Calculation of Loading Rate
The small volume of effluent from the single-family home does not lend
itself to calculation of a standard water balance. However, the design of
other successful systems shows us a way to proceed:
Assume: 450 gal/day flow
2
Assume: area 85' x 85' for sprayfield = 7225 ft
Loading rate = gal/day/ft2 = 450/7225 = .0623 gal/day/ft2
How does this compare to in/wk, or to another imaginable number?
Assume: 1 gal = 128 fl. oz.
128 x .0623 gal/day/ft2 = 7.97 oz/day/ft2
This amount, 8 oz/day/ft2, is equivalent to disposing of about 2/3 of a canned
drink per day per ft2 of land. But how does this look when converted to inches
Of H20/ft2/day?
Assume: 27,000 gal/acin
Assume: 450 gal/day flow
Thus: 450/27,000 = .0167 in/AC day
convert to a 7225 ft2 basis: 7225/43,560 = 0.1659 AC
Rounding off, application at this rate is .02 in/.2 AC/day, or 0.14 in/.2 AC/wk.
Experience has shown this to be much like a dew.

Proposal
It is proposed to develop an 85' x 85' area as the sprayfield for
receiving effluent treated in two two -compartment septic tanks and chlorinated
in the chamber of the second. Contact time will be timer -controlled for at
least 12 hours.
Short riser height sprinklers will be used inside a fenced -off area
maintained in mowed fescue grass. Sprinklers will operate at night to avoid
nuisance attraction. A 200-foot buffer will be established, and the nearest
structure is 400 feet away. Maintenance will be agreed upon between
Mr. Dietrich and DNRCD-DEM.

3/l/84
CMO Associates, Inc.
Cary, N.C. 27511
Kimberly Kocik Residence, Union County, N.C.
Residential Effluent Spray System
by H. C. Klose, P.E.
SPECIFICATIONS:
Sprinklers:
1-#L30H-7/32" Rain Bird Sprinkler, 8.26 GPM @ 81' Dia. @ 35 psi
2-#25FP-5/32" Rain Bird Sprinkler, 4.1 GPM @ 39' Rad. @ 35 psi
Area covered - 80' x 85' = 6800 sq. ft.
Average application rate = .231'/hr
Pump Required: 16.5 GPM @ 112' TDH
STA-RITE Model DS2HF-Self Priming Centrifugal Pump
12 HP, single phase, 2" suction x 12" discharge, rated 20 GPM @ 112' TDH.or equal
Suction line 2" with 2" foot valve and strainer, 1/8" mesh, max., Berkeley
Model #815D-S-21029 or equal
Install 12" non -slam check valve followed by 12" bronze gate valve in pump
discharge line or equal
Float controls in pump tank to be set at 20" min (STOP) and 36" max (START)
Use Water Guard CK1W or equal
High Water Alarm Float to be set at 47" off bottom of pump tank
Alarm Bell and Light to be mounted on top of pump tank
Use Water Guard TAC1-AL1-T in outdoor enclosure or equal
Motor Starter, Safety Switch, and Controls shall be mounted in weather protected
enclosure, adjacent to pump
Fence: The wetted area around the sprayfield shall be enclosed by a 3 strand
barbed wire fence. It is suggested that 12" x 18" signs be placed, one on
each side of fence, 4 in all, to read "SPRAY FIELD ... KEEP OUT"
Head Loss Calcularinns:
Sprinkler
Friction -Pipe & Fittings
Pump House
Elevation 8'
Total
35.0 psi
5.0 "
5.0 "
3.5
48.5 psi = 112' TDH
CARD ''�
SStpt9�;9
�. SE Al
�F'••FryG� NEE4;.p•
S ,
T

four
r
ways.
d
;F 1000 1001
Complete, one-piece system for highly
the user to tell, instantaneously. the
reliable disinfection of treated effluent
erfluent fiov. rate 6otn modes are made
from any sewage plant having a designed
of tough, corrosion resistant molded fiber -
capacity of up to 50.000 GPD., with a
glass and polvvin,vl chloride Comoac: and
maximum flow rate of 80 GPM. Two
easy to handle. Modei- 1000'1001
chlorinators in parallel will handle plants
measure 21 inches long 121 z inches wide
with capacities as high as 100.000 GPD
and 13 1 41ncnes deec. The four feed tubes
Chlorinators are furnished with a selection
are 24 incnes long with an outside diameter
of calibrated weir plates, with weirs
of 31,,2 inches. Eacn tube hoids 29 Sanuril
ranging in size from 1 to 3 inches in width
115 tablets The Model 1000 has a 6 incn
for insertion at the outlet end to control
diameter inlet pipe SiZe the Model 1001
the internal water level. depending upon
has a blank inlet end for easy field adap-
plant capacity and the residual chlorine
tat,on to the outlets of existing pants.
required. The calibrated weir plate enables
100
Complete, one-piece system for small
controls the water level ir. the chiorinator.
treatment plants with a capacity of 10,000
Made of molded fibe,p!ass and polyvinyl

_1/Z
J 7
The SANURIL wastewater chlorinator is a
complete, one piece system designed for
Positive disinfection of treated effluent from
any sewage treatment plant with a daily
capacity of up to 50,000 gallons. SANURIL
chlorinators in parallel will handle capacities
as high as 100,000 gallons per day. They
operate automatically without personal
attention for as long as sixty days, depending
upon plant size and the required chlorine
residual. There are no complex piping
arrangements such as bypasses, feed lines or
mixing tanks. Electrical power is not required,
since there are no pumps or electrical control
devices. In fact, there are no moving parts.
Operation is simple, automatic and continuous.
Typical installations includes:
• housing developments •trailer parks
• highway rest stops • motels
• industrial plants • c3mo crounds
• offshore drdlina • oar,.s
The SANURIL system consists of a compact,
adjustable, flow regulated chlorinator which
dispenses a pre -determined quantity of
SANURIL 115 ... a new and improved
disinfecting agent used to provide a chemically
stable source of chlorine for disinfecting the
wastewater. The entire flow of treated
wastewater passes into the chlorinator through
a pipe or trough. As the stream of water flows
past the feed tubes containing the SANURIL
115 tablets, active chlorine is released into
the wastewater by the dissolving action of
the water stream in contact with the tablets.
As the incoming water flow rate increases, the
water level in the chlorinator rises, immersing
a greater number of SANURIL 115 tablets.
A drop in water level exposes fewer tablets
I
o the water. Since the amount of SANURIL
1 15 dissolved depends upon the number of
tablets in contact with the water stream. the
ni-:3. chiOrlre concentration rerra!,.s C : s?ant
:-acjr.�:ess of -,he �,vater 'e,;ei ,n tre

D'SCONNECT Q Q
CIR: uiT 6-E^1 1 V II
220/ 110 V
POWER SUPPLY
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T I JT2 J, TI r2
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D I{ F E 7fAL, 1- I; 4i IT IALF104T0A•
110 VOLT PUMPS 220 VOLT PUMPS
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1 I t.i
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SELF PRIminG CEnTRIFUGAL PUMPS

. oESIGN
SERIES
SELF PRiminG
CEf1TRIfUGRL
PUMPS
The Sta-Rite "DS2" Series self priming centrifugal
pump is one of the fastest priming pumps on
the market. Available in 1 thru 2% H.P. models in
high head and medium head series. "DS2" Series
pumps are especially suited for lawn sprinkling
applications ... can operate from one to 30 or
more sprinkler heads.
SPECIAL IMPELLER ... Both the high head and
medium head models feature Lexan° impellers to
provide low friction water passages.
MECHANICAL SEAL ... virtually leak proof ... never
requires adjustment... is especially corrosion resistant.
EASY SERVICE DESIGN ... when necessary, normal
wearing parts are easily accessible for service and
replacement, without disturbing piping or mounting.
HEAVY DUTY MOTORS ... designed for continuous
operation. Capacitor start, will not interfere electrically
with T.V. or other appliances. Nationally known 3450
R.P.M. motors have ball bearings and stainless steel
shaft.
NEW STURDY CONSTRUCTION ... improved cast
iron tank body with lightweight steel base weighs less.
Medium head pumps use light weight Lexan° diffusers
AIR VOLUME CONTROL TAPPING ... enables use of
pump with air volume control and pressure tank for
water system applications. -
® Registered Trademark General Electric Co.
ORDERING INFORMATION
APPLICATIONS
LAWN SPRINKLING... "DS2" Series fast priming
pumps are especially designed for lawn sprinkling
applications. Self -priming design permits use on auto-
matic lawn sprinkling installations ... can be safely
operated by timer or other automatic device in absence
of owner.
CONTRACTORS ... for dewatering, excavation, getting
water supply to concrete mixers ... tank wagons, etc.
AGRICULTURE ... for fire protection ... stock water-
ing ... seed bed plot irrigation ... dewatering.
INDUSTRIAL ... for sump drainage ... fire protection
... marine pumping ... many liquid transfer and
supply applications.
HIGH HEAD
MEDIUM HEAD
Approx.
Approx.
Cat.
Motor
Ship.
Cat.
Motor
Ship.
No.
H.P.
Voltage
Phase
Suct.
Disch.
Wt.
No.
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Phase
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wt.
DS2HE
1
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1
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1 2
73
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1
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1
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73
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1
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3
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73
DS2ME3
1
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73
DS2HF
1Y2
115/230
1
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79
DS2MF
1%2
115/230
1
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1%"
79
DS2HF3
1 %2
230/460
3
2"
1 %2
79
DS2M F3
1 %
230/460
3
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1 %"
79
DS2HG
2
230
1
2"
2"
91
DS2MG
2
230
1
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91
DS2HG3
2
230/460
3
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2"
91
DS2MG3
2
230/460
3
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91
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2%
230
1
2"
2"
93
DS2MMG
2%
230
1
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1 Y22"
93
DS2HHG3
2%2
230/460
3
2"
2"
93
DS2MMG3
2%
230/460
3
2"
1 %2"
93

GERIES
SELF PRIfT11f1G
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PUMPS
OUTLINE
DIMENSIONS
C N.PT. DISCHARGE
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11/i
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1%
DS21HG
2
18%
2
2
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2
2
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2
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2
2
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1
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1 Y2
DS2ME3
1
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1%
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DS2MF
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17'e/te
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1'/4
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1
WATER EQUIPMENT DIVISION
• Delavan, Wis. • Los Angeles, Calif.
• Orlando, Fla. • Kaufman, Tex.
• Chamblee, Ga. • Ledgewood, N.J.
STA=RITE
INDUSTRIES, INC.
8 DIA.(4)HOLES/
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SOLD AND SERVICED BY:
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Water Resources
ENVIRONMENTAL QUALITY
RAT #AVSRORY
IvIll"M Gnvernoi
y;
DONALD R. VAN DER VAART
Secreloq
S. JAY ZIMMERMAN
May 31, 2016
Ms. Kimberly Kocik
5311 Flint Ridge Church Road
Marshville, North Carolina 28103
Subject: Non -Discharge Permit Inspection Report
Wastewater Surface Irrigation System
Permit #WQ0003158
Union County
Dear Ms. Kocik:
Uirecim•
Enclosed you will find the report for the compliance inspection that was conducted on
May 25th, 2016 for the referenced facility's treatment and disposal system. I would like
to thank you and Allen Tholen for your time during the inspection.
The treatment and irrigation systems appeared to be operating in accordance with permit
conditions and record keeping was in excellent order, at the time of inspection. Per our
conversation, enclosed is an Ownership/Name Change form to add Mr. Tholen after you
add him to the deed. This form may also be found at the web address below:
https://deg. nc. gov/about/d ivisions/water-resources/water-resources-perm its/wastewater-
branch/non-discharge-permitting-unit/appIication
The report should be self-explanatory; however, should you have any questions, feel
free to call me at 704-235-2184 or contact me via email at maria.schutte(c_ncdenr.gov.
Sincerely,
1
Maria Schulte, Environmental Specialist
Mooresville Regional Office
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ
Enclosure(s): Inspection Report May 2016
Ownership/Name Change Form
CC: Kipp Glazier, LAU Permitting Staff, CO -Raleigh (email)
State of North Carolina I Environmental Quality I Water Resources I Water Quality Regional Operations
Mooresville Regional Office) 610 East Center Avenue, Suite 3011 Mooresville, North Carolina 28115
704 663 1699

State of North Carolina Department of Environmental Quality
Division of Water Resources
Pat McCrory, Governor
Donald R. van der Vaart, Secretary
NON -DISCHARGE COMPLIANCE INSPECTION
Single Family Spray/Drip Irrigation
GENERAL INFORMATION
Owner: Ms. Kimberly Kocik County: Union
Permit #: W00003158 Project Name: 5111 Flint Ridge Church Rd. SFR
Issuance Date: 01/30/2009 Expiration Date: 12/31/2017
Permittee Contact: Kimberly Kocik Phone: [phone] Email: allent68gwindstream.net
Reason for Inspection
X ROUTINE COMPLAINT FOLLOW-UP Facility Start-up
Inspection Date(s): May 25, 2016
Inspection Summary: (additional comments may be included on attached pages)
The wastewater treatment and irrigation systems appear to be operating satisfactorily. The application field
is in excellent condition. Records are well kept and appeared to be complete.
• The MRO should be informed of any changes to the contact information noted above.
Is a follow-up inspection necessary _yes X no
Inspector Name/Title: Maria Schutte, Environmental Specialist
Telephone No.: 704-235-2184 Fax No. 704-663-6040
Date of Inspection: 5/25/2016

FPerSingle Family Spray Irrigation Inspection
mit #WQ0003158 Kocik Residence
Treatment
Y Are treatment facilities consistent with those outlined in the permit?
Y Do all treatment units appear to be operational? If no, note below.
Y Septic tank pumped within last 12 months?
Y Sand filter in good condition?
Comments: The alarm system is.functional.
Disinfection
X Tablets Y Present in chlorinator? Y Proper Size?
UV System Spare bulb on hand?
Comments: Chlorine tablets were in place in the chlorinator.
Effluent Storage
In ground dosing tank X Other — Specify
Number of days of storage NE Y Alarm system tested?
Page 2
Comments: Alarm was tested at the box, the float was not pulled This system was not designed with a visual
alarm, only has an audible alarm.
Disposal (final end use)
N Is application equipment in need of repair?
Y Are buffers adequate?
Y Are cover crops the type specified in the permit? N In need of improvement?
N Signs of run-off? N Signs of ponding? N Signs of drift?
Y Is the acreage specified in the permit being utilized?
Y Is the application equipment present and operational?
N Are there any limiting slopes in the disposal fields?
NA Are restrictions for use of these areas specified? This is a SFR there are no side requirements, but
the permittee understands the field is for the effluent disposal and afence is in place.
Y Is the permit being followed?
Y Is site access restricted in accordance with the permit? If so, how? The site is restricted by a two_
wire strand, electrically charged fence.
Y Is the permit available upon request?
Y Are operational logs present?
Y Are operation and maintenance records present?
N Has the permittee received any public complaints in the last 12 months?
Comments: The application field and spray heads appeared to be well maintained and the a uent
distributed evenly.

kPIWA
NCDENRFILE
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Ms. Kimberly Kocik
5311 Flint Ridge Church Road
Marshville, North Carolina 28103
Dear Ms Kocik:
Coleen H. Sullins
Division of Water Quality
Dee Freeman
Secretary
December 23, 2011
RE: Inspection Report
Wastewater Surface Irrigation System
Permit No. W00003158
Union County, N.C.
Enclosed you will find the report for the inspection that I conducted on December 19, 2011. Both the
treatment system and the spray irrigation appear to be operating well and record keeping is excellent. Per
our conversation, I have verified that your permit expiration has indeed been extended. Recently passed
legislation (SL 2009-406 & SL 2010-177) has extended the expiration date of your permit to December 31,
2017. Your renewal application is due at least 6 months prior to that expiration date. The report should be
self-explanatory but, should you have any questions, please call me at 704-235-2184.
Sincerely,
Maria Schutte
Environmental Senior Technician
Enclosure: Inspection Report December 2011
Division of Water Quality / Aquifer Protection Section / Mooresville Regional Office
610 East Center Avenue, Suite 301, Mooresville, NC 28115
One
NorthCarolina
Phone: [phone] Fax: [phone] �atura!!lf
Internet: www.ncwaterquality.org

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Beverly Eaves Perdue, Governor
Dee Freeman, Secretary
Coleen H. Sullins, Director
NCDENR
NON -DISCHARGE COMPLIANCE INSPECTION
Single Family Surface Irrigation
GENERAL INFORMATION
City/Town/Owner: Kimberly Kocik County: Union
Project: Kocik Residence SFR Permit # WQ0003158
Issuance Date: 8/9/04 Expiration Date: 12/31/17
Permittee Contact: Kimberly Kocik Telephone No.: 1-704/221-8719 (cell)
ORC Name: NA Telephone No.
Email address: [e-mail]
Reason for Inspection
X ROUTINE COMPLAINT FOLLOW-UP OTHER
Date of Inspection 12/19/11
Inspection Summary: (additional comments may be included on attached pages)
Ms. Kocik is very knowledgeable of the system and conscientious about the operation and
maintenance. The sand filter and spray field are in excellent condition. The records were
complete and in good order. Her logbook is outstanding!
Is a follow-up inspection necessary yes X no
Inspector Name/Title — Maria Schutte, Environmental Senior Technician
Tel. No. 704-235-2184 Fax No. 704-663-6040
Date of Inspection: 12/19/11

Single Family Spray/Drip Irrigation page 2
WQ0003158
Treatment
Y Are treatment facilities consistent with those outlined in the permit?
Y Do all treatment units appear to be operational? If no, note below.
NE Septic tank pumped within last 12 months?
Y Sand filter in good condition?
Comments:
Disinfection
Y Tablets Y Present in chlorinator? Y Proper Size?
UV System Spare bulb on hand?
Effluent Storage
Y In ground dosing tank Other — Specify
Number of days of storage Spill control plan on site?
Y Alarm system tested?
Disposal (final end use)
N Is application equipment in need of repair?
Y Are buffers adequate?
N Is cover crop in need of improvement?
N Signs of run-off? N Signs of ponding? N Signs of drift?
Y Is the acreage specified in the permit being utilized?
Y Is the application equipment present and operational?
NA Are there any limiting slopes in the disposal fields?
NA Are restrictions for use of these areas specified?
Y Is the permit being followed?
Y Is site access restricted in accordance with the permit? If so, how? Double strand of
wire fence.
Y Is the permit available upon request?
Y Are operational logs present?
Y Are operation and maintenance records present?
N Has the permittee received any public complaints in the last 12 months?
Comments:

WAIF Michael F. Easley, Governor
\O�� 9QG N William G. Ross Jr., Secretary
C North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
> Division of Water Quality
AQUIFER PROTECTION SECTION
October 31, 2008
Ms. Kimberly Kocik
5311 Flint Ridge Church Road
Marshville, North Carolina 28103
RE: Inspection Report
Wastewater Surface Irrigation System
Permit No. WQ0003158
Union County, N.C.
Dear Ms Kock
Enclosed you will find a copy of the report for the inspection that I conducted on October 29, 2008. The
report should be self-explanatory but feel free to call me at 704/235-2183 if you should have any
questions.
Sincerely,
Peggy Finley
Environmental Specialist
Enclosure: Inspection Report
MAF/kocik inspect rpt 10-29-08
One
NorthCarolit
Division of Water Quality / Aquifer Protection Section / Mooresville Regional Office Phone: [phone] Fax: [phone] i1 �aturalll
610 East Center Avenue, Suite 301, Mooresville, NC 28115 Customer Service 1-877-623-6748 Internet: http://gw.ehnr.state.nc.us �/ V

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Secretary
Coleen H. Sullins. Director
NCDENR
NON -DISCHARGE COMPLIANCE INSPECTION
Single Family Surface Irrigation
GENERAL INFORMATION
City/Town/Owner: Kimberly Kocik
Project: Kocik Residence SFR
Issuance Date: 8/9/04
Permittee Contact: Kimberly Kocik
ORC Name: NA
Email address: [e-mail]
Reason for Inspection
X ROUTINE COMPLAINT
Date of Inspection 10/29/08
County: Union
Permit # WQ0003158
Expiration Date: 6/31/09
Telephone No.: 1-704/221-8719 (cell)
Telephone No.
FOLLOW-UP OTHER
Inspection Summary: (additional comments may be included on attached pages)
The treatment and disposal area are in excellent condition. The permittee is very
conscientious about operation and maintenance. The records were complete and in
good order.
Is a follow-up inspection necessary yes no _X
Inspector's Name/Title: Peggy Finley, Environmental Specialist
Telephone No. 704/235-2183 Fax No. 704/663-6040

Single Family Spray/Drip Irrigation
WQ0003158
Treatment
_Y_Are treatment facilities consistent with those outlined in the permit?
_Y_Do all treatment units appear to be operational? If no, note below.
_Y_Septic tank pumped within last 12 months?
_Y Sand filter in good condition?
Coments:
Disinfection
Tablets
UV System
Present in chlorinator?
Spare bulb on hand?
Residuals
Y_ Septic tank pumped out regularly?
Effluent Storage
_X_ Inground dosing tank
Number of days of storage
_Y Alarm system tested?
page 2
_Y_ Proper Size?
Other — Specify
Spill control plan on site?
Disposal (final end use)
_N Is application equipment in need of repair?
_Y Are buffers adequate?
_N Are cover crops the type specified in the permit?
_N_ In need of improvement?
_N Signs of run-off? _N Signs of ponding? _N_ Signs of drift?
_Y Is the acreage specified in the permit being utilized?
Y Is the application equipment present and operational?
NA_ Are there any limiting slopes in the disposal fields?
_NA_ Are restrictions for use of these areas specified?
_Y Is the permit being followed?
_Y Is site access restricted in accordance with the permit? If so, how? Double
strand fence
_Y Is the permit available upon request?
_Y Are operational logs present?
_Y_ Are operation and maintenance records present?
_N Has the permittee received any public complaints in the last 12 months?
Comments:

PV
AQUIFER PROTECTION REGIONAL STAFF REPORT
goo
py
Date: 10/31/08 County: Union
To: Aquifer Protection Central Office Permittee: Kimbery Kocik
Central Office Reviewer: John McCray Project Name: Kimberly Kocik SFR
Application No.: WQ0003158
L GENERAL INFORIFIATION
1. This application is for: X Renewal only
❑ Minor Modification ❑ Major Modification
X Surface Irrigation Reuse ❑ Recycle ❑ High Rate Infiltration ❑ Evaporation/Infiltration Lagoon
❑ Land Application of Residuals ❑ Attachment B included ❑ 503 regulated ❑ 503
exempt
❑ Distribution of Residuals ❑ Surface Disposal
❑ Closed -loop Groundwater Remediation ❑ Other Injection Wells (including in situ remediation)
Was a site visit conducted in order to prepare this report? X Yes or No.
a. Date of site visit: 10/29/08
b. Person contacted and contact information: Kimberly Kocik
c. Site visit conducted by: Peggy Finley
d. Inspection Report in BIMS: X Yes or No.
2. Is the following information entered into the BIMS record for this application correct?
X Yes or ❑ No. If no, please complete the following or indicate that it is correct on the current
application.
For Treatment Facilities:
a. Location:
b. Driving Directions:
c. USGS Quadrangle Map name and number:
d. Latitude: Longitude:
e. Regulated Activities / Type of Wastes (e.g., subdivision, food processing, municipal wastewater):
domestic wastewater
For Disposal and Injection Sites:
(,If multiple sites either indicate which sites the information applies to copy and paste a new section
into the document for each site or attach additional pages for each site
a. Location(s):
b. Driving Directions:
c. USGS Quadrangle Map name and number:
d. Latitude: Longitude:
FORM: Kocik Staff report 10-31-08 1

AQUIFER PROTECTION REGIONAL STAFF REPORT
II.RENEWALS AND MINOR MODIFICATION APPLICATIONS
Discription of Waste and Facilities
1. Are there appropriately certified ORCs for the facilities? NA
'IN
2. Is the design, maintenance and operation (e.g. adequate aeration, sludge wasting, sludge storage,
effluent storage, etc.) of the treatment facilities adequate for the type of waste and disposal
system? YES
3. Are the site conditions (soils, topography, depth to water table, etc) maintained appropriately and
adequately assimilating the waste? YES
4. Has the site changed in any way that may affect the permit? NO Does the application (maps,
plans, etc.) represent the actual site (property lines, well surface drainage)? YES
5. Is the residuals management plan for the facility adequate and/or acceptable to the Division? XYes
or ❑ No. If no, please explain:
6. Are the existing application rates (hydraulic or nutrient) still acceptable? YES or ❑ No.
7. Is the existing groundwater monitoring program (number of wells, frequency of monitoring,
monitoring parameters, etc.) adequate? NA
8. Will seasonal or other restrictions be required for added sites? NA
9. Are there any buffer conflicts (treatment facilities or disposal sites)? NO
10. Is the description of the facilities, type and/or volume of waste(s) as written in the existing permit
correct? YES
11. Were monitoring wells properly constructed and located? NA
12. Has a review of all self -monitoring data been conducted (GW, NDMR, NDAR as applicable)?
Please summarize any findings from this review: NO SUCH MONITORING IS REQUIRED
13. Check all that apply: X. No compliance issues
permit cycle ... Current enforcement action
... Notice(s) of violation within the last
... Currently under SOC, JOC, moratorium
14.If any items checked, please explain and attach any documents that may help clarify
answer/comments
15. Have all the compliance dates/conditions in the existing permit, (SOC, JOC) been complied with?
16. Are there any issues related to compliance/enforcement that should be resolved before issuing the
permit? NO
FORM: Kocik Staff report 10-31-08 2

PVAQUIFER PROTECTION REGIONAL STAFF REPORT
V. EVALUATIONAND RECOMMENDATIONS
1. Provide any additional narrative regarding your review of the application.- The treatment system
and disposal area are in excellent condition. The permittee is very conscientious about
maintenance and operation. The number of occupants of the two houses has not changed. This
office recommends renewal of the permit.
2. Attach Well Construction Data Sheet - if needed information is available
3. Do you foresee any problems with issuance/renewal of this permit? Yes X No. If yes, please
explain briefly.
4. List any items that you would like APS Central Office to obtain through an additional information
request. Make sure that you provide a reason for each item:
Item Reason
5. List specific Permit conditions that you recommend to be removed from the permit when issued.
Make sure that you provide a reason for each condition:
Condition Reason
6. List specific special conditions or compliance schedules that you recommend be included in the
permit when issued. Make sure that you provide a reason for each special condition:
Condition Reason
7. Recommendation: ❑ Hold, pending receipt and review of additional information by regional office;
❑ Hold, pending review of draft permit by regional office; Issue upon receipt of needed additional
information and engineering review; X Issue; ❑ Deny. If deny, please state reasons:
8. Signature of report preparer(s):
Signature of APS regional super
Date:
FORM: Kocik Staff report 10-31-08 3

AQUIFER PROTECTION SECTION
APPLICATION REVIEW REOUEST FORM
Date: October 3.2008
To: ❑ Landon Davidson, ARO-APS ❑ David May, WaRO-APS
❑ Art Barnhardt, FRO-APS ❑ Charlie Stehman, WiRO-APS
® Andrew Pitner, MRO-APS ❑ Sherri Knight, WSRO-APS
❑ Jay Zimmerman, RRO-APS
From: John McCrav, , Groundwater Protection Unit M
Telephone: [phone] Fax: [phone] V
E Mail. john.mccray@a,ncmail.net
OCT - 6 2008
A. Permit Number: W00003158
B. Owner: Kimberly Kocik NC UENR RO
DWQ - Aquifer Protection
C. Facility/Operation: Kimberly Kocik SFR
❑ Proposed ® Existing ® Facility ❑ Operation
D. Application:
1. Permit T tpe: ❑ Animal ® Surface Irrigation ❑ Reuse ❑ H-R Infiltration
❑ Recycle ❑ I/E Lagoon ❑ GW Remediation (ND)
❑ UIC - (5QW) closed loop water only geothermal
For Residuals: ❑ Land App. ❑ D&M ❑ Surface Disposal
❑ 503 ❑ 503 Exempt ❑ Animal
2. Project Type: ❑ New ❑ Major Mod. ❑ Minor Mod. ® Renewal ❑ Renewal w/ Mod.
E. Comments/Other Information: ❑ I would like to accompany you on a site visit.
Attached, you will find all information submitted in support of the above -referenced application for your
review, comment, and/or action. Within 30 calendar days, please take the following actions:
® Return a Completed Form APSARR.
❑ Attach Well Construction Data Sheet.
❑ Attach Attachment B for Certification by the LAPCU.
❑ Issue an Attachment B Certification from the RO*.
* Remember that you will be responsible for coordinating site visits, reviews, as well as additional
information requests with other RO-APS representatives in order to prepare a complete Attachment B for
certification. Refer to the RPP SOP for additional detail.
When you receive this request form, please write your name and dates in the spaces below, make a copy
of this sheet, and return it to the appropriate Central Office -Aquifer Protection Section contact person
listed above.
RO-APS Reviewer:
Date:
FORM: APSARR 02/06 Page 1 of 1

�OF W A 7, 9p Michael F. Easley, Governor
�o G William G. Ross Jr., Secretary
CO r North Carolina Department of Environment and Natural Resources
J �
Coleen H. Sullins Director
Division of Water Quality
October 2, 2008 D [E v
Kimberly Kocik
5311 Flint Ridge Church Road OCT - 6 2008
Marshville, NC 28103
NC DENR MRO
Subject: Acknowledgement of Application No. WQ0003158 DWQ - Aquifer Protection
Kimberly Kocik SFR
Surface Irrigation System - SFR
Union
Dear Ms. Kocik:
The Aquifer Protection Section of the Division of Water Quality (Division) acknowledges receipt of your permit
application and supporting materials on September 26, 2008. This application package has been assigned the number
listed above and will be reviewed by John McCray.
The reviewer will perform a detailed review and contact you with a request for additional information if necessary.
To ensure the maximum efficiency in processing permit applications, the Division requests your assistance in
providing a timely and complete response to any additional information requests.
Please be aware that the Division's Regional Office, copied below, must provide recommendations prior to final
action by the Division. Please also note at this time, processing permit applications can take as long as 60 - 90 days
after receipt of a complete application.
If you have any questions, please contact John McCray at 919-715-6168, or via e-mail at [e-mail].
If the reviewer is unavailable, you may leave a message, and they will respond promptly. Also note that the Division
has reorganized. To review our new organizational chart, go to
http://h2o.enr.state.ne.us/documents/dwg orgchart.pdf.
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAKING INQUIRIES ON THIS
PROJECT.
Sincerely,
C bik A.
for Debra J. Watts
Supervisor
cc:
Permit Application Fie WQ0003158
Aquifer Protection Section 1636 Mail Service Center
Internet: www.ncwaterguality.org Location: 2728 Capital Boulevard
An Equal Opportunity/Affirmative Action Employer- 50% Recycled/10% Post Consumer Paper
o`
Nt rhCarotina
Naturally
Raleigh, NC 27699-1636 Telephone: [phone]
Raleigh, NC 27604 Fax 1: [phone]
Fax 2: [phone]
Customer Service: [phone]

�t State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
o a
co
INSTRUCTIONS FOR FORM: WWR 09-06 C/)
(RENEWAL WITHOUT MODIFICATION OF WASTEWATER NON -DISCHARGE SYSTEMS) ':
For more information or for an electronic version of this farm, visit the Land Application Unit (LAU) weC4te at: o �
hil'i_h2o.enr.state. nc.us;7ay,main.himl --+c
-� rr: rTi
This form is for renewal without modification for all wastewater non -discharge systems. Wastewater non-h�chargg-,
systems include: High Rate Infiltration Systems; Infiltration/Evaporation Lagoons; Reclaimed Water Utgation r--',--
cY Y g g Y g � rn
Systems; Wastewater Recycle Systems; Single Family Surface Irrigation Systems; and Surface Irrigation terns.yff rfti =-'
P
This application may not be used for renewal of Land Application of Residuals Permits.
A. Application Form (All Application Packages):
✓ Submit one (1) original and two (2) copies of the completed and appropriately executed application form.
Any changes made to this form will result in the application package being returned.
✓ If the Applicant is a corporation or company, it must be registered for business with the NC Secretary of
State (http•//w-ww.secretary.state.nc.us/Corporations/CSearch.aspx).
✓ If the Applicant is a partnership, sole proprietorship, trade name, or d/b/a enclose a copy of the certificate
filed with the register of deeds in the county of business.
✓ The application must be signed appropriately in accordance with 15A NCAC 2T .0106(b). An alternate
person may be designated as the signing official, provided that a delegation letter is provided from a person
who meets the referenced criteria. You may download an example delegation letter from the LAU web site.
✓ Submit three (3) copies of the most recently issued existing permit.
B. Additional Forms (Single Family Residence Surface Irrigation Systems OnTZr%%Atr)_AnuiferPr0e
=SR
✓ Submit one (1) original and two (2) copies of a completed and properly exForm may be downloaded at: http:/:h2o.enr.state.nc.us/lau'applications.htmC. site Map Submit three (3) copies of an updated site map if required as part of thewith 15A NCAC 2T.0105(d). ENR M
wfer Protection
I. GENERAL INFORMATION:
1. Permittee'sname (Owner of the facility): Al c i
2. Complete mailing address of Permittee: aldoe- U Or.
City: Mar -A) U I I( e, State: %U Zip: 3
Telephone number: c2�Jp 1e,2!? -tr- 5e Facsimile number:
Email Address: C1 it T L, T Q LA_; rti � S i -e e vy, e t `
3. Facility name (name of the subdivision, shopping center, etc.):
4. Complete address of the physical location of the facility (if different from above):
City:
5. County where project is located:
State:
Zip:
6. Name and affiliation of contact person who can answer questions about project: K t m Vy Wy(7
Va ck I t7 Cy n e-/y Email Address: kvc,,yR 6-
FORM: WWR 09-06 Page 1

A * II. PERMIT INFORMATION:
1. Existing permit number boo `3 [ s D and the issuance date
2. Existing permit type:
❑ High -Rate Infiltration ❑ Evaporation Lagoons ❑ Reclaimed Water Utilization
C9 Single Family Surface Irrigation ❑ Surface Irrigation ❑ Wastewater Recycle
3. Has the treatment and disposal system been constructed? ® Yes ❑ No
4. If the system has not been constructed, would you like to rescind your permit (i.e. the permitted facilities
will not be needed)? ❑ Yes ❑ No
5. Has the wastewater system been connected to a municipal or community sewer system? ❑ Yes a No
Applicant's Certification [signing authority must be in compliance with 15A NCAC 2T .0106(b)):
n e-r .
(sigriing authority name and title)
attest that this application for
C
- (facility nam6)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that any discharge
of wastewater from this non -discharge system to surface waters or the land will result in an immediate enforcement
action that may include civil penalties, injunctive relief, and/or criminal prosecution. I will make no claim against
the Division of Water Quality should a condition of this permit be violated. I also understand that if all required
parts of this application package are not completed and that if all required supporting information and attachments
are not included, this application package will be returned to me as incomplete. I further certify that the applicant or
any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility without
proper closure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are
compliant with any active compliance schedule, and do not have any overdue annual fees under Rule 2T .0105.
Note: In accordance with NC General Statutes 143-215.6A and 143-215.613, any person who knowingly makes any
false statement, representati n, or certification in any application package shall be guilty of a Class 2 misdemeanor,
which may include a f e t to exceed $10,000 as Avell as civil penalties up to $25,000 per violation.
Signature: Date:
THE COMPLETED RENEWAL APPLICATION SHALL BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
AQUIFER PROTECTION SECTION
By U.S. Postal Service:
1636 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1636
TELEPHONE NUMBER: [phone]
f- ')
C/)
r*t
-:J
By Courier/Special Delivery:N
2728 CAPITAL BOULEVARIr
RALEIGH, NORTH CAROLINA -23604
FAX NUMBER: (919) 715-604*
N
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FORM: WWR 09-06 Page 2

'
OPERATION AND MAINTENANCE AG �D>w` TIOXtia
��)N R071rCT10� SAC.
SINGLE FAMILY RESIDENCE SURFACE IRRIGA `1 YSTEM
DIVISION OF WATER QUALITY
08 SEP 26 Pil ?: 2-
Property Owner(s) (as appearing on the property deed): //�'l hv( G
Mailing Address: L�3 11 ��� n oQ ��y r r K ��1 U( ��t�,%��' Z9� 3
Facility Address (if different than above):
Disposal Method: C- -u-SPRAY-I_RRIGATION_-) o DRIP IRRIGATION (Check One)
County: Penn it No. it] Q Do 3/ S
I/We agree to operate and maintain the wastewater treatment system as follows:
1. The Permittee is responsible for the operation and maintenance of the entire treatment and disposal
system including, but not limited to, the following items:
a. The septic tank shall be checked annually and pumped out as needed. The effluent filter shall be
checked and cleaned at the same frequency of the septic tank.
b. The sand filter surface shall be raked and leveled every six (6) months and any vegetative growth
shall be removed by hand [accessible sand filters only].
c. Check one:
o Xhe tablet chlorinator shall be checked every week. Tablets shall be added so as to provide
proper chlorination.
o The ultraviolet disinfection unit shall be checked every week. The lamp shall be cleaned
and/or replaced to ensure proper disinfection.
d. The storage, pump, and alarm systems shall be inspected monthly. The scum layer shall be
removed at the same time interval as the septic tank is pumped out.
e. The irrigation system shall be inspected monthly to make certain of proper operation, that
vegetative growth does not interfere with the system inspection or operation, that the soil is
assimilating the disposed treated wastewater with no surface runoff, and that no objectionable
odors are being generated.
2. Failure of the Permittee to properly operate this system is subject to a penalty up to $25,000 per day.
3. Failure to meet the permit conditions or violation of the State's surface or groundwater regulations
will require evacuating the dwelling and may void the permit.
NOTE:AII persons (owners) appearing on the legally registered property died must sign this O&M
Agreement
I/We understand the above require ents and agree to ese terms as part of the issued permit.
Owner(s) Signature(s): l Date: 1�z- "
Owner(s) Signature(s):
Date:
SFR O&M (version 07/07)

_ ! ! ti ; "I [
r,-----r
!'
NCDENK o8 SEP 26 PM 2: 27
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
August 9, 2004
KIMBERLY KOCIK, OWNER
5311 FLINT RIDGE CHURCH ROAD
MARSHVILLE, NORTH CAROLINA 28103
Dear Ms. Kocik:
Subject: Permit No. WQ0003158
Single Family Residence
Surface Irrigation Facility
Union County
In accordance with your renewal request received December 11, 2003 and additional information
received March 8, 2004, we are forwarding herewith Permit No. WQ0003158, dated August 9, 2004, to
Kimberly Kocik for the continued operation of the subject single family wastewater treatment and surface
irrigation facilities. The system was designed and originally permitted in 1984 (Pen -nit No. 10269) to serve a
single family at 450 gallons per day. In 1985, a permit modification changed the flow to 750 gallons per day
to include a second single-family type dwelling. However, this modification did not change the capacity of
the treatment facilities designed to serve these two single-family residences. The Division is assuming,
although records are incomplete, that this action was taken to accommodate a family member residing at the
same location in the second house. Please be advised that this system cannot accommodate an increase in
flow if more than one person resides in this second house and therefore, a modification to the existing
facilities would be necessary prior to that occurring. A system failure may result if actual flows exceed
design capacity of the subject system. Please note Condition 1(1) and other permit conditions in this permit
that require action for any type of system failure or any other problems resulting in the operation of this
system.
This permit shall be effective to the date of issuance until July 31, 2009, shall void Permit No.
WQ O)3158 issued July 1, 1999, and shall be subject to the conditions and limitations as specified therein.
Please pay particular attention to the monitoring requirements in this permit. Failure to establish an adequate
system for collecting and maintaining the required operational information will result in future compliance
problems. Please also pay particular attention to Conditions V(3) and V(10) of this permit.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the
right to request an adjudicatory hearing upon written request within thirty (30) days following receipt of this
permit. This request must be in the form of a written petition, conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service Center,
Raleigh, NC 27699-6714. Unless such demands are made this permit shall be final and binding.
Aqurfer Protection Section - Land Application Permitting and Compliance Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
512 N. Salisbury St.. Raleigh, North Carolina 27604
Phone: [phone] / FAX: [phone] I Internet: h2o.enr.state.nc.us
M Eaual 0wortunitVAt innative Action Emolever - 50 Recvvted110'= Post C^ s-jrrer Pako ar
NoithCarofilia
V%�lfltll rally

IPV
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH
SINGLE FAMILY RESIDENCE SURFACE IRRIGATION PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Kimberly Kocik
Union County
FOR THE
continued operation of a 750 gallon per day (GPD) surface spray irrigation wastewater treatment and
disposal system consisting of a 1,200 gallon baffled septic tank, a 1,200 gallon pump tank with a 52 GPM
recirculation pump, a flow splitter, a 150 square foot recirculating sand filter, a tablet chlorinator, a 2,000
gallon chlorine contact storage/pump tank, a 20 GPM self priming effluent dosing pump, a 6,969 square
foot spray irrigation area with three (3) sprinklers, and all associated piping and appurtenances to serve
the Kimberly Kocik Residence and the second single-family type dwelling, with no discharge of wastes to
the surface waters, pursuant to the application received December 11, 2003, and in conformity with the
project plan, specifications, and other supporting data subsequently filed and approved by the Department
of Environment and Natural Resources and considered a part of this permit.
This permit shall be effective from the date of issuance until July 31, 2009. shall void Permit No.
WQ0003158 issued July 1, 1999 and shall be subject to the following specified conditions and
limitations:
I. PERFORMANCE STANDARDS
The surface irrigation facilities shall be effectively maintained and operated at all times so
that there is no discharge to surface waters, nor any contamination of ground waters which
will render them unsatisfactory for normal use. In the event that the facilities fail to perform
satisfactorily, including the creation of nuisance conditions or failure of the irrigation area to
adequately assimilate the wastewater, the Permittee shall take immediate corrective actions
including those actions that may be required by the Division of Water Quality (Division).
such as the construction of additional or replacement wastewater treatment and disposal
facilities.
The issuance of this permit shall not relieve the Permittee of the responsibility for damages to
surface or ground waters resulting from the operation of this facility.

If you need additional information concerning this matter, please contact Toni Wyche at (919) 733-
5083 extension 546.
Sincerely,
Alan W. Klimek, P. E.
cc: Union County Health Department
Mooresville Regional Office, Water Quality Section
Technical Assistance and Certification Unit
Water Quality Central Files
NDPU Files

IF
3. The residuals generated from these treatment facilities must be disposed in accordance with
General Statute 143-215.1 and in a manner approved by the Division.
4. Diversion or bypassing of the untreated wastewater from the treatment facilities is prohibited.
The following buffers shall be maintained:
a. 400 feet between wetted area and any residence or places of public assembly under
separate ownership,
b. 150 feet between wetted area and property lines,
c. 100 feet between wetted area and wells,
d_ 100 feet between wetted area and drainage ways or surface water bodies,
e. 50 feet between wetted area and public right of ways.
f. 100 feet between treatment/storage units and any wells, and
g. 50 feet between treatment units and property lines.
Some of the buffers specified above may not have been included in previous permits for this
waste treatment and disposal system. These buffers are not intended to prohibit or prevent
modifications, which are required by the Division, to improve performance of the existing
treatment facility. These buffers do, however, apply to modifications of the treatment and
disposal facilities that are for the purpose of increasing the flow that is tributary to the
facility. These buffers do apply to any expansion or modification of the surface irrigation
areas and apply in instances in which the sale of property would cause any of the buffers now
complied with, for the treatment and disposal facilities, to be violated. The applicant is
advised that any modifications to the existing facilities will require a permit modification.
6. The pump tank(s) shall have functional audible and visual high water alarms that are external
to any structure.
II. OPERATION AND MAINTENANCE REQUIREMENTS
1. The facilities shall be properly maintained and operated at all times.
2. Upon classification of the wastewater treatment and surface irrigation facilities by the Water
Pollution Control System Operators Certification Commission (WPCSOCC). the Permittee
shall designate and employ a certified operator to be in responsible charge (ORC) and one or
more certified operator(s) to be back-up ORC(s) of the facilities in accordance with 15A
NCAC 8G .0201. The ORC shall visit the facilities in accordance with 15A NCAC 8G .0204
or as specified in this permit and shall comply ,N ith all other conditions specified in these
rules.
3. A suitable year round vegetative corer shall be maintained.
4. Irrigation shall not be performed during inclement weather or «hen the ground is in a
condition that will cause runoff.
5. Adequate measures shall be taken to prevent wastewater runoff from the irrigation field.
6. The application rate shall not exceed a cumulative loading of 39.0 inches over any twelve
(12) month period at an instantaneous application rate not to create any pdnding or runoff.
M

H..�
The facilities shall be effectively maintained and operated as a non -discharge system to
prevent the discharge of any wastewater resulting from the operation of this facility.
No type of wastewater other than that from the Kimberly Kocik Residence and the second
single-family type dwelling shall be sprayed onto the irrigation area.
9. In the event that the sprinkler heads fail to achieve the design diameter, to cover all the
designed wetted area, the obstructions shall be removed or the sprinkler heads shall be raised
and supported to such height that the design diameter is achieved.
10. No traffic or equipment shall be allowed on the disposal area except while installation occurs
or while normal maintenance is being performed.
11_ The irrigation field shall be fenced with at least a two -strand wire fence.
12. Wastewater treatment units open to the atmosphere shall have restricted access and pump
control panels shall be locked.
13. The Permittee is responsible for the operation and maintenance of the entire treatment and
disposal system including, but not limited to, the following items:
a. The septic tank shall be checked annually and pumped out as needed. The septic tank
effluent filter shall be checked and cleaned at the same frequency of the septic tank.
b. The tablet chlorinator shall be checked every week. Tablets shall be added to provide
proper chlorination.
c. The storage, pump, and alarm systems shall be inspected monthly. The scum layer shall
be removed at the same interval as the septic tank is cleaned out.
d_ The system shall be inspected monthly to make certain of the proper operation of the
spray head(s), that the vegetative growth allows a proper spray pattern, that the soil is
assimilating the disposed treated wastewater with no surface runoff, and that no
objectionable odors are being generated.
III. MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring deemed necessary by the Division to insure surface and ground water protection will
be established and an acceptable sampling reporting schedule shall be followed.
2. The Permittee shall maintain records of all maintenance performed on the system and irrigation area,
as required in Condition H(12) for a minimum of five years. This information shall be provided to the
Division upon request.
3. Noncompliance Notification:
The Permittee shall report by telephone to the Mooresville Regional Office. telephone
number [phone], as soon as possible, but in no case more than 24 hours or on the next
working day following the occurrence or first knowledge of the occurrence of any of the
following:
5

a. Any process unit failure, due to known or unknown reasons, that renders the facility
incapable of adequate wastewater treatment, such as mechanical or electrical failures of
pumps, spray heads, etc.; or
b. Any failure of a pumping station or treatment facility resulting in a by-pass directly to
receiving waters without treatment of all or any portion of the influent to such station or
facility.
Occurrences outside normal business hours may also be reported to the Division's
Emergency Response personnel at telephone number [phone] or [phone].
Persons reporting such occurrences by telephone shall also file a written report in letterform
within five (5) days following first knowledge of the occurrence. This report must outline the
actions taken or proposed to be taken to ensure that the problem does not recur.
IV. INSPECTIONS
Adequate inspection, maintenance, and cleaning shall be provided by the Permittee to insure
proper operation of the subject facilities.
2. Any duly authorized officer, employee, or representative of the Division may, upon
presentation of credentials, enter and inspect any property, premises or place on or related to
the disposal site or facility at any reasonable time for the purpose of determining compliance
with this permit, may inspect or copy any records that must be maintained under the terms
and conditions of this permit, and may obtain samples of groundwater, surface water, or
leachate.
V. GENERAL CONDITIONS
This permit shall become void unless the facilities are constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data_
2. This permit is effective only with respect to the nature and volume of wastes described in the
application and other supporting data.
3. This permit is not transferable. In the event there is a desire for the facilities to change
ownership, or there is a name change of the Permittee, a formal permit request must be
submitted to the Division accompanied by documentation from the parties involved, and
other supporting materials as may be appropriate. The approval of this request will be
considered on its merits and may or may not be approved.
4. Upon the availability of a municipal or regional sewerage collection system. the subject
wastewater treatment facilities shall be abandoned and all wastewater discharged into the
municipal or regional sewerage system.
5. Failure to abide by the conditions and limitations contained in this permit may subject the
Permittee to an enforcement action by the Division in accordance with North Carolina
General Statute 143-215.6A to 143-215.6C.
6

E:1
The issuance of this permit does not preclude the Permittee from complying with any and all
statutes, rules, regulations, or ordinances which may be imposed by other government
agencies (local, state, and federal) which have jurisdiction.
This permit may be revoked if the Permittee fails to abide by the conditions of the "Operation
and Maintenance Agreement" previously signed by the Permittee.
A set of approved plans, specifications for the subject project must be retained by the
Permittee for the life of the project.
9. The annual administering and compliance fee must be paid by the Permittee within 30 days
after being billed by the Division. Failure to pay the fee accordingly may cause the Division
to initiate action to revoke this permit as specified by 15A NCAC 2H .0205 (c)(4).
10. The Permittee, at least six (6) months prior to the expiration of this permit, shall request its
extension. Upon receipt of the request, the Commission will review the adequacy of the
facilities described therein, and if warranted, will extend the Permit for such period of time
and under such conditions and limitations, as it may deem appropriate.
Permit issued this the 9`' day of August, 2004
NORTH CAROLINA ENVIRONMENTAL. MANAGEMENT COMMISSION
Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number WQ0003158

W AT �qQG
15
r
O `C
Ms. Kimberly Kocik
5311 Flint Ridge Church Rd
Marshville, North Carolina 28103
Dear Ms. Kocik:
Michael F. Easley, Governor
William G. Ross Jr., Secretary
LD North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
AQUIFER PROTECTION SECTION
December 12, 2006
RE: Compliance Inspection
WQ0003158
Single Family Surface Irrigation System
Union County
Thank you for meeting with me on November 15, 2006 during my inspection of your wastewater disposal
system. The enclosed report should be self-explanatory but should you have any questions, please call
me at 704/235-2183.
Sincerely,
Peggy Finley
Hydrogeological Technician
MAF/sfr/Kocik inspection 11-15-06
Division of Water Quality / Aquifer Protection Section / Mooresville Regional Office Phone: [phone] Fax: [phone] N�o thCarolina
610 East Center Avenue, Suite 301, Mooresville, NC 28115 Customer Service 1-877-623-6748 Internet: www.ncwaterguality.org Naturally

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Secretary
Alan W. Klimek, P.E. Director
NCDENR
NON -DISCHARGE COMPLIANCE INSPECTION
Single Family Spray/Drip Irrigation
GENERAL INFORMATION
City/Town/Owner: Ms. Kimberly Kocik County: Union
Permit # WQ0003158 Project: Kocik Residence SFR
Issuance Date: 8/9/04 Expiration Date: 7/31/09
Permittee Contact: Kimberly Kocik Telephone No.: 704/624-6304
ORC Name Not Applicable Telephone No.:
24hr Contact Name: Kimberly Kocik work phone [phone] x211
Reason for Inspection
X ROUTINE COMPLAINT FOLLOW-UP OTHER
Date of Inspection 11/15/06
Inspection Summary: (additional comments may be included on attached pages)
The treatment is well maintained and operating properly. The irrigation field is in excellent
condition. Records are well kept and complete. Ms. Kocik stated that her mother still lives
alone in the blue house (closest to the application area).
Is a follow-up inspection necessary yes no _X
Inspector's Name/Title Peggy Finley, Hydro Tech 11
Telephone No. 704/235-2183 Fax No. 704/663-6040
11

Single Family SprayDrip Irrigation Inspection
WQ0003158
Treatment
_Y_ Are treatment facilities consistent with those outlined in the current permit.
Y Do all treatment units appear to be operational. If no, note below.
Pg 2
Comments: Chlorine tablets were in place in the chlorinator. The sand filter was in good condition.
The alarm system is functional. The septic tank was pumped on Nov. 3, 2006.
Effluent Storage
In ground dosing tank _Y_
Number of days storage
Other:
Spill control plan on site
Disposal (final end use)
Is application equipment in need of repair? N . Are buffers adequate? Y
Are cover crops the type specified in permit? N In need of improvement? _N_
Signs of runoff? N . Signs of ponding? N
Y Is the acreage specified in the permit being utilized?
Y Is the application equipment present and operational?
N Are there any limiting slopes in disposal fields?
NA Are restrictions for use of these areas specified?
Y Is permit being followed?
N Is there evidence of runoff or drift?
Y Is site access restricted in accordance with permit? If so, how? Double strand wire fence.
Y Is permit available upon request?
Y Are operational logs present?
Y Are operation and maintenance records available?
N Has permittee received any public complaints in the last 12 months?
Comments:

Compliance Inspection Report
Permit: WQ0003158 Effective: 08/09/04 Expiration: 07/31/09 Owner: Kimberly Kocik
SOC: Effective: Expiration: Facility: Kimberly Kocik SFR
County: Union 5311 Flint Ridge Church R
Region: Mooresville
Marshville NC 28103
Contact Person: Kimberly Kocik Phone: [phone]
Directions to Facility:
From the intersection of Landsfor Raod (SR 1005) and Flint Ridge Church Road (SR 1983) southeast of the Town of Marshville, travel
east on Flint Ridge Chu ` Road approx. 0.1 mile. The site is the first residence on the left (north) side of Flint Ridge Church Road
Primary ORC: S Certification: Phone:
� 6
Secondary ORC(s): S� s
SF
On -Site Represer
Related Permits
Inspection D
Primary Ins 363-1699
Secondary `� 238
Reason h' - ion
01
Permit Inspection i y,._
Facility Status: Q Compliant � ,�
of
Question Areas:
Miscellaneous Questions 0 Treatment all- cord Keeping
■ End Use -Irrigation ■ Treatment Disinfection
(See attachment summary)
b a
j,\
Page: 1

Permit: VVQ0003158 Owner - Facility: Kimberly Kocik
Inspection Date: Inspection Type: Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
Page: 2

Permit: VVQ0003158 Owner - Facility: Kimberly Kocik
Fr
Inspection Date: Inspection Type: Compliance Evaluation
Reason for Visit: Routine
Yes No
NA NE
Reuse (Quality)
n
Lagoon Spray, LR
n
Infiltration System
n
fzl
Single Family Spray, LR
Activated Sludge Spray, LR
n
Activated Sludge Drip, LR
n
Activated Sludge Spray, HR
n
Recycle/Reuse
n
Single Family Drip
■
Yes No
NA NE
Are Treatment facilities consistent with those outlined in the current permit?
n
n n
Do all treatment units appear to be operational? (if no, note below.)
I n
n n
Yes No
NA NE
Is the filter media present?
n n
F n
Is the filter media the correct size and type?
n n
V n
Is the air scour operational?
n n
F,� n
Is the scouring acceptable?
n n
ran
Is the clear well free of excessive solids?
n n
n n
Is the mud well free of excessive solids and filter media?
n n
n n
Does backwashing frequency appear adequate?
n n
n' n
Yes No NA NE
Is the system working? Y n n n
Do the fecal coliform results indicate proper disinfection? ❑ ❑ ❑
Is there adequate detention time (-30 minutes)? io
Is the system properly maintained? ly ❑ f_l n
If gas, does the cylinder storage appear safe? n n r,, ,//n
Is the fan in the chlorine feed room and storage area operable? ❑ ❑ !L n
Page: 3

Permit: WQ0003158 Owner - Facility: Kimberly Kocik
Inspection Date: Inspection Type: Compliance Evaluation Reason for
Visit: Routine
Is the chlorinator accessible? t_I n n n
If tablets, are tablets present? fv� n n n
Are the tablets the proper size and type? 1Fj n n n
Is contact chamber free of sludge, solids, and growth? Cg n n n
If UV, are extra UV bulbs available? n n n n
If UV, is the UV intensity adequate? n n T' n
# Is it a dual feed system? n n n n
Does the Stationary Source have more than 2500 Ibs of Chlorine (CAS No. 7782-50-5)? n n n n
If yes, then is there a Risk Management Plan on site? n n n n
If yes, then what is the EPA twelve digit ID Number? (1000- )
If yes, then when was the RMP last updated?
Is a copy of current permit available? f4 n n n
Are monitoring reports present: NDMR?
NDAR? n n n n
Are flow rates less than of permitted flow? 4 n n n
Are flow rates less than of permitted flow? 171 I_l n n
Are application rates adhered to?
r� n
n n
4
Is GW monitoring being conducted, if required (GW-59s submitted)?
n
n
n
n
n
d n
Are all samples analyzed for all required parameters?
Are there any 2L GW quality violations?
n
n
r n
Is GW-59A certification form completed for facility?
Q
n
r
fa
Is effluent sampled for same parameters as GW?
n
n
o
Do effluent concentrations exceed GW standards?
n
n
n' n
Are annual soil reports available?
n
n
n n
# Are PAN records required?
n
n
n n
# Did last soil report indicate a need for lime?
n
n
n n
If so, has it been applied?
n
n
n n
Are operational logs present?
n
n
n n
,,,f� Page: 4

Permit: WQ0003158 Owner - Facility: Kimberly Kocik
Inspection Date: Inspection Type: Compliance Evaluation Reason for Visit: Routine
Are lab sheets available for review? n n n n
Do lab sheets support data reported on NDMR? n n n f_1
Do lab sheets support data reported on GW-59s?
n
n
n
n
Are Operational and Maintenance records present?
n
n
n
n
Were Operational and Maintenance records complete?
n
n
n
❑
Has permittee been free of public complaints in last 12 months?
n
n
n
n
Is a copy of the SOC readily available?
n
n
n
n
No treatment units bypassed since last inspection?
n
n
n
n
Are buffers adequate?
n
n
n
n
Is the cover crop type specified in permit?
o
n
n
n
Is the crop cover acceptable?
n
n
n
n
Is the site condition adequate?
n
n
n
o
Is the site free of runoff / ponding?
n
n
n
n
Is the acreage specified in the permit being utilized?
n
n
n
n
Is the application equipment present?
n
n
n
n
Is the application equipment operational?
n
n
n
n
Is the disposal field free of limiting slopes?
n
n
n
n
Is access restricted and/or signs posted during active site use?
n
n
n
o
Are any supply wells within the CB?
n
n
n
n
Are any supply wells within 250' of the CB?
o
n
o
o
How close is the closest water supply well?
n
n
n
n
Is municipal water available in the area?
n
o
o
n
# Info only: Does the permit call for monitoring wells?
n
n
n
n
Are GW monitoring wells located properly w/ respect to RB and CB?
n
n
n
n
Are GW monitoring wells properly constructed, including screened interval?
n
n
n
n
Are monitoring wells damaged?
n
n
o
n
,�— Page: 5

NON -DISCHARGE REGIONAL WATER QUALITY
STAFF REPORT AND RECOMMENDATIONS
Date: 04-1-2004 County: Union
To: Non -Discharge Permitting Unit Permittee: Kimberly Kocik
NDPU Reviewer: Toni Wyche Application No.: W00003158
Regional Login No: MRO 04-18
GENERAL INFORMATION
1. This application is (check all that apply): ❑ New ® Renewal
❑ Minor Modification ❑ Major Modification
® Surface Irrigation ❑ Reuse ❑ Recycle ❑ High Rate Infiltration ❑ Evaporation/Infiltration Lagoon
❑ Land Application of Residuals ❑ Attachment 3B included as appropriate ❑ 503 regulated ❑ 503
exempt ❑ Distribution of Residuals ❑ Surface Disposal
2. Was a site visit conducted in order to prepare this report? ® Yes or ❑ No.
a. Date of site visit: 03-30-2004 p
b. Person contacted and contact information: Ms. Kimberly Kocik y,
c. Site visit conducted by: Michael L. Parker, Environmental Engineer II
d. Inspection report attached: ❑ Yes, ® No or ❑ N/A (New Facility) i
3. Is the following information entered into the BIMS record for this application correct? 00
.�
® Yes or ❑ No. If no, please complete the following or indicate that it is correct on the current
application.
For Treatment Facilities:
a. Location: Approximately 2.9 miles southeast of the Town of Marshville
b. Driving Directions: From the intersection of Landsford Road (SR 1005) and Flint Ridge Church
Rd. (SR 1983) southeast of the Town of Marshville travel east on Flint Ridge Church Rd approx.
0.1 mile. The site is the first residence on the left (north) side of Flint Ridge Church Rd
c. USGS Quadrangle Map name and number: H17NE
d. Latitude: 34° 56' 21" Longitude: 80120' 40"
e. Regulated Activities / Type of Wastes (e.g., subdivision, food processing, municipal wastewater):
For Disposal Sites:
a. Location(s): Same as above
b. Driving Directions: Same as above
c. USGS Quadrangle Map name and number: Same as above
d. Latitude: Same as above Longitude: Same as above
FORM: NDSRR 03/02

I
RENEWAL AND MOD IFICATIONAPPLICATIONS (use previous section for new or major
modification systems)
DESCRIPTION OF WASTE(S) AND FACILITIES
1. Are there appropriately certified ORCs for the facilities? ❑ Yes ® No (not required for this facility)
Operator in Charge: Certificate #:
Back- Operator in Charge: Certificate #:
2. Is the design, maintenance and operation (e.g. adequate aeration, sludge wasting, sludge storage,
effluent storage, etc) of the treatment facilities adequate for the type of waste and disposal system?
® Yes or ❑ No. If no, please explain:
3. Are the site conditions (soils, topography, etc) maintained appropriately and adequately assimilating
the waste? ® Yes or ❑ No. If no, please explain:
4. Is the residuals management plan for the facility adequate and/or acceptable to the Division?
® Yes or ❑ No. If no, please explain:
5. Are the existing application rates (hydraulic or nutrient) still acceptable? ® Yes or ❑ No. If no,
please explain:
6. Are there any buffer conflicts (treatment facilities or disposal sites)? ❑ Yes or ® No. If yes, please
attach a map showing conflict areas or attach any new maps you have received from the applicant to
be incorporated into the permit:
7. Is the type and/or volume of waste(s) as written in the existing permit correct? ® Yes or ❑ No. If
no, please explain:
8. Is the description of the facilities as written in the existing permit correct? ® Yes or ❑ No. If no,
please explain:
9. Has a review of all self monitoring data been conducted? ❑ Yes or ® No. Please summarize any
findings resulting from this review: Self montoring_is not required by the permit.
10. Check all that apply: ® No compliance issues; ❑ Notice(s) of violation within the last permit cycle;
❑ Current enforcement action(s) ❑ Currently under SOC; ❑ Currently under JOC; ❑ Currently
under rporatorium. If any items checked, please explain and attach any documents that may help
clarify answer/comments (such as NOV, NOD etc):
11. Have all compliance dates/conditions in the existing permit, SOC, JOC, etc. been complied with?
❑ Yes ❑ No or ® N/A. If no, please explain:
12. Are there any issues related to compliance/enforcement that should be resolved before issuing this
permit? ❑ Yes or ® No. If yes, please explain:
FORM: NDSRR 03/02 2

I
EVAL UATIONAND RECOMMENDATIONS
1. Provide any additional narrative regarding your review of the application.: _This is a simple renewal
of a SFR spray irrigation wastewater treatment system There are no issues with regards to the
application that need to be addressed in this renewal The information submitted in the renewal
application is consistent with the facilities that have been constructed
2. List any items that you would like NDPU to obtain through an additional information request. Make
sure that you provide a reason for each item:
Item Reason
None
3. List specific Permit conditions that you recommend to be removed from the permit when issued.
Make sure that you provide a reason for each condition:
Condition Reason
None
4. List specific special conditions or compliance schedules that you recommend to be included in the
permit when issued. Make sure that you provide a reason for each special condition:
Condition Reason
No compliance schedule is recommended
5. Recommendation: ❑ Hold, pending receipt and review of additional information by regional office;
❑ Hold, pending review of draft permit by regional office; ® Issue; ❑ Deny. If deny, please state
reasons:
6. Signature of report preparer:
Signature of WQS regional supervisor:
Date: a�i�/;
r�
ADDITIONAL REGIONAL STAFF REVIEW ITEMS
The existing WWT system was well maintained during the site visit All of the treatment units
appeared to be in good operational condition and functioning_ properly. Chlorine tablets were present
in the chlorinator. The irrigation field was well maintained adequately fenced and had an excellent
fescue cover crop. There were no signs of ponding or over application
FORM: NDSRR 03/02

NC DEPT r)r-MR0NMEyT
AND NAr `SOURCES
`,GORES' ° A! OFFICE
NON -DISCHARGE APPLICATION REVIEW REQUEST FORM
To: ❑ Forrest Westall, ARO-WQS
❑ Paul Rawls, FRO-WQS
Rex ,Gleason,., MR, 0=.�
❑ Ken Schuster, RRO-WQS
❑ Jim Mulligan, WaRO-WQS
❑ Rick Shiver, WiRO-WQS
❑ Steve Mauney, WSRO-WQS
❑ Debra Watts, CO-GW S
Copies Sent to CO-GWS: 0
JAN 3 0 2004
""E SECTION
Copies Sent to RO-WQS: 1
❑ Distribute 0 Copies to RO-GWS
From: Toni Wyche, Non -Discharge Permitting Unit
Telephone: [phone] ext. 546 Fax: [phone]
E-Mail: [e-mail]
A. Permit Number: W00003158
B. Owner: Kimberly Kocik
C. Facility/Operation: Kimberly Kocik SFR
❑ Proposed ® Existing ® Facility ❑ Operation
D. Application:
1. Permit 7ype: ❑ CS (O&M) ® Surface Irrigation ❑ Reuse ❑ H-R Infiltration
❑ Recycle ❑ I/E Lagoon ❑ GW Remediation (ND)
For Residuals: ❑ Land App. ❑ D&M ❑ Surface Disposal
❑ 503 ❑ 503 Exempt ❑ Animal
2. Project Type: ❑ New ❑ Major Mod. ❑ Minor Mod. ® Renewal ❑ Renewal w/ Mod.
E. Comments/Other Information: ❑ I would like to accompany you on a site visit.
Attached, you will find all information submitted in support of the above -referenced application for your
review, comment, and/or action. Within 30 calendar days, please take the following actions:
For RO-WQS:
® Return a Completed Form NDARR. ❑ Attach Attachment B for Certification by the NDPU.
❑ Issue an Attachment B Certification from the RO*.
* Remember that you will be responsible for coordinating site visits, reviews, as well as additional
information requests with other RO-WQS and RO-GWS representatives in order to prepare a complete
Attachment B for certification. Refer to the RPP SOP for additional detail.
For CO-GWS:
❑ Return a Memorandum with Permit Condition Recommendations.
When you receive this request form, please write your name and dates in the spaces below, make a copy
of this sheet, and return 'a to the ap ropriate Non -Discharge P tting Unit contact person listed above.
RO-WQS Reviewer: ooOi Date:
CO-GWS Reviewer:
Date:
FORM: NDARR 09/02
Page 1 of 1

01 /14/04
Permit Number W00003158
Program Category
Non -discharge
Permit Type
Surface Irrigation - SFR (Single Family Residence)
Primary Reviewer
toni.wyche
Permitted Flow
Facility
Facility Name
Kocik Kimberly-Kocik SFR Spr
Location Address
5311 Flint Ridge Church R
Marshville NC 28103
Owner
Permit Tracking Slip
Status Project Type
In review Renewal
Version Permit Classification
Individual
Permit Contact Affiliation
Major/Minor Reqion
Minor Mooresville
County
Union
Facility Contact Affiliation
Owner Name Owner Type
Individual
Kimberly Kocik Owner Affiliation
Kimberly Kocik
5311 Flint Ridge Church R
Marshville NC 28103
Dates/Events
Scheduled
Oriq Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
07/01 /90 12/11 /03
Regulated Activities Requested/Received Events
Private residence, single family Additional information requested
Additional information received
RO staff report requested
RO staff report received
Outfall NULL
Waterbody Name Stream Index Number Current Class Subbasin

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
Non• + `�gepe� LE FAMILY RESIDENCE SURFACE IRRIGATION
PERMIT RENEWAL, APPLICATION
SYSTEN,1
(THIS FORM MAY RF. PHOTOCOPIED FOR USE AS AN ORIGINAL) RECEIVED
�) WATER�netnrvcFr
Application Number: 'L f��.. �_ -• _� 5 - TION
or_t, 1
Note: Renewals without modifications should just fill out sections I & II; sign the applicants signature
below, attach Form SFR O&M 04/01, and attach Form PNOCF 06/00 (if necessary). NWR)kNrgePermbng
I. GENERAL INFORMATION: L�
1. Applicant's name (Name of the owner of the facility) : f l / /1& ('' ( 1y F
�, �-
2. Name and complete address of applicant:
i
tn�i_Ltnt f I�C c.-L 1—!1Lf i '` 4�,( r =`
City: tl 1 M\CO.110 State: Zip: i /C 5 --
Telephone number: ( -LXf ) (o cl - (0-5Cy Facsimile number: ( ) _ ! I 14
Email Address:
3. Complete address of the treatment and disposal site (if different than above):
City:
State:
4. County where project is located:
5. Fee submitted: $ No Fee Required
II. PERMIT INFORMATION:
Zip:
1. Project is: X renewal without modification
2. 2. What is the existing permit number � C�00 3 1,4) �5' and the issuance date +. 4)
3. Has the treatment and disposal system been constructed? 0 Yes ❑ No
4. If the system has not been constructed, would you like to rescind your permit (i.e. the permitted facilities
will not be needed)? ❑ Yes ❑ No
Applicant's Certification:
I, -1 ]Ad eU (y 1 [06 , attest that this application for 'S i l jl'c Fnt'v t u,54ty
<,, �Cl 61 5+C ��iery�l t��' d1 ei.�stt� 'j�_ has been reviewed by me and is
accurate and complete to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if all required supporting information and attachments are not included, this application package
will be returned to me as incomplete. Note: In accordance with NC General Statutes 143-215.6A and 143-215.613,
any person who knowingly makes any false statement, representation, or certification in any application shall be
guilty of a Class 2 misdemeanor, which may include a fine not to exceed $10,000 as well as civil penalties up to
$25,000 per violatio n
Date:
Signature: --- —
FORM: SFR-SIA-R I1-03 Page I of 1

So RECEIVED
AEG ��FC110� State of North Carolina WATERn11Ai%Tve1:rT10N
WA"I5kt 1 Department of Environment and Natural Resources
epetm �' Division of Water Quality Non-DischargePermittine
Non-�1Scha�9
SINGLE FAMILY RESIDENCE SURFACE IRRIGATION SYSTEM
PERMIT RENEWAL APPLICATION
(THIS FORM MAYBE PHOTOCOPIED FOR USE AS AN ORIGINAL)
Application Number:
Note: Renewals without modifications should just fill out sections I & II; sign the applicants signature
below, attach Form SFR O&M 04/01, and attach Form PNOCF 06/00 (if necessary).
I. GENERAL INFORMATION:
1. Applicant's name (Name of the owner of the facility) : / /11 i^ f
2. Name and complete address of applicant: t ' 1� (,t f 1L &= t L&d\
City: it 1 \ft �`�11 VI State: Zip:
Telephone number: ( ?LEI ) (Od c1 - (03� �a Facsimile number: (
Email Address:
3. Complete address of the treatment and disposal site (if different than above):
City:
State:
4. County where project is located: _ V n i a f>
5. Fee submitted: $ No Fee Required
II. PERMIT INFORMATION:
Zip:
1. Project is: X renewal without modification
2. What is the existing permit number (,f) Q (')00 3 1,) cY and the issuance date fd+ X,
3. Has the treatment and disposal system been constructed'? 0 Yes ❑ No
4. If the system has not been constructed, would you like to rescind your permit (i.e. the permitted facilities
will not be needed)? ❑ Yes ❑ No
Applicant's Certification:
I, 9 /jnbt_V (k, / Il%&& , attest that this application for
rII 6k 5+C has been reviewed by me and is
accurate and complete to the besl of my knowledge. I understand that if all required parts of this application are not
completed and that if all required supporting information and attachments are not included, this application package
will be returned to me as incomplete. Note: In accordance with NC General Statutes 143-215.6A and 143-215.613.
any person who knowingly makes any false statement, representation, or certification in any application shall be
guilty of a Class 2 misdemeanor, which may include a fine not to exceed $10,000 as well as civil penalties up to
$25,000 per violatio .
Signature: ii�zlDate: __�
FORM: SFR-SIA-R 11-03 Page 1 of 1

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
Kerr T. Stevens, Director
July 1, 1999
Ms. Kimberly A. Kocik
5311 Flint Ridge Church Road
Marshville, North Carolina 28103
Dear Ms. Kocik:
Now
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: Permit No. WQ003158
Two Single Family Residences
Single Family Wastewater
Spray Irrigation Facility
Union County
In accordance with your application received February 2, 1999 we are forwarding herewith Permit No.
WQ0003158, dated July 1, 1999 to Ms. Kimberly A. Kocik for the continued operation of the subject two
single family wastewater treatment and spray irrigation facilities. The system was designed and originally
permitted in 1984 (Permit No. 10269) to serve a single family at 450 gallons per day. In 1985, a permit
modification changed the flow to 750 gallons per day to include a second single family type dwelling.
However, this modification did not change the capacity of the treatment facilities designed to serve these two
single family residences. The Division is assuming, although records are incomplete, that this action was
taken to accommodate a family member residing at the same location in the second house. Please be advised
that this system cannot accommodate an increase in flow if more than one person resides in this second house
and therefore, a modification to the existing facilities would be necessary prior to that occurring. A system
failure may result if actual flows exceed design capacity of your system. Please note, condition I.1 and other
permit conditions in this permit that require action for any type of system failure or any other problems
resulting in the operation of this system.
This permit shall be effective from the date of issuance until Jun3 30, 2004 shall void Permit No.
WQ0003158 issued November 30, 1994, and shall be subject to the conditions and limitations as specified
therein. Please pay particular attention to the monitoring requirements in this permit. Failure to establish an
adequate system for collecting and maintaining the required operational information will result in future
compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right
to request an adjudicatory hearing upon written request within thirty (30) days following receipt of this permit.
This request must be in the form of a written petition, conforming to Chapter 150B of the North Carolina
General Statutes, and filed with the Office of Administrative Hearings, P.O. Drawer 27447, Raleigh, NC
27611-7447. Unless such demands are made this permit shall be final and binding.
PO Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post -consumer paper

If you need additional information concerning this matter, please contact Ron Palumbo at (919) 733-
5083 extension 533.
n
Sincefe ,
(Kerr T. Stevens
cc: Union County Health Department
Mooresville Regional Office, Water Quality Section
Technical Assistance and Certification Unit
Non -Discharge Compliance/Enforcement Unit

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH
SINGLE FAMILY SPRAY IRRIGATION PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Ms. Kimberly A. Kocik
Union County
FOR THE
continued operation of a 750 GPD spray irrigation wastewater treatment and disposal system consisting of a
1,200 gallon baffled septic tank, a 1,200 gallon pump tank with a 52 gpm recirculation pump, a flow splitter, a
150 square foot recirculating sand filter, a tablet chlorinator, a 2,000 gallon chlorine contact storage/pump
tank, a 20 gpm self priming effluent dosing pump, a 6,969 square foot spray irrigation area with three (3)
sprinklers and all associated piping, valves, controls, meters and appurtenances to serve the two related single
family residence (One being the Kimberly A. Kocik Residence and the other being her mother's residence),
with no discharge of wastes to the surface waters, pursuant to the application received February 6, 1999, and in
conformity with the project plan, specifications, and other supporting data subsequently filed and approved by
the Department of Environment and Natural Resources and considered a part of this permit.
This permit shall be effective from the date of issuance until June 30, 2004 shall void Permit No.
WQ0003158 issued November 30, 1994, and shall be subject to the following specified conditions and
limitations:
I. PERFORMANCE STANDARDS
The spray irrigation facilities shall be effectively maintained and operated at all times so that there
is no discharge to the surface waters, nor any contamination of ground waters which will render
them unsatisfactory for normal use. In the event that the facilities fail to perform satisfactorily,
including the creation of nuisance conditions or failure of the irrigation area to adequately
assimilate the wastewater, the Permittee shall take immediate corrective actions including those
actions that may be required by the Division of Water Quality (Division), such as the construction
of additional or replacement wastewater treatment and disposal facilities.
4. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to
surface or groundwaters resulting from the operation of this facility.
The sand media of the sand filter must comply with the Division's sand specifications. The
engineer's certification will serve as evidence that these specifications have been met.

6. The residuals generated from these treatment facilities must be disposed in accordance with
General Statute 143-215.1 and in a manner approved by the Division.
7. Diversion or bypassing of the untreated wastewater from the treatment facilities is prohibited.
The following buffers shall be maintained:
a) 400 feet between wetted area and any residence or places of public assembly under separate
ownership,
b) 150 feet between wetted area and property lines,
c) 100 feet between wetted area and wells,
d) 100 feet between wetted area and drainageways or surface water bodies,
e) 50 feet between wetted area and public right of ways,
f) 100 feet between treatment/storage units and any wells, and
g) 50 feet between treatment units and property lines.
Some of the buffers specified above may not have been included in previous permits for this waste
treatment and disposal system. These buffers are not intended to prohibit or prevent
modifications, which are required by the Division, to improve performance of the existing
treatment facility. These buffers do, however, apply to modifications of the treatment and disposal
facilities which are for the purpose of increasing the flow that is tributary to the facility. These
buffers do apply to any expansion or modification of the spray irrigation areas and apply in
instances in which the sale of property would cause any of the buffers now complied with, for the
treatment and disposal facilities, to be violated. The applicant is advised that any modifications to
the existing facilities will require a permit modification.
II. OPERATION AND MAINTENANCE REQUIREMENTS
1. The facilities shall be properly maintained and operated at all times.
2. Upon classification of the facility by the Water Pollution Control System Operators Certification
Commission (WPCSOCC), the Permittee shall employ a certified wastewater treatment plant
operator to be in responsible charge (ORC) of the wastewater treatment facilities. The operator
must hold a certificate of the type and grade at least equivalent to or greater than the classification
assigned to the wastewater treatment facilities by the WPCSOCC. The Permittee must also
employ a certified back-up operator of the appropriate type and grade to comply with the
conditions of 15A NCAC 8A .0202. The ORC of the facility must visit each Class I facility at
least weekly and each Class II, III, and IV facility at least daily, excluding weekends and holidays,
and must properly manage and document daily operation and maintenance of the facility and must
comply with all other conditions of 15A NCAC 8A .0202.
3. A suitable year round vegetative cover shall be maintained.
4. Irrigation shall not be performed during inclement weather or when the ground is in a condition
that will cause runoff.
5. Adequate measures shall be taken to prevent wastewater runoff from the spray field.
6. The application rate shall not exceed a cumulative loading of 39 inches over any twelve (12)
month period at an instantaneous application rate that does not allow any runoff.
7. The facilities shall be effectively maintained and operated as a non -discharge system to prevent
the discharge of any wastewater resulting from the operation of this facility.

8. No type of wastewater other than that from the two single-family Kocik Residences shall be
sprayed onto the irrigation area.
9. In the event that the sprinkler heads fail to achieve the design diameter, to cover all the designed
wetted area, the obstructions shall be removed or the sprinkler heads shall be raised and supported
to such height that the design diameter is achieved.
10. No traffic or equipment shall be allowed on the disposal area except while installation occurs or
while normal maintenance is being performed.
11. The spray irrigation field shall be fenced with at least a two strand wire fence.
12. The Permittee is responsible for the operation and maintenance of the entire treatment and disposal
system including, but not limited to, the following items:
a. The septic tank shall be checked annually and pumped out as needed.
b. The tablet chlorinator shall be checked every week. Tablets shall be added so as to provide
proper chlorination.
c. The storage, pump, and alarm systems shall be inspected weekly. The scum layer shall be
removed at the same interval as the septic tank is cleaned out.
d. The spray system shall be inspected weekly to make certain of the sprayers proper operation,
that the vegetative growth allows a proper spray pattern, that the soil is assimilating the
disposed treated wastewater with no surface runoff, and that no objectionable odors are being
generated.
III. MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring deemed necessary by the Division to insure surface and ground water protection
will be established and an acceptable sampling reporting schedule shall be followed.
2. The Permittee shall maintain records of all maintenance performed on the system and irrigation
area, as required in Condition II 12 for a minimum of five years. This information shall be
provided to the Division upon request.
3. Noncompliance Notification:
The Permittee shall report by telephone to the Mooresville Regional Office, telephone number
704-663-1699, as soon as possible, but in no case more than 24 hours or on the next working day
following the occurrence or first knowledge of the occurrence of any of the following:
a. Any process unit failure, due to known or unknown reasons, that renders the facility incapable
of adequate wastewater treatment, such as mechanical or electrical failures of pumps, spray
heads, etc.; or
b. Any failure of a pumping station or treatment facility resulting in a by-pass directly to
receiving waters without treatment of all or any portion of the influent to such station or
facility.
Persons reporting such occurrences by telephone shall also file a written report in letter form
within five (5) days following first knowledge of the occurrence. This report must outline the
actions taken or proposed to be taken to ensure that the problem does not recur.
3

IV. INSPECTIONS
1. Adequate inspection, maintenance, and cleaning shall be provided by the Permittee to insure
proper operation of the subject facilities.
2. Any duly authorized officer, employee, or representative of the Division may, upon presentation
of credentials, enter and inspect any property, premises or place on or related to the disposal site or
facility at any reasonable time for the purpose of determining compliance with this permit, may
inspect or copy any records that must be maintained under the terms and conditions of this permit,
and may obtain samples of groundwater, surface water, or leachate.
V. GENERAL CONDITIONS
This permit shall become voidable unless the facilities are constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data.
2. This permit is effective only with respect to the nature and volume of wastes described in the
application and other supporting data.
3. This permit is not transferable. In the event there is a desire for the facilities to change ownership,
or there is a name change of the Permittee, a formal permit request must be submitted to the
Division accompanied by an application fee, documentation from the parties involved, and other
supporting materials as may be appropriate. The approval of this request will be considered on its
merits and may or may not be approved.
4. Upon the availability of a municipal or regional sewerage collection system, the subject
wastewater treatment facilities shall be abandoned and all wastewater discharged into the
municipal or regional sewerage system.
5. Failure to abide by the conditions and limitations contained in this permit may subject the
Permittee to an enforcement action by the Division in accordance with North Carolina General
Statute 143-215.6A to 143-215.6C.
6. The issuance of this permit does not preclude the Permittee from complying with any and all
statutes, rules, regulations, or ordinances which may be imposed by other government agencies
(local, state, and federal) which have jurisdiction.
7. This permit may be revoked if the Permittee fails to abide by the conditions of the "Operation and
Maintenance Agreement" previously signed by the Permittee.
8. A set of approved plans and specifications for the subject project must be retained by the Permittee
for the life of the project.
4

9. The Permittee, at least six (6) months prior to the expiration of this permit, shall request its
extension. Upon receipt of the request, the Commission will review the adequacy of the facilities
described therein, and if warranted, will extend the Permit for such period of time and under such
conditions and limitations as it may deem appropriate.
Permit issued this th irst day of July, 1999
NORTH ROL E IRO TAL MANAGEMENT COMMISSION
Kerr T. Stevens, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number WQ0003158

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SOC PRIORITY PROJECT: Yes No_X
To: Permits and Engineering Unit
Water Quality Section
Attention: Ron Palumbo
Date: March 17, 1999
NON -DISCHARGE STAFF REPORT AND RECOMMENDATION
COUNTY: Union
Permit No. WQ0003158
MRO No. 99-045
PART I - GENERAL INFORMATION
1. Facility and Address: Kocik SFR Spray Irrigation System
Kimberly A. Kocik
5311 Flint Ridge Church Road
Marshville, North Carolina 28103
2. Date of Investigation: 03-17-99
3. Report Prepared By: G. T. Chen
4. Persons Contacted and Telephone Number: Mr. Mark Kocik, (704)
624-6304
5. Directions to Site: From the intersection of Landsford Road
(SR 1005) and Flint Ridge Church Road (SR 1983) approximately
2.9 miles southeast of Marshville, Union County, travel east
on SR 1983 approximately 0.1 mlie. The site is located on the
left (north) side of the road.
6. Size (land available for expansion and upgrading): There is
adequate land available for upgrading/expansion.
7. Topography (relationship to 100 year flood plain included):
Relatively flat, the site is not in a flood plain.
Attach a U.S.G.S. map extract and indicate facility site.
USGS Quad No.: H 17 NE USGS Quad Name: Marshville, NC
Latitude: 340 56' 21" Longitude: 800 20' 40"

8. Any buffer conflicts with location of nearest dwelling and
water supply well: Yes Now_ If Yes, explain:
9. Watershed Stream Basin Information: Barkers Branch
a. Watershed Classification: WS-V
b. River Basin and Subbasin No.: Yadkin -Pee and 03-07-14
C. Distance to surface water from disposal system: Greater
than 500 feet.
PART II - DESCRIPTION OF WASTES AND TREATMENT WORKS
1. a. Volume: 0.00075 MGD (Design Capacity)
Residuals: N/A
b. Types and quantities of industrial wastewater: N/A
C. Pretreatment Program (POTWs only): N/A
2. Treatment Facilities
a. What is the current permitted capacity of the facility?
0.00075 MGD
b. What is the actual treatment capacity of the current
facility (design volume)? 0.00075 MGD
C. Please provide a description of existing or substantially
constructed wastewater treatment facilities: The
existing facility consists of a 1,200 gallon septic tank,
1,200 gallon pump tank, recirculating sand filter, tablet
chlorinator, 2,000 gallon chlorine contact/storage tank,
and a 0.16 acre spray irrigation field with three (3)
stationary sprinklers.
d. Please provide a description of proposed wastewater
treatment facilities: N/A
3. Residuals handling and utilization/disposal scheme:
a. If Residuals are being land applied, please specify
DWQ Permit No.: N/A
Residual Contractor: N/A
Telephone Number: N/A
2

b. Residuals stabilization: PSRP: N/A
PFRP: N/A
Other: N/A
C. Landfill: N/A
d. Other disposal/utilization scheme (specify): Septage is
pumped by a private septage pumping company from
Wadesboro, Anson County.
4. Treatment plant classification (attach completed rating
sheet): SFR Spray Irrigation, no rating given.
5. SIC Code (s) : 9999
Wastewater Code (s):
Primary: 04 Secondary:
Main Treatment Unit Code: 45057
PART III - OTHER PERTINENT INFORMATION
1. Is this facility being constructed with Construction Grant
Funds (municipals only)? N/A
2. Special monitoring requests: None
3. Important SOC, JOC or Compliance Schedule dates: (Please
indicate): N/A
4. Air Quality and/or Groundwater concerns or hazardous materials
utilized at this facility that may impact water quality, air
quality, or groundwater: There are no known air quality,
groundwater, or hazardous materials concerns.
5. Other Special Items: None
PART IV - EVALUATION AND RECOMMENDATIONS
It is recommended the Non -Discharge permit be renewed as
requested.
3

LIP
Signature of Report Preparer
Water Quality l44 onal Supervisor
://
Date

i6�_' d 3 %�
State of North Carolina
Department of Environment ;. r6IF!NWA
•
and Natural Resources �•r
Division of Water Quality / 1
James B. Hunt, Jr. Governor
Wayne McDevitt, Secretary "'NCDENR
A. Preston Howard, Jr., P.E., Director
e{{� TH CAROLINA DEPARTMENT OF
` 0;*1VI ONMENT AND NATURAL RESOURCES
March 1, 1999 �—ss
Ms. Kimberly Ann Kocik
5311 Flint Ridge Church Road
Marshville, North Carolina 28103
Subject: Application No. WQ0003158
Kimberly A. Kocik
Spray Irrigation
Union County
Dear Ms. Kocik:
The Divisions Permits and Engineering Unit acknowledges receipt of your permit application and
supporting materials on February 26, 1999. This application has been assigned the number listed above.
Your project has been assigned to Mr. Ron Palumbo for a detailed engineering review. Should there be
any questions concerning your project, the review will contact you with a request for additional information.
Be aware that the Division's Regional Office, copied below, must provide recommendations from the
Regional Supervisor or a Procedure Four Evaluation for this project, prior to final action by the division.
If you have anv questions, please contact Mr. Ron Palumbo at 919/733-5083 ext. 533.I17 the engineer is
unavailable, you may leave a message on their voice mail and they will respond promptly.
PLEASE REFER TO THE ABOVE APPLICATION NUMBER WHEN MAKING INQUIRES ON
THIS PROJECT.
Si nc rely,
4-1
1`-Mr. Kim H. Colson,P.E.✓
Supervisor, Non -Discharge Permrng nit
cc: Mooresville Regional Office, Water Quality
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

NON NPDES FACILITY AND PERMIT DATA 03/03/99 08:03:38
,UPDATE OPTION TRXID 5OU KEY WQ0003158
•PERSONAL DATA FACILITY APPLYING FOR PERMIT APP/PERMIT FEE-$ 120.00 REGION
FACILITY NAME> KOCIK, KIMBERLY-KOCIK SFR SPR6 COUNTY> UNION 03
ADDRESS: MAILING (REQUIRED) ENGINEER:
STREET: 5311 FLINT RIDGE CHURCH ROAD STREET:
CITY: MARSHVILLE ST NC ZIP 28103 CITY: ST ZIP 0
TELEPHONE [phone] TELEPHONE:
STATE CONTACT> PALUMBO FACILITY CONTACT KIMBERLY KOCIK
TYPE OF PROJECT> SPRAY IRRIGATION FACILITY LAT: 345621 LONG: 802040
DATE APP RCVD 02/06/99 N=NEW,M=MODIFICATION,R=REISSUE> R
DATE ACKNOWLEDGED 03/01/99 DATE REVIEWED / / RETURN DATE
REG COMM REQS / / DATE DENIED / / NPDES #-
REG COMM RCVD / / DATE RETURNED / / TRIB Q .0000 MGD
ADD INFO REQS / / OT AG COM REQS / / TRIB DATE-
ADD INFO RCVD / / OT AG COM RCVD
END STAT APP P 05/07/99 DATE ISSUED / / DATE EXPIRE
FEE CODE( 4)1=(>lMGD),2=(>10KGD),3=(>lKGD),4=(<lKGD+SF),5=(S>300A),6=(S<=300A),
7=(SENDEL),8=(SEDEL),9=(CLREC),0=(NO FEE) DISC CODES ASN/CHG PRMT
ENG CERT DATE / / LAST NOV DATE / / CONBILL( )
COMMENTS: 750 GPD-2 SFR-ALLOWED GPD >ORIGINAL DESIGN (450GPD)
MESSAGE: *** ENTER DATA FOR UPDATE ***

TO
FROM
RE
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT,
HEALTH AND NATURAL RESOURCES.
KIMBERLY A. KOCIK
5311 FLINT RIDGE CHURCH RD.
MARSHVILLE, NC 28103
RENEWAL PERMIT
WQ 0003158
TO KIMBERLY YOUNG,
DATE: 02-23-99
VvIli DECEIVED
I KIMBERLY A. KOCIK REQUEST A RENEWAL FOR A SINGLE FAMILY
SYSTEM ON PERMIT NO WQ0003158 THAT EXPIRES ON 10-31-99.
A NARRATIVE DESCRIPTION OF THE RESIDUALS MANAGEMENT PLAN IS
AS FOLLOWS, WE PUMP THE SOLIDS COMPARTMENT AND TEST 77- ALARMS
AND PUMPS REGULARL-Y. THE CLORINE TABLETS , IRRIGATION FIELD
AND THE FILTER ARE INSPECTED AND SERVICED WEEKLY. THE CLORINE
TABLETS ARE REPLACED AS NEEDED AND SPRIKLER HEAD FUNCTION
CHECKED AND SERVICED REGULARLY, ALSO THE FIELD IS INSPECTED
FOR STANDING WATER. THE FILTER IS CLEANED OF DEBRIS 6ND
DRAINAGE IS CHECKED. IF YOU NEED ANY MORE INFORMATION OR
HAVE ANY QUESTIONS, PLEASE FEEL FREE TO CONTACT ME AT
(H) 704-624-6304 OR (W) 704-289-5481. PLEASE NOTIFY
IF ANY FEE IS REQUIRED FOR PERMIT.
S CER Y,
KIMBERLY A. KOCIK

State of North Carolina
Department of Environment,
.^Health and Natural Resources
Division of Environmental Management
James 9. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
Kimberly Kocik
Rt. 1 Box 25
Marshville NC 28103
Dear Ms. Kocik:
�A&LT.WAA
IT 0
j
�EHN1�
November 29, 1993
Subject: Certified Operator Requirements
Singie family Treatment Systems
Permit No. WQ0003158
Union County
During February of this year, public hearings were held on proposed changes to modify the
operator certification rules. The proposed rules included a requirement that single-family
spray irrigation systems would be classified wastewater treatment systems, which would
require an annual inspection by a certified operator. The intent of the rule was to insure that
the systems are being properly operated and maintained.
During the public comment period, a significant amount of comments, statements and
additional information was submitted. As a result, the Water Pollution Control System
Operators Certification Commission amended the proposed rules. The rule, as adopted and
effective July 1, 1993, now requires single-family spray irrigation systems to be classified
only if they are permitted after July 1, 1993 or if upon inspection by the Division of
Environmental Management (DEM) it is found that the system is not being adequately
operated and maintained. Systems can be inspected by DEM during routine compliance
inspections, permit renewals, or complaint investigations. Once a system is classified, it
will be required to have at a minimum, an annual inspection by a certified operator.
It is important to remember that the spray irrigation permit is administered by the State of
North Carolina and that violations of the permit are enforceable by State laws. Although
your system will not be required to have a certified operator at this time, proper operation
and maintenance is needed for the system to function satisfactorily. In as much as each
system must be individually designed and sited, special maintenance requirements may
apply to a specific installation. The attached maintenance schedule should however be
applicable to most systems. The frequencies suggested are considered to be the minimum
necessary. More frequent attention may be needed for a specific system and may be
required by conditions of the permit.
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

Certified Operator Requirements
WQ000? 158
Page 2
In addition to being required by your permit, proper maintenance of your treatment system
is extremely important to the long term serviceability of your wastewater treatment system.
If proper maintenance is not given to the system, it will fail and will result in major
expenses for repairs.
We would encourage you to take the necessary action to insure that your system is
operating properly. If we can be of any assistance to you or if you have any questions or
comments, please call Dwight Lancaster of our staff at [phone].
:erely,
in.
Training a
cc: Mooresville Regional Office - Water Quality
Facilities Assessment Unit
Central Files
Unit

MINIMUM ROUTINE MAINTENANCE FOR
SINGLE-FAMILY SPRAY IRRIGATION SYSTEMS
Experien-e and study has shown that single-family direct discharge and spray irrigation
systems require routine maintenance in order to function satisfactorily. The following
system components, if applicable, should be checked for proper operation and repaired or
replaced as necessary by qualified personnel. All permit conditions should be followed at
all times.
System Component Frequency Maintenance
1. Septic Tank 6-12 months Check for leakage, blockage of
influent/effluent lines, structural
integrity, condition of baffle and tee,
condition of riser (should be
accessible from ground level), scum
and solids levels anti Pffl.tleni clarity.
3-4 years (or more Pump septage or sludge before the
frequently as required) solids depth exceeds 1/3 of the liquid
depth in the inlet (first) compartment.
2. Pump or Dosing Tanks Weekly Check for leakage, structural
integrity, condition of riser (should be
accessible from ground surface),
solids level and effluent clarity.
As Required Pump solids accumulations when
solids are removed from septic tank
and when the solids level is up to the
pump/siphon intake level.
Monthly Check for proper automatic
functioning, floats/pipes/control
valves/unions/anti-siphon hole in
proper working condition, control
panel/electrical connections properly
maintained and operational and alarms
for proper operation.
3. Buried Sand Filters Weekly Check for " ponding" of water over
the filter bed.
Divert surface water away from the
filters

4. Free Access/Above Weekly Check for "ponding" of wastewater
Ground Sand Filter on the filter surface and even
distribution of wastewater onto the
filter. Remove vegetation and debris
(leaves sticks, etc.) from filter
surface. Rake (for a depth of 2
inches) and smooth the filter surface.
As Needed Remove solids from filter surface and
replace sand.
5. Disinfection Weekly Check that the chlorinator is operating
properly (that the proper chlorine
tablets are being used and are in
contact with the wastewater).
6. Effluent Storage Weekly Check depth of solids and remove
solids as needed. Check for proper
operation of pumps and alarms.
7. Spray irrigation Weekly Check that there are no broken or
leaking lines and that spray heads are
functioning properly. There should be
no water run-off from the spray site.
Check that there in no interference of
the spray pattern due to vegetative
growth.
8. General At All Times Encourage practice of water
conservation to reduce wastewater
load on system. Do not permit entry
of grease, oil, paints, yard chemicals,
non -biodegradable material or any
unauthorized waste to system. Be
careful in choosing "friendly"
household cleaning products. Do not
add garbage disposals to systems
without checking with the permitting
agency as rrran% systems anrc not
i
designed to treat excess food waste.
Do not load system beyond permit
linuts. Addition of chemical or
biological additives has not been
demonstrated to be necessary to
maintain proper system function.

- State of North Carolina
Department of Environment, Health and Natural Resources
Division of Environmental Management RECEIVED
Non -Discharge Permit Application Form VypTERQUWVSEC-11QN
(THIS FORM MAY BE PHOTOCOPIED FOR USE AS AN ORIGINAL) DEB 2 6 1999
SPRAY IRRIGATION DISPOSAL SYSTEMS
I. GENERAL INFORMATION:
Non- Discharge Permitting
1. Applicant's name (please specify the name of the municipality, corporation, individual, etc.):
i 1W �p e ; , \ �. ,41 (� 4� r (V_ ► �_
2. Print Owners or Signing Official's name and title (the person who is legally responsible for the facility and its compliance):
I 1 -
tom._
3. Mailing address: (� Gv? U z �` l \
City: MG2. SS State: ,_i_% C_ Zip: Q'C I r"-7
Telephone Number. ( ":2C) y • 6, C,q. ( (-0 � a� C( rc—C� j
4. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters of flow acceptance, Operational Agreements, etc.):
4�1
5. Location of Spray Irrigation Facility (Street Address): S _� I I F1, n,+ (< _ IA V ,�
City: 0 11 \ `2 State: J_� L Zip: zLd� C;.�
6. Latitude:
; Longitude
of Spray Irrigation Facility
7. Contact person who can answer questions about application: S 4 g
Name: ,cc_ Telephone Number. ( �
8. Application Date: C?
9. Fee Submitted: $
[The permit processing fee should be as specified in 15A NCAC 2H .0205(c)(5).]
10. County(ies) where project is located: ( )C1 I --- I-4
II. PERMIT INFORMATION:
1. Application No. (will be completed by DEM):
2. Specify whether project is: new; renew modification
For renewals, complete only sections I, II, and applicant signature (on page 7). Submit only pages 1, 2, and 7 (original
and three copies of each). Engineer's signature not required for renewal without other modifications.
3. If this application is being submitted as a result of a renewal or modification to an existing permit, list the existing permit
number W (S C,O 0 3 1 c� � and its issue date %/ - -3n
4. Specify whether the applicant is
public or X mat
FORM: SIDS 06/94 Page 1 of 8

Name and Complete Address of Engineering Finn:
City:
Telephone Number:
Professional Engineer's Certification:
S tate:
attest that this application for
Zip:
has been reviewed by me and is accurate and complete to the best of my knowledge. I further attest that to the best of my knowledge
the proposed design has been prepared in accordance with the applicable regulations. Although certain portions of this submittal
package may have been developed by other professionals, inclusion of these materials under my signature and seal signifies that I have
reviewed this material and have judged it to be consistent with the proposed design.
North Carolina Professional Engineer's Seal, Signature, and Date:
Applicant's Certification:
I, ::L i /I M-er /(/��'i"/ /� , attest that this application for Lo Ce
Rio �J �C>o-z 15Sf
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of this
application are not completed and that if all required supporting information and attachments are not included, this application package
will be returned to me as incontnlete.
Signature
Date 2 1:2
THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DIVISION OF ENVIRONMENTAL MANAGEMENT
WATER QUALITY SECTION
PERMITS AND ENGINEERING UNIT
POST OFFICE BOX 29535
RALEIGH, NORTH CAROLINA 27626-0535
TELEPHONE NUMBER: [phone]
FAX NUMBER: [phone]
FORM: SIDS 06/94 Page 7 of 8

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
Ms. Kimberly A. Kocik
5311 Flint Ridge Church Road
Marshville, North Carolina 28103
Dear Ms. Kocik:
I ffl1.V;VA
qT 0
A&�j
IDEHNR
November 30, 1994
Subject: Permit No. WQ0003158
Two Single Family Residences
Wastewater Spray Irrigation Facility
Union County
In accordance with your application received September 19, 1994, we are forwarding herewith
Permit No. WQ0003158 dated November 30, 1994, to Kimberly A. Kocik for the continued operation of
the subject single family wastewater treatment and spray irrigation facilities. The subject system was
designed and originally permitted in 1984 (Permit No. 10269) to serve a single family at 450 gallons per
day. In 1985, a permit modification changed the flow to 750 gallons per day (to include a second single
family type dwelling) however, this modification did not change the capacity of the treatment facilities
designed to serve these two single family residences. The Division is assuming, although records are
incomplete, that this action was taken to accommodate a family member residing at this same location in
the second home. Please be advised that this system cannot accommodate an increase in flow if more than
one person resides in this second home and therefore, modification to the existing facilities would be
necessary prior to that occurring. A system failure may result if actual flows exceed design capacity of
your system. Please note, condition I.1 and other permit conditions in this permit that require action for
any type of system failure or any other problems resulting in the operation of this system.
This permit shall be effective from the date of issuance until October 31, 1999, and shall be subject
to the conditions and limitations as specified therein. Please pay particular attention to the monitoring
requirements in this permit. Failure to establish an adequate system for collecting and maintaining the
required operational information will result in future compliance problems. Issuance of this permit hereby
voids Permit No. WQ0003158 issued May 3, 1990.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the
right to request an adjudicatory hearing upon written request within thirty (30) days following receipt of
this permit. This request must be in the form of a written petition, conforming to Chapter 150B of the
North Carolina General Statutes, and filed with the Office of Administrative Hearings, P.O. Drawer
27447, Raleigh, NC 27611-7447. Unless such demands are made this permit shall be final and binding.
If you need additional information concerning this matter, please contact Mr. John Seymour at
[phone].
Sincerely, (�
`v • `7 Al. Prest Howard, Jr., P.E.
cc: Union County Health Department
Mooresville Regional Office, Water Quality
Facilities Assessment Unit
Training and Certification Unit
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

NORTH CAROLINA
f �
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT, HEALTH AND NATURAL RESOURCES
RALEIGH
SINGLE FAMILY SPRAY IRRIGATION PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Kimberly A. Kocik
Union County
FOR THE
continued operation of a 750 GPD spray irrigation wastewater treatment and disposal system consisting of
a 1,200 gallon baffled septic tank, a 1,200 gallon pump tank with a 52 gpm recirculation pump, a flow
splitter, a 150 ft2 recirculating sand filter, a tablet chlorinator, a 2,000 gallon chlorine contact
storage/pump tank,a 20 gpm self priming effluent dosing pump, a 6,969 ft2 spray irrigation area with three
(3) sprinklers, and all associated piping, valves, controls, meters, and appurtenances to serve the two
related single family residences (one being the Kimberly A. Kocik Residence and the other being her
mother's residence), with no discharge of wastes to the surface waters, pursuant to the application
received September 19, 1994, and in conformity with the project plan, specifications, and other supporting
data subsequently filed and approved by the Department of Environment, Health and Natural Resources
and considered a part of this permit.
This permit shall be effective from the date of issuance until October 31, 1999, and shall be subject
to the following specified conditions and limitations:
I. PERFORMANCE STANDARDS
1. The spray irrigation facilities shall be effectively maintained and operated at all times so that
there is no discharge to the surface waters, nor any contamination of ground waters which
will render them unsatisfactory for normal use. In the event that the facilities fail to
perform satisfactorily, including the creation of nuisance conditions or failure of the
irrigation area to adequately assimilate the wastewater, the Permittee shall take immediate
corrective actions including those actions that may be required by the Division of
Environmental Management, such as the construction of additional or replacement
wastewater treatment and disposal facilities.
2. The issuance of this permit shall not relieve the Permittee of the responsibility for damages
to surface or groundwaters resulting from the operation of this facility.
3. The sand media of the sand filter must comply with the Division's sand specifications. The
engineer's certification will serve as evidence that these specifications have been met.
i

4. The residuals generated from these treatment facilities must be disposed in accordance with
General Statute 143-215.1 and in a manner approved by the North Carolina Division of
Environmental Management.
5. Diversion or bypassing of the untreated wastewater from the treatment facilities is
prohibited.
6. The following buffers shall be maintained:
a) 400 feet between wetted area and any residence or places of public assembly under
separate ownership,
b) 150 feet between wetted area and property lines,
c) 100 feet between wetted area and wells,
d) 100 feet between wetted area and drainageways or surface water bodies,
e) 50 feet between wetted area and public right of ways,
f) 100 feet between treatment/storage units and any wells, and
g) 50 feet between treatment units and property lines.
Some of the buffers specified above may not have been included in previous permits for
this waste treatment and disposal system. These buffers are not intended to prohibit or
prevent modifications, which are required by the Division, to improve performance of the
existing treatment facility. These buffers do, however, apply to modifications of the
treatment and disposal facilities which are for the purpose of increasing the flow that is
tributary to the facility. These buffers do apply to any expansion or modification of the
spray irrigation areas and apply in instances in which the sale of property would cause any
of the buffers now complied with, for the treatment and disposal facilities, to be violated.
The applicant is advised that any modifications to the existing facilities will require a permit
modification.
II. OPERATION AND MAINTENANCE REQUIREMENTS
The facilities shall be properly maintained and operated at all times.
2. A suitable vegetative cover of the spray field shall be maintained.
3. Irrigation shall not be performed during inclement weather or when the ground is in a
condition that will cause runoff.
4. Adequate measures shall be taken to prevent wastewater runoff from the spray field.
5. The application rate shall not exceed 39 inches per acre per year at an instantaneous
application rate that does not allow any runoff.
6. The facilities shall be effectively maintained and operated as a non -discharge system to
prevent the discharge of any wastewater resulting from the operation of this facility.
7. No type of wastewater other than that from the two single family Kocik Residences shall be
sprayed onto the irrigation area.
8. In the event that the sprinkler heads fail to achieve the design diameter, to cover all the
designed wetted area, due to obstructions, the obstructions shall be removed or the
sprinkler heads shall be raised and supported to such height that the design diameter is
achieved.
9. No traffic or equipment shall be allowed on the disposal area except while installation
occurs or while normal maintenance is being performed.
2

10. The Permittee is responsible for the operation and maintenance of the entire treatment and
disposal system including, but not limited to, the following items:
a. The septic tank shall be checked annually and pumped out as needed.
b. The tablet chlorinator shall be checked every week. Tablets shall be added so as to
provide proper chlorination.
c. The storage, pump, and alarm systems shall be inspected weekly. The scum layer shall
be removed at the same interval as the septic tank is cleaned out.
d. The spray system shall be inspected weekly to make certain of the sprayers proper
operation, that the vegetative growth allows a proper spray pattern, that the soil is
assimilating the disposed treated wastewater with no surface runoff, and that no
objectionable odors are being generated.
III. MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring deemed necessary by the Division of Environmental Management to insure
surface and ground water protection will be established and an acceptable sampling
reporting schedule shall be followed.
2. The Permittee shall maintain records of all maintenance performed on the system and
irrigation area, as required in Condition II.10 for a minimum of five years. This
information shall be provided to the Division of Environmental Management upon request.
3. Noncompliance Notification:
The Permittee shall report by telephone to the Mooresville Regional Office, telephone
=' number 704/ 663-1699 as soon as possible, but in no case more than 24 hours or on the
next working day following the occurrence or first knowledge of the occurrence of any of
the following:
a. Any process unit failure, due to known or unknown reasons, that renders the facility
incapable of adequate wastewater treatment, such as mechanical or electrical failures of
pumps, spray heads, etc.; or
b. Any failure of a pumping station or treatment facility resulting in a by-pass directly to
receiving waters without treatment of all or any portion of the influent to such station or
facility.
Persons reporting such occurrences by telephone shall also file a written report in letter
form within 15 days following first knowledge of the occurrence. This report must outline
the actions taken or proposed to be taken to ensure that the problem does not recur.
IV. INSPECTIONS
1. Adequate inspection, maintenance, and cleaning shall be provided by the Permittee to
insure proper operation of the subject facilities.
2. Any duly authorized officer, employee, or representative of the Division of Environmental
Management may, upon presentation of credentials, enter and inspect any property,
premises or place on or related to the disposal site or facility at any reasonable time for the
purpose of determining compliance with this permit, may inspect or copy any records that
must be maintained under the terms and conditions of this permit, and may obtain samples
of groundwater, surface water, or leachate.
3

V . GENERAL CONDITIONS
1. This permit shall become voidable unless the facilities are constructed in accordance with
the conditions of this permit, the approved plans and specifications, and other supporting
data.
2. This permit is effective only with respect to the nature and volume of wastes described in
the application and other supporting data.
3. This permit is not transferable. In the event there is a desire for the facilities to change
ownership, or there is a name change of the Permittee, a formal permit request must be
submitted to the Division of Environmental Management accompanied by an application
fee, documentation from the parties involved, and other supporting materials as may be
appropriate. The approval of this request will be considered on its merits and may or may
not be approved.
4. Upon the availability of a municipal or regional sewerage collection system, the subject
wastewater treatment facilities shall be abandoned and all wastewater discharged into the
municipal or regional sewerage system.
5. The spray irrigation field shall be fenced with at least a two strand wire fence.
6. Failure to abide by the conditions and limitations contained in this permit may subject the
Permittee to an enforcement action by the Division of Environmental Management in
accordance with North Carolina General Statute 143-215.6(a) to 143-215.6(c).
7. The issuance of this permit does not preclude the Permittee from complying with any and
all statutes, rules, regulations, or ordinances which may be imposed by other government
agencies (local, state, and federal) which have jurisdiction.
8. This permit may be revoked if the Permittee fails to abide by the conditions of the
"Operation and Maintenance Agreement" previously signed by the Permittee.
9. A set of approved plans and specifications for the subject project must be retained by the
Permittee for the life of the project, if available upon issuance of this permit.
10. The Permittee, at least six (6) months prior to the expiration of this permit, shall request its
extension. Upon receipt of the request, the Commission will review the adequacy of the
facilities described therein, and if warranted, will extend the Permit for such period of time
and under such conditions and limitations as it may deem appropriate.
11. Issuance of this permit hereby voids Permit No. WQ0003158 issued May 3, 1990.
Permit issued this the 30th day of November, 1994
NORTH CAROLINA ENVIRONMENTAL MANAQEMENT COMMISSION
A. Preston 4oward, Jr., P. , Director
Division of Unvironmental anagement
By Authority of the Environmental Management Commission
Permit Number W00003158
4

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OPERATION AND MAINTENANCE AGREEMENT FOR THE
DIVISION OF ENVIRONMENTAL MANAGEMENT
Ms. Kimberly A. Kocik
5311 Flint Ridge Church Road
Marshville, North Carolina 28103
Single Family Residence Wastewater Treatment System
Final Disposal by Spray Irrigation
Permit No. WQ0003158
Union County
I agree to operate and maintain the wastewater treatment system as follows:
1. The Permittee is responsible for the operation and maintenance of the entire treatment and
disposal system including, but not limited to, the following items:
a. The septic tank shall be checked every six (6) months and pumped out as required.
b. The tablet chlorinator shall be checked every week until the actual usage rate is
established and thence on a monthly basis. Tablets shall be added so as to provide
proper chlorination.
C. The storage system, pump system, and alarm system shall be inspected monthly.
The scum layer shall be removed at the same interval as the septic tank is cleaned
out.
d. The spray system shall be inspected monthly to make certain of the sprayers proper
operation, that the vegetative growth allows proper spray patterns, that the soil is
absorbing the disposed treated wastewater with no surface runoff, and that no
objectionable odors are being generated.
2. Failure of the Perm ittee to properly operate this system is subject to a penalty up to $10,000
per day.
3. Failure to meet permit conditions or violation of the State's surface or groundwater
regulations will require cessation of occupancy of the residence.
I understand that failure to comply with these conditions along with the permit conditions may result in
voiding the permit.
i < <%2�
Signature: Date:
Kimberly A o
Not:ary Seal
i
Notary Signature: Date:
.3o��1��

SOC Priority Project: Yes No X
If Yes, SOC No.:
To: Permits and Engineering Unit
Water Quality Section
Attention: John Seymour
Date: October 11, 1994
NON -DISCHARGE STAFF REPORT AND RECOMMENDATION
County: Union
Permit No. WQ0003158
PART I - GENERAL INFORMATION
1. Facility and Address: Kocik SFR Spray Irrigation
Kimberly Kocik
5311 Flint Ridge Church Road
Marshville, North Carolina 28103
2. Date of Investigation: October 11, 1994
3. Report Prepared by: Kim H. Colson, Environmental Engineer I
4. Persons Contacted and Telephone Number: Kimberly Kocik, (704)
624-6304
5. Directions to Site: From the intersection of SR 1005
(Landsford Road) and SR 1991 (Flint Ridge Church Road)
southeast of the Town of Marshville, travel east on SR 1991
approximately 0.1 mile. The site is located on the left side
of the road.
6. Size (land available for expansion and upgrading): There is
adequate land available for minor upgrading and expansion.
7. Topography (relationship to 100 year flood plain included):
Flat slopes; the site is not located within the 100 year
flood plain.
Attach a U.S.G.S. map extract and indicate facility site.
U.S.G.S. Quad No.: H17NE U.S.G.S. Quad Name: Marshville, NC
Latitude: 340 56' 21" Longitude: 800 20' 40"
8. Any buffer conflicts with location of nearest dwelling and
water supply well? Yes No X If Yes, explain:
9. Watershed Stream Basin Information: Barkers Branch
a. Watershed Classification: WS-V
b. River Basin and Subbasin No.: Yadkin - Pee Dee 030714
C. Distance to surface water from disposal system: Greater
than 500 ft.

c.
- DESCRIPTION OF WASTES AND TREATMENT WORKS
Volume : 0.00075 MGD (design capacity)
Residuals: N/A
Types and quantities of industrial wastewater: N/A
Pretreatment Program (POTWs only): N/A
2. Treatment Facilities
a. Current permitted capacity of the facility: 0.00075 MGD
b. Actual treatment capacity of the current facility (design
volume): 0.00075 MGD
C. Please provide a description of existing or substantially
constructed wastewater treatment facilities: The
existing WWT facilities consist of a 1,200 gal. septic
tank, 1,200 gal. pump tank, recirculating sand filter,
tablet chlorinator, 2,000 gal. chlorine contact/storage
tank, and a 0.16 acre spray irrigation field.
d. Please provide a description of proposed wastewater
treatment facilities: N/A
3. Residuals handling and utilization/disposal scheme:
a. If Residuals are being land applied, please specify DEM
Permit No: N/A
Residual Contractor: N/A
Telephone No.: N/A
b. Residuals stabilization: PSRP PFRP Other
C. Landfill: N/A
d. Other disposal/utilization scheme (Specify): Septage is
pumped by a private septage pumping company.
4. Treatment plant classification (attach completed rating
sheet): SFR Spray Irrigation - No rating.
5. SIC Code(s): 9999
Wastewater Code(s)
Primary: 04 Secondary:
Main Treatment Unit Code: 45007
PART III - OTHER PERTINENT INFORMATION
1. Is this facility being constructed with Construction Grant
funds (municipals only)? N/A
2. Special monitoring requests: N/A

e Three
3. Important SOC, JOC or Compliance Schedule dates (Please
indicate): N/A
4. Air quality and/or groundwater concerns or hazardous materials
utilized at this facility that may impact water quality, air
quality, or groundwater: There are no known air quality,
groundwater, or hazardous materials concerns.
5. Other Special Items: N/A
PART IV — EVALUATION AND RECOMMENDATIONS
The permittee, Kimberly Kocik, has applied for permit renewal.
The WWT facility serves both Ms. Kocik's and her mother's
residences.
The spray irrigation facility appears to be adequately
maintained and functioning properly. It is recommended that the
permit be renewed as requested.
Signature of Report Preparer
Water Quality jWgional Supervisor
Date-T

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ALE FOR CLASSIFICATION OF WATER POLLUTION CONTROL SYSTEMS
of Facility: Vc,%t, ST;Z S?IA-/ 1.12RiCAi1oN
ner or Contact Person:
Mailing Address: 5A11 rLtrtT R obi Ctk„TZcN 2aP0>
County: Telephone: -4-c-A G2y - h3oti
Present Classification: New Facility Existing Facility ✓
NPDES Per. No. NC00 Nondisc. Per. No.WQ 2nai13L.�$ Health Dept.Per No.
Rated by: V tM Cot_sota /MRo Telephone: -+oy-663- 165q Date:
Reviewed by: Health Dept. Telephone:
Regional Office Telephone:
Central Office Telephone:
•.
SubsurfaceChock Classification(s): •_
tion X Land Application
Wastewater Classification: (Circle • -Total
-------------------------------------------------------------
i : ►/ R E. AND RR . /7D CONIM EClLJFMe4TYMK>1 ARE AN INTEGRAL:1 OF ► S O 1 O %iSl I • Q
!err . :� �:_71 is :1..=►1 .!: 1. i.:i�� ! ! _ i..:l.!► �JI. :►. yi=... �er:.yl:.. !► ! :11. :N•
.►• Iia .11;il J.VA 109..7 .: a 2..J 2:A.4a ks �. : 1.�•
--------------------------
SUBSURFACE CLASSIFICATION
(check all units that apply)
1 septic tanks
2. pump tanks
3. siphon or pump -dosing systems
4. __ _ sand filters
5. grease lrapAnterceptor
6. _oil/water separators
7 _gravity subsurface treatment and disposal:
8. pressure subsurface treatment and disposal
SPRAY FFdGATiON CLASSIFIcATION
(check all units that apply)
i.
preliminary treatment (definition no. 32 )
2.
lagoons
3.
septic tanks
4.
pump tanks
5.
pumps
6-sand
filters
7-grease
trapinterceptor
8.
oi7/water sepandors
9
disinfection
10.
chemical addition for nutrient/algae control
11. spray irrigation of wastewater
In addition to the above classifications, pretreatment of wastewater In excess of these components shrill
be rated using the point rating system and will require an operator with an appropriate dual certification.
LAND APPLICATi0"ESIDUALS CLASSIFICATION (Applies only to permit holder)
1. Land application of biosolids, residuals or contaminated soils on a designated Me.
-------------------------------------------------------------
WASTEWATER TREATMENT FACILITY CLASSIFICATION
The lotlowing systems shalt be assigned a Class I classification, YJ31g-,s the flow is or a significant quantity or the technology is unusually
complex, to require conskWalion by the Commission on a case -by -case basis: (Check I Appropriate)
1. OiVwaler Separator Systems consisting only of physical separation, pumps and disposal:
2 Septic TanWSand Fitter Systems consisting onty of septic tanks, dosing apparatus, pumps,sand fiflers, disinfection
and dived discharge;
3. Lagoon Systems consisting only of pretiminary treatment, lagoons, pumps, disinfection, necessary chemical treatment for
algae or nutrient control, and dired discharge;
4. _ Closed -bop Recycle Systems;
3.Groundwater Remediation Systems consisting only of oNwaler separators, pumps, air -stripping, carbon adsorption, disinfection
and disposal;
6. Aquaculture operations with discharge to surface waders:
7-Water Plant sludge handling and back -wash water treatment;
8. Seafood processing consisting of screening and disposal.
9. Singte-family discharging systems, with the exception of Aerobic Treatment Units, wM be classified i permitted after July 1,
1993 or I upon inspediont by the Division, I Is found that the system is not being adequately operated or maintained. Such
systems will be notified of the cfassllication or reclassification by the Commission, in writing.

The following scale is used for rating wastewater treatment facilities: (circle
(3)
REM
Industrial Prstromment Unks or Indusutal Prstrsatmwx Program (see detinhbn No. 33)...................................................4'
DESIGN FLOW OF PLANT IN gpd (rot applicable to non -contaminated cooing waters, sludge handing facilhoa for
water purification plants, totally closed cycle syttems(ses definition No. I ) and facilities cortoWing only of hem
(4xd) or hems (4)(d) and (11)(d)j
0 - 20,000................................................................................................................................................1
20.001 - 50.000 ............................................... .......................................................................................2
60,001 100,000............................................................ ........................................................................3
100,001 - 250,000...................................................................................................................................4
250,001 - 500.000..................................................................................................................................5
500,001 - i.000.000................................................. ................................ .................. ............................
...........................................................................10
.
1,000,o0i - 2,000,000.......................... ......................
2.000.001 (and up) rate 1 point additional for each 200,000 gpd capacky up to a muimum of .._._._.......30
Design Flow (gpd)
PRELIMINARY UNrfS/PROCESSES (see definition No.32)
(a) Bar Screens ...............................................................................................................................................1
(b)
or
Mechanical Screens, Static Screens or Commlrwting Devices......_._._....._._._._...._._.... ._..........................
1
(c)
... .....................................................................................................
GrGrit Removal.........................................
(d)
or
M&chartfcal or Aerated Grit Rornoval.............................................................................................................
1
(e)
Flow Measuring DWAM................................................................................................................................
(f)
or
instrumented Flow Measurement................................................................................................................
...................2
(g)
Preaeration............................................................................................................................
2
(h)
influent Flow Equalization..........................................................................................................................
........................2
(i)
Grease or Oil Separators - Gravity ..._..._........._........._..._..._...._..._........._........._
y......_..._. .9
Mechanical ............................. .........................................
E
DlosoN.............................
ed Air Flotation ..........................
())
...................
Prechbrination ................................................5
(4) pgIMAR1'TREA7MENT
LNRSrPACCESSES
(a)
Septic Tank (sea definition No. 43)...._.................................... _.........................._................
....................................5
(b)
Imhoff Tank ......... _...................................... ..........................................................................
(c)
(d)
Primary Clarifiers........................................................................(.... ...................................................
Settling Ponds or Settling Tanb for inorg"c Norrtoxk Materials &tu handli lacllhwn for water
recreational activities such as gem
purification plans, sand, gravel. atone, and other mining operations except
.2
orgold mining)........................................._._.........................................................................................
(5) SECONDARY
(a)
TREATMENT
Carbonaceous Stage
Aeratlon-Mgh Purftr Oxygen System- ............................... ........... __........
.......10
_.........................
(I)
Diffused Air Systsm.......................................................................................
Machanical Air System (fixed, floating or rotor)....._...__..._.-----._..._..._..._..._..._..._...E
1 0
3
Separate Sludge Reaerstion........................... .... ............................................................
(il) Trldtthg inter
HighRate ............ .............. ...... ..................... ................ _...............
.......................5
StandardRate................................_................................. ............ ...._..._...............
PackedTower................................................................................................................5
fill) Bobgical Aerated Finer or Aerated Biological Flher------------------------------------- 1 0
10
(N) Aerated Lagoons ................ _........................................................................................
10
(v) Rotating Biological Corttaaons......... ............ ._....... ........................ .............................
.... ..2
(VI) Sand Filters -intermittent biological..................................................... .......
.... .........
"'3
Recirculating biological .......................... .......................................................................
n Lagoons......._» ..................... ..
(vR) SiabfRzatb..
.....................5
(vRl) oarf'sr.........................................................................................................................
(U) Single stage systsm for combined carboraceous removal d BOD and nitrogenous removal by
Items
Ntrtrr&tan (&se definition No. 12)(Points for this kern have to be in addition to
(5)(a)(1) through (5)(a)(vlll),
udttzing the extended &Oration process (see deftr pion No.3a) .. ».. ..........................2
vialzing other than the extended &Oration process ....._.»._.... ..» ....».....__..._...._._...5
(x) Nutrient adcfAiors to enhancs DOD removal ..... ....... ..._......... ............. ........
....................
(xl) Biological Cuhurs ('Super Bugs')addhb.. n..............................».....................................5
(b)
Nitrogenous Stage
(I) Aeration - High Purity Oxygen System._....�..�..._.._._._».._...._....»...._...._...._...._..20
10
DkfusedAir System ................. ..................... .......-...-............._...........
Mechanical Air System (fixed, floating or rotor)_...._..._..._.,._..._..._..._..._..._..._..._..._..
........ .............
E
.7
S&parats Studge Rs "Ion ....................... _. ........ ......... .............
....................
(II) Tricicling Fitter -High Rate. .................._......._................................-._........
5......._...............
Standard Rate ................ _—--------- _.»..------- ....... ..................................._.
....................
Packed Tower .......... .. r_...
(III) Biological Aerated Finer or Aerated Biobgicaf FNfsr----._-.__-.-----.--.__._
».....................1
M-------. .1 0
(IV) Rotating Bbbgkal COMACIOrs...................... ......_................... _...............
(v) Sand Flttar - hlermlttert bbbgkal........ _.......................... ...... ...-.»_._.........._..............
»...................3
Rociculating biological ..- ----------------- ------------ .. __.. »...
..... _............
(vl) clarfir.................... ...--.»
(5) TERTIARY OR ADVANCED TREATMENT LNiT50P OCESSES
(a)
Activated Carbon Beds -
5
without carbon regeneratIon.—
with carbon rageneratbn.........._._...............»._........._.............
(b)
Powdered or Granular Activated Carbon Feed•
_ .
without carbon regeneration.._ ....» .._ _ » . _ _ _
i 5
withcarbon regeneration ....................-------------- ---------- --------- ---..
.. _. ..10
....... ._. »....
(d)
Denhrtrrcation Process.......--.-...._......... ._�_»....._». .»..._._._. ... ....
(0)
Elecirodlatysls...___..»._.................._.._._.__...._._.....r....._.._........._..._.._._..r...»_.......
......... ...... ..._........................5
(f)
Foam Separation. ---- ......»._...--------------- .._..............._..............._......
ionExcha _................._......»...._......_.._..._.
Treated Effluent (sae de(Wtlon No. 22b) (not appllcabls for sand. gravel,
stone
Land Appilwbn of
and other simRw mining operations) by high rats itfNtration _._..._..._..._..._..._..._..._..._...._..._...r.._..t
(i)
())
Microscreenz ............................................... -........................................................................... 20
Phosphorous Removal by Biological Proan:ses (See definition No. 26).......... .........................................._ .... _......... _... _ . 2
(k)
Polishing Ponds . without aeration ............... _.................................. ...._...........................
........
....... ........
.5with
sention.... ....... ........ . ......................................._..............

(a)
(9)
(10)
f-tRt rest auvn -
diffusedor mechanical........................................................................................................2
ReverseOsmosis........................................................................................................................................5
Sand or Mixed -Media Filters - low rate ........... _....... ................... _.................... _........................................... 2
highrate......................................................................5
(o)
Treatment processes for removal o1 metal or cyanide...................................................................................1 5
(p)
treatment processes for rwnoval of toxic materials other than metal or cyanide....._.»...-_...»......_........__....1 5
SURGETREATi
ENT
(a)
Sludge Digestion Tank - Heated (anaerobic) ....................... ................ ................. -......._......................10
...................................................................................................................................5
Aerobic ..........
Unheated(anaeroblc)...............................................................................................................................3
(b)
Sludge Stabilization (ct»rnlcal or thermal)...................................................................................................5
(c)
Sludge Drying Beds - Gravity......................................................................................................................2
VacuumAssisted......................................................................................................................................5
(d)
Sludge Eiutriatfon.....................................................................................................................................5
(a)
Sludge Conditioner (chemical or thermal) ........ _..........................................................................................5
(1)
Sludge Thickener (gravity).........................................................................................................................5
(0)
Dissolved Air Flotation Unit (not applicable to a unh rated as(3)(i)).............................................................a
(h)
Sludge Gas Utilization (including gas storage) ........ ............................... .................................................2
(1)
Sludge Holding Tank - Aerated .......................................... »........................................................................
Non-as rat ed............................................................................................................................................. 2
([)
Sludge incinerator (not Including activated carbon regeneration)................................................................10
(k)
Vacuum Flher, Centrifuge, or Rher Press or other similar dewatering devices .._.... __...._....... _........................1 0
RESIDUALS UTILIZATIOWDISPOSAL (mduding incinerated ash)
(a)
Lagoons..................................................................................................................................................2
(b)
Land Application (surface and subsurface) (see definition 22a)
by contracting to a land application operator or landfill operator who holds the land application permit
orlandii pom-it........................................................................................................................................2
(c)
Dedicated Landfill(burial) by the perminee of the wastewater treatment facility..._ ...................._ ....................
D6WECTI
(a)
N
Chlorination.............................................................................................................................................5
(b)
Dechlorination.........................................................................................................................................5
(c)
Ozone......................................................................................................................................................5
(d)
Radiation .......................... .............................................................................................5
CHEMICAL ADDITION SYSTEM(S) ( see definition No. g) [not applicable to chemical addhio s rated as Rom (3)0),
(5)(a)(xi).
(6)(a). (6)(b). (7)(b). (7)(e). (go). (0)(b) or (G)(c) 5 points each:
List....................................................................................................................................5
................................................................................................................................... 5
................................................................................................................................... 5
.............................. -............................................................................... ........................
(1 1) MSCELLANEQJS L"I"SIPROCESSES
(a) Holding Ponds, Holding Tanks or Settling Ponds for Organic or Toxic Materials inducing wastes from mining
operations containing nhrogen or phosphorus compounds in amounts signlficartly greater than is common
fordomestic wastewater...........................................................................................................................A
(b) Effluent Flow Equal"tlon (rot applicable to storage basins which are Inherent in land application systams).....2
(c) Stage Discharge (not applicable to storage basin; Inherent In Wand application systems) .._.-----.--.---_»---5
(d) Pumps............................................-.......................................................................................................3
(e) Stand -By Power Supply ..................................................... ................ .................................. ....................
3
(f ) Thermal Pollution Control Device ......................................................... ......................................................
TOTAL POINTS .......................... ............... - ..............................
.
CLASSFICATiCN
CisI .................................................. .......... ............................................. 6.25 Points
Class11 ..................................................................................................»-...26.50 Points
Cities11........................................................................................................61-65 Points
passN......................................................... ... _........................ -........ .... 66-Up Points
Facilities having a rating of one through bur points, indusiw, do not require a certified operator.
Facilftles having an activated sludge process wll be assigned a minirnum dasaMialior of Class IL
F&dlftles having treatmert processes for the removal of metal or cyanide will be assigned a minimum dtssfrication of Class II.
Facahies having treatment processes for the blobgtoat removal of phosphorus will be assigned a minimum classh'icatfon of Class III.
-------------------------------------------------------------
A004 DEFNITCM
The following definitions shall apply throughout this Subchapter.
(1) Activated Carton Beds. A physical/chemical method for reducing soluble organic material from wastewater effluent; The column -type beds used In this
method will have a flow rate varying from two to eight gallon per minute per square foot and may be either upflow or downflow carbon beds. Carbon may or
may not be regenerated on the wastewater treatment plan she;
(2) Aerated Lagoons. A basin in which all sofdc we maintained In suspension and by which biological oxidation or organic matter is reduced through ariftialy
amelerafed transfer of oxygen on a Now -though basis;
(3) Aeration. A process of bringing about Intimate contact between air or high purity oxygen In a Illiquid by spraying, aghation or dnusiongU) Extended
Aeration. An activated sludge process utilizing a minimum hydraulic detention tame of 1E tours.
(4) Agricuhuraly managed she. Any she on which a crop Is produced, ramped, and harvested (Crop Includes grasses. grains, trees, ate.);
(5) Air Stripping. A process by which the ammonium Ion Is Nest converted to dissolved ammonia (pH adjustment) with the ammonla then released to the
atmosphere by physical means; or other almilar processes which remove petroleum products such as bertzerte, toluene, and xpi!irw;
(6) Carbon Regeneration. The regeneration of exhausted carbon by the use of a furnace to provide extremely nigh temperatures which volatilize and oxidize the
absorbed impurities;
(7) Carbonaceous Stage. A stage of wastewater treatmenl designed to achieve %econdary' effluertt inks;
(8) Convlluge. A mechanical owice in which cerruffugal force Is used to separate sonde from flquids or to separate Squids of dRferwt donsY.as;
(9) Chemical A6dhion Systems- The addition of chomical(s) to wastewater at an apptirstlon point for purposes of ktproving sotrda removal, pH ad)usimem,
alkalinity control, etc.; the capabiliy to experiment with dfferent chemicals and dtfereht apprlkatlon points to achieve a epecft result will be considered one
system; the capability to add cherltcal(s) to dual units wO be rated as one system; capability to add a chemical at a different application points for different
purposes wNf result In the systems being rated as separate systems;
(10) Chemical Sludge Con&loriing. The addition of a chemical compound such as f1mo. ferric chloride, or a polymer to wet sludge to coalesce the mass prior to
Its apprication to a dewatering device•
(11) Closed Cycle Systems. Use of holding ponds or folding tanks for oontatnmem of wastewater containing inorganic, non -toxic materials from sand, gravel,
crushed dons or other simnar operations. Such systems shah carry a maximum of two points regaeass of pumping factmiss or any other appurtenances;
(12) Combined Removal of Carbonaceous BOO and Nitrogenous Removal by Nhrtfkation- A single stage system requlred to achieve pormh effluent Timhs on SOD
and ammonia Mrogen whNn the game biological reactor,
(13) Dechlorinallon. The paniai or oomplwe reduction of residual chlorine In a liquid by arty chemical or physical process;
(14) Dentlrtfication Process. The conversion of Mrate-nitrogen to nitrogen gas;

(15) Electrodaysls. Process for removing ionized safts from water through the use of Ion -selective ion -exchange mwmbrares;
(16) Fitter Press. A process operated mechanically for partially dowatering sludge:
(17) Foam Separation. The planned frothing of wastewater or wastewater effluent as a means of removing excessive amount of dotergert
the Introduction of air In the form of line bubalso called foam fractionation;
(18) Grit Removal. The process of removing grit and other heavy mineral manor from wastewater;
(19) Imhotl Tanis. A deep two story wastewater tank cons sting of an upper sedimentation chamber and a lower sludge digestion chamber.
bles;
(20) Instrumented Flow Measurement. A device which Indicates and records rate of flow;
(21) ion Exchange. A chemical process In which lots from two different molecules are exchanged:
(22) Land application:
(a) Sludge Disposal. A final sludge disposal method by which wet sludge may be applied to land either by spraying on the surface or by subsurface inject on
p.s., chisel plow); (not applicable for types of sludge described In (11) of this Rule);
(b) Treated Effluent. The process of spraying treated wastewater onto a land area or otter methods of application of wastewater pro a land area as a
means of final disposal or treatment;
(23) Microscreen. A low speed, continuously back -washed, rotating drum filter operating under gravity conditions as a polishing method for removing
suspended wilds from effluent;
(24) Nitrification Procosa. The biochemical conversion of unoxidrzod nitrogen (ammonia and organic nitrogen) to oxidized nitrogen (usually nitrate);
(25) Nitrogenous Stage. A separate stage of wastewater treatment designed for the specific purpose of converting ammonia nitrogen to nitrate nitrogen;
(26) Phosphate Removal, Biological. The removal of phosphorus from wastewater by an oxic/anoxic process designed to enhance luxury uptake of phosphorus
by the microorganisms;
(27) Polishing Pond. A holding pond following secondary troalmert with sufficient detention time to allow settling of finey, suspended solids;
(28) Post Aeration. Aeration following conventional secondary treatment units to Increase effluent D.O. or for any other purpose;
(29) Post Aeration. (Cascade) A polishing method by which dissolved oxygen is added to the effluent by a nonmochanical, gravity means of flowing down a
series of steps or weirs; The flow occurring across the steps or weirs moves in a fairly thin layer and the operation of the cascade requires no operator
adjustment; thus, zero points are assigned even though this is an essential step to meeting the limits of the discharge permit;
(30) Powdered to Granular ActNated Carbon Food. A biophysical carbon process that utilizes biological activity and organic absorption by using powdered or
granular activated carbon; Virgin or regenerated carbon Is food controlled into the system;
(31) Preaeration. A tank constructed to provide aeration prior to primary treatment;
(32) Preliminary Unths. Unit operations in the tredmenl process, such as screening and comminution, that prepare the liquor for subsequent major operations;
(33) Industrial Pretreatment.
(a) Pre-treatment Unit, Industrial. The conditioning of a waste at its sourcebefore discharge, to remove or to neutralize substances Injurious to sewers and
treatment processes or to effect a partial reduction in bad on the treatment process which is operated by the "me governing body as the wastewater
treatment plant being rated;
b) Pre-treatment Program, Industrial - must be a State or EPA required program to receive points on the rating sheet;
(34) Primary Ctarffiens. The first settling tanks through which wastewater is passed in a treatmert works for the purpose of removing settleable and suspended
solids and BOD which is associated with the solids;
(35) Pumps. All Influent, effluent and in -plant pumps;
(36) Radiation. Disinfection or sterilization process utilizing devices emitting ultraviolet or gamma rays;
(37) Reverse Osmosis. A insatrnett process in which a heavy contaminated liquid is pressurized through a membrane forming nary pure liquid free from
suspended solids;
(38) Rotating Biological Contractors. A fixed biological growth process In which wastewater flows through tanks In which a series of partlafy submerged circular
surfaces are rotated;
(39) Sand Filters:
(a) Intamninent Biological. Filtration of effluent following septic tanks, Lagoons, or some other treatment process In which further biodecomposltbn is
expected to produce desired effluents; Hydraulic loading rates on these flhom are computed in gpdiac and have a resulting low gpmhf (less than one);
b) Recirculating biological - the sa-w type of sand fitter as defined in Subparagraph (39) (a) of this Rule with the added capability to recycle effluent back
through the sand filter,
(40) Sand or Mixed -Media Filters. A polishing process by which effluent limits are achieved through a further reduction of suspended Solids;
(a) low raw — gravity, hydraulicaly, loaded fitter with loading rates in the one to three gprr✓d range;
(b) high rate — a pressure, hydraulically boded fitter with Loading rates In the five gprtVd range; At any, rate, the loading rate will exceed three gprNd;
(41) Secondary Ctartflers. A tank which follows the biological unit of treatment plant and which has the purpose of removing sludges associated with the
biological treatment units;
(42) Separate Sludge Reiteration. A pan of the contact stabilization process where the activated sludge is transferred to a tank and aerated before returning it
to the contact basin;
(43) Septic Tank A single -story settling tank in which settled sludge Is In contact with the wastewater flowing through the tank; shell not be applicable for
septic tank systems serving single family residences having capacty of 2,000 gallons or less which discharge to a nitrification field;
(44) Sludge Digestion. The process by which organic or volatile matter and sludge is gasified. liquefied mineralized or convened into more stable organic manor
through the activity of living organisms, which Includes aerated holding tanks;
(45) Sludge Drying Beds. An area comprising natural or artificial layers of porous materials upon which digested sewage sludge Is dried by drainage and
evaporation;
(46) Sludge Elutriation. A process of sludge conditioning In whlch certain constituents are mmoved by successive washings with hash water or pLart[ effluent:
(47) Sludge Gas Utiltzdlon The process of using sewage gas for the purpose of heati.tp buildings, drtvkV engines, etc.;
(48) Sludge Holding Tank (Aerated and Nonasrated). A tank utilized for small wastewater treatment plants not containing a digester In which sludge may be
kept fresh, and wpematart withdrawn prior to a drying method (I.e. sludge drying beds); This may be done by adding a small amount of air simply to keep the
sludge fresh, but not necessarily an amount that would be required to achieve stabilization of organic matter. A ronaerated tank would simply be used to
decant sludge prior to dewatering and would not allow long periods (several days of detention) without resulting odor problems;
(49) Sludge Incinerators. A fumace designed to bum sludge and to remove an moisture and combuslbie materials and reduce the sludge to a sterile ash;
(50) Sludge Stabilization (Chemical or Thermal} A process to make treated sludge less odorous and porescble, and to reduce the pathogenic organism
conioni This may be done by pH adjustment, chlodne dosing, or by head treatment;
(51) Sludge Thickener. A typo of sedimentation tank in which the sludge Is permitted to settle and thicken through agitation and gravity:
(52) Stabilization Lagoon. A type of oxidation Lagoon In which biological oxidation of organic matter is effected by natural trarsler of oxygen to the water from
ale (not a polishing pond);
(53) Stand -ter Power Supply. On site or portable electrical generating equipment;
(54) Static Screens. A stationary screen designed to remove solids, Including non-bbdegradabie particulate (tbatable solids, suspended solids and SOD
reduction) from municipal and industrial wastewater treatment systems;
(55) Tertlary Treatment A stage of treatment following secondary which Is primarily for the purpose of effluent polishing; A settling Lagoon or sand or coal fitter
might be employed for this purpose;
(56) Thermal Pollution Control Device. A device providing for the transfer of heat from a fktid flowing In tubes to another fluid outside the tubes, or vice versa;
or other means of regulating liquid temperatures;
(57) Thermal Sludge Conditioner. A conditioning process by which heat Is added for a protracted period of time to Improve the dewderablilty of sludge by the
Sotubilhzing and hydraufzing of Ue smaller and more highly hydrated sludge particles; tin, Intnalatbn
(58) Toxic Materials. Those wastes or combinations of wastes, Including disease -causing agents which after dsctwge and upon exposure, hpec
or assimilation Into try organism, either directly from the environment or Indirectly by Ingestion through food rain, WIN cuss dsath, disease. behavioral
abnormalities. cancer. genetic mutatiors, physiological malfunctions (Snduding malfunctions in reproduction) or physical deformations, In such organisms or their
offspring; Toxic materials Include, by way of 9lustratlon and not iimhdlon: lead, cadmium, chromium, mercury, vanadium, arsenic, zinc, ort ho-nitro-chbrobanzere
(ONCE), potychiortrtated biphenyk (PCBs) and dichbrodiphertyl trichbroelhare (DDT); and any other materials that have or may hereafter be determined to have
toxic properties;
(59) Trickling Filter. A blologhcal treatment unit consisting of a material such as broken store or rock over which wastewater is dstrbuted; A high rate tricking
inter Is one which operated d between 10 and 30 mo per acre. A low rate trickling fitter is ore which Is designed to operde at one to four mgd per acre;
(80) TrSc" Mar (Packed Tower). A ph ig flow type of operation In which wastewaer flows down through success" layers of mediar 1
1tle emay bOrganic
mdertal Is removed oortlnuafy by Be active biological fixed growth In each successive layer. This method may produce 'secondary' quality r
adapted to produce a nfl led o uient;
(61) Vacuum Filter, Canlrtfugm or Filter Presses_ Devices which are designed to remove excess water from otther digested or undigested studgo prior to disposal
or further lreatmwn4

X
Py�Y"
rth
North Carolina
ent of Environment,
nd Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
p C. Dr, OF
E1,nnl, NMENT, HEALTH.
ar NATURAL RESOURCE
September 20, 1994 gFP �8 144ii
MS KIMBERLY KOCIK
5311 FLINT RIDGE CHURCH ROAD is`oN Ct ENV;flQN4mEf1SRl ' p41A6E1
MARSHVILLE, NORTH CAROLINA 28103 �► �nCR'sV.tlE aEsl><n� urFicE
Subject: Application No. WQ0003158
Kocik SFR Spray
Spray Irrigation Facility
Union County
Dear MS KOCIK:
The Division's Permits and Engineering Unit acknowledges receipt of your permit application and
supporting materials on September 19, 1994. This application has been assigned the number listed
above. PLEASE REFER TO THE ABOVE WATER QUALITY NUMBER WHEN MAKING
INQUIRES ON THIS PROJECT.
Your project has been assigned to John Seymour for a detailed engineering review. Should there be any
questions concerning your project, the reviewer will contact you with an additional information letter.
Be aware that the Division's regional office, copied below, must provide recommendations from the
Regional Supervisor or a Procedure Four Evaluation for this project, prior to final action by the
Division. L--
If you have any questions, please contact John Seymour at [phone].
cc: Mooresville Regional Office
Sincerely,
%1
Carolyn McCaskill
Supervisor, State Engineering Review Group
Pollution Prevention Pays
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

State of North Carolina
tment of Environment, Health and Natural Resources
Division of Environmental Management
N.C. of
Non -Discharge Permit Application Form ENVIRONMENT,
HEALTH.
(THIS FORM MAY BE PHOTOCOPIED FOR USE AS AN ORIGINAL)& NATURAL RESOURCES
SPRAY IRRIGATION DISPOSAL SYSTEMS SEp 26 i994
GENERAL INFORMATION:
DIVISION OF ENVIRONMENTAL MANAGEMENT
MORRISVILLE RE61ONAL OFFICE
[ s name (please specify the name of the municipality, corporation, individual, etc.):
2. Print Owners or Signing Official's name and title (the person who is legally responsible for the facility and its compliance):
u
3. Mailing address: i 11 COE l , \ ��. G�U �� � CQ p
City: State: __UC_ Zip:
Telephone Number: y' -G3 U 4
4. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters of flow acceptance, Operational Agreements, etc.):
IPPI 1cecV1 on C pV ft k, 0SAE��<_2' `r wrkme
Ai-
5. Location of Spray Irrigation Facility (Street Address): 3) � Ell L\± 9 AP 6NO `/1— `�0
City: M ax,�k_N \te, State: Zip: Q
6. Latitude:
; Longitude
of Spray Irrigation Facility
7. Contact person
--who
`` hocan answer questions about application: /
Name: -Y, 1 V �`��` lA h, 1 V_ Telephone Number: (10_) �D q
8. Application Date: (? 13 I `t
9. Fee Submitted: $ 1 rQn • Ub [The permit processing fee should be as specified in 15A NCAC 2H .0205(c)(5).]
10. County(ies) where project is located: Of\ \ O T) I4 (?--
II. PERMIT INFORMATION:
1. Application No. (will be completed by DEM):
2. Specify whether project is: new; _X_ renewal*; modification
* For renewals, complete only sections I, II, and applicant signature (on page 7). Submit only pages 1, 2, and 9 (original
and three copies of each). Engineer's signature not required for renewal without other modifications.
3. If this application is being su itted as a result of a renewal or modification to an existing permit, list the existing permit
number O q R I and its issue date Y! �r N
4. Specify whether the applicant is public or _� private.
G� :� ►� y t d�5 +i�
FORM: SIDS 06/94 Page 1 of 8
a'^ ;J

DN ON WASTEWATER:
;tewater: % Domestic;
o Other waste (specify):
% Commercial; % Industrial;
2. Please provide a one or two word description specifying the origin of the wastewater, such as school, subdivision, hospital,
commercial, industrial, apartments, etc.:
3. If wastewater is not domestic in nature, what level of pretreatment has been provided to ensure protection of the receiving
wastewater treatment facility:
4. Volume of wastewater generated by this project:
5. Explanation of how the wastewater volume was determined:
6. Brief project description:
gallons per day
IV. FACILITY DESIGN CRITERIA FOR SINGLE FAMILY SPRAY IRRIGATION
1. Number of bedrooms: x 120 GPD per bedroom = gallons (minimum 240 GPD design flow per home).
2. Dimensions of baffled septic tank: ft. by ft. by ft.
3. Volume of baffled septic tank: gallons.
4. Check the categories that apply for the sand filter: surface; subsurface; single; dual;
in series; in parallel; recirculating; pressure dosed.
5. a) Primary sand filter dimensions: ft. by ft = square feet.
b) Sand filter surface loading rate: GPD per square foot.
6. a) Secondary sand filter dimensions (if applicable) ft. by ft. = square feet.
b) Secondary sand filter surface loading rate (if applicable) GPD per square foot.
7. Type of disinfection:
Volume of contact tank: gallons; and detention time: minutes
8. Volume of storage provided: gallons; Storage time provided: days
NOTE: A minimum of 5 days storage must be provided in the pump/storage tank.
9. Volume of pump tank: gallons; number of pumps in pump tank
10. Capacity of pumps in pump tank: GPM
11. Specify which high water alarms have been provided: audible and visual; auto dial
FORM: SIDS 06/94
Page 2 of 8

f Engineering Firm:
City:
Telephone Number: (
State:
Professional Engineer's Certification:
I, , attest that this application for
Zip:
has been reviewed by me and is accurate and complete to the best of my knowledge. I further attest that to the best of my knowledge
the proposed design has been prepared in accordance with the applicable regulations. Although certain portions of this submittal
package may have been developed by other professionals, inclusion of these materials under my signature and seal signifies that I have
reviewed this material and have judged it to be consistent with the proposed design.
North Carolina Professional Engineer's Seal, Signature, and Date:
Applicant's Certification:
I, /A b& lV / � LTG , attest that this application for 5-p D: (C�
L�1 I(Jo�c-�Q S `I �e cnn S rQp o
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of this
application are not completed and that if all required supporting information and attachments are not included, this application package
will be returned to me as incomplete._ j i
Signature
Date 2117
THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING INFORMATION AND MATERIALS,
SHOULD BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DIVISION OF ENVIRONMENTAL MANAGEMENT
WATER QUALITY SECTION
PERMITS AND ENGINEERING UNIT
POST OFFICE BOX 29535
RALEIGH, NORTH CAROLINA 27626-0535
TELEPHONE NUMBER: [phone]
FAX NUMBER: [phone]
FORM: SIDS 06/94 Page 7 of 8

To: Permits and Engineering Unit
Water Quality Section
Date: April 10, 1990
NON -DISCHARGE STAFF REPORT AND RECOMMENDATION
County: Union
Permit No. WQ 0003158
PART I - GENERAL INFORMATION
1. Facility and Address: Kocik Residence
Kimberly Kocik
Route 1, Box 25
Marshville, North Carolina 28103
2. Date of Investigation: March 20, 1990
3. Report Prepared By: Kim H. Colson, Environmental Engineer I
4. Persons Contacted and Telephone Number: Kimberly Kocik;
704/624-6304
5. Directions to Site: Site is located on the north side of S.
R. 1991 (Flint Ridge Church Road) at the intersection of S.
R. 1991 and S. R. 1005 (Landsford Road).
6. Size (land available for expansion and upgrading): There is
adequate land available for expansion and upgrading.
7. Topography (location map or topographic indicating
relationship to 100 year flood plain included): Site is
relatively flat and is not located within a flood plain.
8. Location of Nearest Dwelling and Water Supply Well: There
is one off -site dwelling located approximately 400 feet from
the existing field, however, there is a buffer of trees
between the field and house.
9. Watershed Stream Basin Information: Site is in the Barkers
Branch Watershed
a. Watershed Classification: WS-III
b. River Basin and Subbasin No.: Yadkin; 03-07-14
C. Distance to surface water from disposal system: No
tributaries to Barkers Branch are located within 1000
feet.
PART II - DESCRIPTION OF DISCHARGE AND TREATMENT WORKS
1. Type of wastewater, sludge or contaminated soil:
100o Domestic
0% Industrial

Page Two
a. Volume: .00075 MGD (Design Capacity)
b. Types and quantities of industrial wastewater: N/A
C. Prevalent toxic constituents in wastewater: N/A
d. Pretreatment Program (POTWs only): N/A
in development approved
should be required not needed
2. Production Rates (industrial discharges only) in Pounds Per
Day: N/A
3. Description of Industrial Process (for industries only) and
Applicable CFR Part and Subpart: N/A
4. Type of Treatment (specify whether proposed or existing):
Treatment system consists of a septic tank, recirculating
sand filter, tablet chlorinator, chlorine contact/storage
tank and a 0.16 acre spray irrigation field.
5. Sludge Handling and Disposal Scheme: Septic tank pumping
facility when necessary.
6. Treatment Plant Classification: Less Than 5 Points; No
Rating (include rating sheet). N/A
7. SIC Code(s): 9999
Wastewater Code(s):
Primary: 04
Secondary:
PART III - OTHER PERTINENT INFORMATION
1. Is this facility being constructed with Construction Grant
Funds (municipals only)? N/A
2. Special monitoring requests: N/A
3. Air Quality and/or Groundwater concerns or hazardous waste
utilized at this facility that may impact water quality, air
quality, or groundwater: N/A
4. Other: N/A
PART IV - EVALUATION AND RECOMMENDATIONS
The Permittee, Kimberly Kocik, has requested permit renewal
for the existing facility. The facility serves two single-family
residences.
The site appears well maintained. The sprinkler heads were
installed at different elevations. This may be causing some
slight ponding surrounding the lowest sprinkler head. The

Page Three
Permittee will be notified to correct this problem. The slight
ponding was not causing a nuisance problem at this time.
This Office recommends that the Permit be reissued for five
years.
Signature of Report Preparer Dam
Water Quality Regional Supervisor Date

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.° .Srnrgo N C.
1990
State of North Carolina M;;o,;�.�<<f
Department of Environment, Health, and Natural Resources 141 ,64
Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27611
James G. Martin, Governor
William W. Cobey, Jr., Secretary
Dear
Date: i19_
SUBJECT: Application No. WQ
R. Paul Wilms
Director
The Division's Permits and Engineering Unit acknowledges receipt of your permit application and supporting
materials on 19 . This application has been assigned the number shown above. Please
refer to this number when making inquiries on this project.,
Your project has been assigned to ; for a detailed engineering
review. A technical acknowledgement will be forthcoming. If this acknowledgement is not received within thirty (30)
days, please contact the engineer listed above.
Be aware that the Division's regional office, copied below, must provide recommendations from the Regional Super-
visor or a Procedure Four Evaluation for this project, prior to final action by the Division.
If you have any questions, please call the review engineer listed above at [phone].
CC:
Sincerely
a
Arthur Mouberry, P.E.
Supervisor, Permits and Engineering
Regional Supervisor
Pollution Prevention Pays
P.O. Box 27687, Raleigh, North Carolina 27611-7687 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

rth Carolina Department of Environment, Health, and Natural Resources
DEM USE ONLY
Environmental Management Commission
Permit Number:
NON -DISCHARGE PERMIT APPLICATION*
min accordance with NC General Statutes Chapter 143, Article 21
County:
Applicant (name of board, individual, or others):
Application Date:
Project (name of city, village, town, sanitary district, establishment):
FOR:
Brief Project Description:
❑ Non -Discharge Treatment/Disposal Facilities
❑ Pretreatment Facilities
❑ Sewer Collection System (private)
❑ Extension of Sewer Systems (public)
❑ Sludge Disposal
❑ Spray Irrigation
NATURE OF WASTEWATER:
❑ Domestic Sewage
❑ Sludge/Industrial Waste
Estimated Completion Date:
❑ Other Waste
From (sewers, pretreatment plant): Serving (city, Institution, industry):
I
I
Into (name of treatment plant): Average Daily Gallons Sewage or Waste Flow:
I
I
At (location of plant): (NPDES No.)
NC00
Name and Complete
Address of Engineering Firm: Zip Code:
Telephone No.
Applicant assures that proposed works will be constructed, supervised, operated and maintained in accordance
with approved plans and specifications or approved changes thereto.
Mailing
Print Name: Address:
Title: Zip Code:
Signature: Telephone No. / /
INSTRUCTIONS:
1. Fill-in All Spaces. If not applicable, enter N / A.
2.Secure appropriate signature (mayor/city manager for municipality, chairman for sanitary district board, owner/proper official of
corporation, or legally constituted board or commission in charge of proposed works). A letter of authorization is required from
proper official if design engineer or other agent signs application.
3. Submit to Division of Environmental Management, Permits and Engineering Unit, P.O. Box 27687, Raleigh, NC 27611 the original
and ALL carbon copies of the application, 3 sets of finalized plans, specifications and other supporting data as required by Com-
mission Rules, and permit fee. Plans and specifications must be signed and sealed by a registered North Carolina engineer.
FOR ASSISTANCE, CALL THE STATE CENTRAL OFFICE [phone], PERMITS & ENGINEERING UNIT, OR:
Asheville [phone] Fayetteville [phone] Mooresville [phone] Winston-Salem [phone]
59 Woodfin Place Suite 714 Wachovia Bldg. 919 North Main Street 8025 North Point Boulevard
Asheville, NC 28802 Fayetteville, NC 28301 Mooresville, NC 28115 Suite 100
Winston-Salem, NC 27106
Raleigh [phone]
3800 Barrrett Drive
P.O. Box 27687
Raleigh, NC 27611
Washington [phone]
1424 Carolina Avenue
P.O. Box 1507
Washington, NC 27889
Wilmington [phone]
7225 Wrightsville Avenue
Wilmington, NC 28403

PERMIT APPLICATION STATUS
Project Name: k4oc ly'
Permit No.: \f-tQ - dc->o 3I Sg
MRO No. : 90 — y 2-
Date Application Received:
Completeness of Application Package: Yes_ No
Date of Investigation: mac) / 19C)o
Date SR Submitted for Review: k4ZN L %p 1%SSd
Information Requested
Date
Person Telephone #
Info.
Date
,Rgst.
Contacted
Rqst_
Recvd.
Other:

n on: le Crisp
X ,
STAFF REPORT AND RECOMMENDATIONS
Part I - INSPECTION OF PROPOSED NON -DISCHARGE WASTEWATER TREATMENT PLANT SITE
1. a. Place visited: Kimberly C. Kocik Residence (proposed)
b. Mailing Address: c/o CMO Associates, Inc.
402 Willowbrook Drive
Cary, North Carolina 27511
2. Date of Investigation: 3/19/84 Date of Report: 4/6/84
3. By: J. Thurman Horne, P. E.
4. a. Person contacted: Mr. nningham, Union County Health Department
b. Phone No.: 704/289-5511
5. Directions to site: From the intersection of Highway 74 and S. R.
1005 (Landsford Road) in Marshville, travel south on S. R. 1005
approximately 4 miles to the intersection of S. R. 1991 (Flint Ridge
Church Road) and S. R. 1005. The proposed site is on the northeast
quadrant of this intersection.
USGS Quad No.: H 17 NE (see attached map)
6. Size (land available for expansion and upgrading): The site encompasses
approximately 11.6 acres. There is adequate land available for the
proposed construction and future expansion if necessary.
7. Topography: The proposed site is an old pasture which is planted in
fescue grass. Slopes range from 2 to 6%. The site is well removed
from any flood plains.
8. Location of nearest dwelling: There is one (1) existing dwelling
located approximately 400 feet from the proposed spray irrigation
site. There is an existing buffer zone of hardwood trees which is
approximately fifty feet in depth.
Part II -- DESCRIPTION OF PROPOSED TREATMENT FACILITIES
1. Proposed Facilities: The proposed facilities are designed to serve
a proposed single family dwelling (mobile home). The applicant
proposes to construct a spray irrigation system consisting of a septic
tank (1200 gallon capacity), a tablet chlorinator, a pump station,
with a wet well serving as chlorine contact chanber, and a spray
irrigation field (6800 square feet). The spray irrigation field will
be fenced to prevent unwanted public access.
Part III - EVALUATION AND RECOMMENDATIONS
1. Evaluation: The site has been determined to be unsuitable for
installation of any type of subsurface disposal system. The site
does appear to be suitable for installation of the proposed
spray irrigation system considering the relatively low design

Page Two
application rate (.0623 gpd/ft2).
Test borings made during the site investigation revealed that
restrictive horizons of saprolite material was encountered at depths
ranging from 18" to 24" below the surface.
The design of the proposed system appears to be in keeping with
accepted practices for land application facilities with the possible
exception of adequate storage facilities. It does not appear that the
proposed facilities would provide adequate storage during periods of
inclement weather. There is also a question with regards to general
operation of the facilities. The specifications indicate that dosing
would be accomplished by a timer and would occur at nights. It is
not clear how this arrangement would avoid dosing during periods of
inclement weather.
2. Recommendations and/or Special Conditions
The applicant should be requested to furnish additional information
with respect to storage capacity and control of spray application during
inclement weather.
When these items have been properly addressed, it is recommended that
a permit be issued for a period not to exceed five (5) years.
It is recommended that the permit contain the following special
conditions:
a. Irrigation shall not be performed during inclement weather or when
the ground is in a condition that will cause runoff including a
wind velocity of greater than 15 mph or a rainfall event 0.5
inches within a 24-hour period.
b. Any monitoring or analysis deemed necessary by the Division of
Environmental Management to insure surface water, groundwater and
public health protection will be established and an acceptable
sampling, reporting schedule shall be followed.
C. The treatment and disposal facilities shall be effectively maintained
and operated at all times so that there is no discharge to the
surface waters, nor any contamination of ground waters which will
render them unsatisfactory for normal use. In event the facilities
fail to perform satisfactorily, including the creation of nuisance
conditions, or failure of the irrigation area to adequately absorb
the wastewater, the Permittee, shall take such immediate corrective
action as may be required by the Division of Environmental Management.

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Koeik Property
his map is prepared for the inventory of real property found within Union County, NC and is compiled from recorded deeds, plats, and oth(
ublic records and data. Users of this map are hereby notified that the aforementioned public primary information sources should be consul
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