NCG550095_Regional Office Historical File Pre 2018

Water Resources
ENVIRONMENTAL DUALITY
Carol R. Brummitt
17632 Randalls Ferry Road
Norwood, NC 28128 .
Dear Permittee:
ROY COOPER
Governor
MICHAEL S. REGAN
Secretory
RS C;AL��IMIiIyIaAN
Director
OCT 3 12017
November 1, 2017 WQROS
f,AOORESVILLE REGIONAL OFFICE
Subject: NPDES General Permit NCG550000
Transfer of NCG550095
17632 Randalls Ferry Road
Stanly County
The Division hereby transmits Certificate of Coverage (CoC) NCG550095, issued under
NPDES General Permit NCG550000. This action is taken to show -that you are now the
owner of the subject facility. This CoC is issued pursuant to the requirements of North
Carolina General Statute 143-215.1 and the Memorandum of Agreement between North
Carolina and the U.S. Environmental Protection Agency dated October 15, 2007 (or as
subsequently amended).
If any parts, measurement frequencies or sampling requirements contained -in the
General Permit are unacceptable to you, you have the right to request an individual NPDES
permit upon written request within thirty (30) days following receipt of this .letter. Unless
such a request is made, this transfer of the subject CoC shall be final and binding.
This CoC is not transferable except after notice to the Division. The Division may
require modification or revocation and reissuance of the CoC. This permit does not affect the
legal requirements to obtain other permits which may be required by any other Federal,
state, or local government. If you have any questions concerning this matter, please contact
Emily Phillips at [phone] or via e-mail [[e-mail]].
c rely,
S. Jay Zimmerman, P.G.
Director
cc:rnre-�s�v� fit -on1� �Offi
NPDES files
State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh, NC 27699-1617
919 807 6300 919-807-6389 FAX
https://deq.n6.gov/about/divisions/water-resources/water-resources-permits/wastewater-branch/npdes-wastewater-permits

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
. DIVISION OF WATER RESOURCES
CERTIFICATE OF COVERAGE NCG550095
Under GENERAL PERMIT NCG550000
TO DISCHARGE 100%-DOMESTIC AND SIMILAR WASTEWATERS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
NPDES
In compliance with the provisions of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
Carol R. Brummitt
are hereby authorized to operate a wastewater treatment facility with a discharge of < 1000
gallons per day); discharging from
17632 Randalls Ferry Road
Norwood
Stanly County
to receiving waters designated as the Pee Dee River [stream segment 13-(1)], a waterbody
currently classified WS-IV, B; CA located within sub -basin 03-07-08 of the Yadkin Pee -Dee
River. Basin, m' accordance with the effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, II, and III of General 'Permit NCG550000 as attached.
This certificate of coverage shall become effective November 1, 2017.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day November 1, 2017.
,G
ay Zimmerman, P. G. '
Director, Division of Water Resources
By Authority of the Environmental Management Commission

General Permit NCG550000
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG550000
DISCHARGE OF DOMESTIC WASTEWATER FROM SINGLE FAMILY
RESIDENCES AND OTHER 100% DOMESTIC DISCHARGES WITH
SIMILAR CHARACTERISTICS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other
lawful standards and regulations promulgated and adopted by the North Carolina
Environmental Management Commission, and the Federal Water Pollution Control
Act, as amended, this permit is hereby issued to all owners or operators, hereafter
permittees, which are covered by this permit 'as evidenced by.receipt of a Certificate
of Coverage by the Environmental Management Commission to allow the discharge of
treated domestic wastewater in accordance with the effluent limitations, monitoring
requirements, and other conditions set forth in Parts I, II, III and IV hereof.
This permit shall become effective August 1, 2013.
This permit shall expire at midnight on July 31, 2018.
Thomas A. Reeder, P.E., Acting Director
Division of Water Quality
By Authority of the Environmental Management Commission
Page 1 of 16 Pages

General Permit
PART
MONITORING, CONTROLS, AND LIMITATIONS FOR PERMITTED DISCHARGES
A. EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS
Applicability of Coverage
This permit authorizes discharges (pursuant to the conditions described in this permit) to all waters
of the state unless otherwise excluded in this section. Discharges to the following waters are
excluded from permit coverage and will require an individual permit to discharge:
Waters classified as WSI (Water Supply I)
Waters classified as HQW (High Quality Waters, excluding WS II)
Waters classified as SA
Waters classified as ORW (Outstanding Resource Waters)
Waters located in the Randleman Lake Watershed
Applicable to Treatment Systems:
'l) Single Pass Filter Systems discharging less than 1000 gallons per day (applicable to existing
facilities only)
2) Multi -Phase Filter Systems (Primary & Secondary Single Pass, Recirculating Sand Filters as well
as other alternative technologies that provide treatment equivalent to, or greater than,
recirculating sand filters) discharging less than 1000 gallons per day
Treatment system requirements for existing -systems (built prior to August 1, 2007) systems:
• Septic Tank.
• Sand or media filter component (Single Pass Filter Systems, Multi -Phase Filter Systems)
• Disinfection. (All facilities adding chlorination after the August 1, 2007 will also be required to
add dechlorination. If a system had chlorination before August 1, 2007, then the addition of
dechlorination is not required)
Treatment system requirements for new and existing systems (built after August 1, 2007):
• Septic tank (with riser)
• Filter media
• Recirculating pump tank(s) per approved design (Multi -Phase Filter Systems only)
• Primary & Secondary Single Pass Filter Systems (Multi -Phase Filter Systems only)
• Filter media component per approved design
• Disinfection unit (Chlorination/dechlorination, or equivalent means of disinfection),
• Effluent pipe/outfall with aeration/erosion control (rip rap)
For pui poses of this permit, failed or failing systems that require replacement will be subject to
requirements for new systems built after August 1, 2007.
For purposes of this permit, systems that were constructed prior to August 1, 2007 that did not have
a valid permit shall be required to get a valid permit. They will not be required to replace or
upgrade systems installed prior to August 1, 2007 unless they are failing and require replacement.
Page 2 of 16 Pages

General Permit NCG550000
During the period beginning on August 1, 2013 and lasting until expiration, the Permittee is -
authorized to discharge domestic wastewater from outfall 001. Such discharges shall be limited and
monitored by the Permittee as specified below:
PARAMETER
LEVIITS
MONITORING REQUIREMENTS
Monthly
Daily
Measurement
Sample
Sample
Average
Maximum
Fre uene
a
Location
Flow [50050]
Annually
Estimate
Effluent
BOD, 5-Day, 20°C3[00310]
30.0 mg/l
45.0 mg/l
Annually
Grab
Effluent
Total Suspended Solids
30.0 mg/1
45.0 mg/l
Annually
Grab
Effluent
[00530]
Fecal Coliform
200/100 ml
400/100 ml
Annually
Grab
Effluent
Geometric mean3161
Total Residual Chlorine
[50060]
Annually
Grab
Effluent
Enterococci3,5
Annually
Grab
Effluent
1. Effluent is defined as wastewater leaving the treatment system, prior to discharge into a creek or
other water body.
2. The wastewater discharge flow from this facility may not in any case exceed 1000 gallons per
day.
3. A North Carolina certified laboratory must perform the wastewater analysis.
4. Receiving stream chlorine levels are not to exceed 17 µg/L. The sample shall be taken from the
effluent pipe, prior to discharge into a creek or other waterbody.
5. Applicable for discharges to SB and SC waters only. In SB and SC waters, the requirement for a
fecal coliform sample is not required.
There shall be no discharge of floating solids or foam visible in other than trace amounts.
Page 3 of 16 Pages

General Permit
Permit Conditions
(Operation & Maintenance)
1) The tablet chlorinator and dechlorinator [if applicable] shall be inspected weekly to ensure
there is an adequate supply of tablets for continuous & proper operation. The dechlorinator
unit shall be labeled "dechlorination only".
2) Treatment systems shall be maintained at all times to prevent seepage of sewage to the surface
of the ground.
3) Septic tanks and secondary tank (recirculating/pump tanks) shall be inspected at least yearly to
determine if solids must be removed or if other maintenance is necessary. Septic tanks shall be
pumped out every five years or when the solids level is found to be more than 1/3 of the liquid
depth in any compartment, whichever is greater. All tanks should be emptied of their contents
whenever any of the tanks meet this requirement. Effluent filters shall be inspected at least
once a year, cleaned and reinstalled or replaced. Contents removed from septic tanks shall be
disposed at a location and in a manner compliant with all local and state regulations.
4) All system components, including but not necessarily limited to, septic tanks, surface sand
filters, other filter components, pump/recirculation tanks, controls and alarms, disinfection
units, dechlorination apparatus, and the outfalls shall be maintained at all times and in good
operating order.
5) All monitoring data shall be retained onsite for a minimum of 'five years and available for
inspection. The permittee shall notify the Division upon receipt of a sampling or monitoring
report indicating noncompliance with the permit.
6) A visual review of the outfall location shall be executed twice each year (one at the time of
sampling) to ensure that no visible solids or other obvious evidence of system malfunctioning
is observed. Any visible signs of a malfunctioning system shall be documented and steps taken
to correct the problem.
Transfer Coverage from Other Permits
7) Upon issuance of this general permit, all existing and acting certificates of coverage issued in
conjunction with the NCG5700000 permits will be eligible for coverage under this permit.
'8) Upon issuance of this general permit, all existing and active individual permits issued since
Jurie of 2010 for discharge of domestic wastewater from single family residences and other
100% domestic discharges with similar characteristics will be eligible for coverage under this
permit.
This permit does not affect the legal requirements to obtain other permits that may be required by the
North Carolina Department of Natural Resources, or any other federal or local governmental permit.
Page 4 of 16 Pages

r
General Permit NCG550000
PART II
STANDARD CONDITIONS FOR NPDES PERMITS
Section A. Definitions
2/Month
Samples are collected twice per month with at least ten calendar days between sampling events. These samples shall be
representative of the wastewater discharged during the sample period.
3/Week
Samples are collected three times per week on three separate calendar days. These samples shall be representative of
the wastewater discharged during the sample period.
Act or "the Act"
The Federal Water Pollution Control Act, also known as the Clean Water Act (CWA), as amended, 33 USC 1251, et.
seq.
Annual Averaee
The arithmetic mean of all "daily discharges" of a pollutant measured during the calendar year. In the case of fecal
coliform, the geometric mean of such discharges.
Arithmetic Mean
The summation of the individual values divided by the number of individual values.
Bypass
The known diversion of waste streams from any portion of a treatment facility including the collection system, which is
not a designed or established or operating mode for the facility.
Calendar Dav
The period from midnight of one day until midnight of the next day. However, for purposes of this permit, any
consecutive 24-hour period that reasonably represents the calendar day may be used for sampling.
Calendar Week
The period from Sunday through the following Saturday.
Calendar Quarter
One of the following distinct periods: January through March, April through June, July through September, and
October through December.
Composite Sample
A sample collected over a 24-hour period by continuous sampling or combining grab samples of at least 100 mL in
such a manner as to result in a total sample representative of the wastewater discharge during the sample period. The
Director may designate the most appropriate method (specific number and size of aliquots necessary, the time interval
between grab samples, etc.) on a case -by -case basis. Samples may be collected manually or automatically. Composite
samples may be obtained by the following methods:
(1) Continuous: a single, continuous sample collected over'a 24-hour period proportional to the rate of flow.
(2) Constant time/variable volume: a series of grab samples collected at equal time intervals` over a 24 hour period
of discharge and combined proportional to the rate of flow measured at the time of individual sample
collection, or
(3) Variable time/constant volume: a series of grab samples of equal volume collected over a 24 hour period with
the time intervals between samples determined by a preset number of gallons passing the sampling point. Flow
measurement between sample intervals shall be determined by use of a flow recorder and totalizer, and the
preset gallon interval between sample collection fixed at no greater than 1/24 of the expected total daily flow at
the treatment system, or
(4) Constant time/constant volume: a series of grab samples of equal volume collected over a 24-hour period at a
constant time interval. Use of this method requires prior approval by the Director. This method may only be
used in situations where effluent flow rates vary less than 15 percent. The following restrictions also apply:
➢ Influent and effluent grab samples shall be of equal size and of no less than 100 milliliters
➢ Influent samples shall not be collected more than once per hour.
Page 5 of 16 Pages

General Permit
➢ Permittees with wastewater treatment systems whose detention time < 24 hours shall collect effluent grab
samples at intervals of no greater than 20 minutes apart during any 24-hour period.
➢ Permittees with wastewater treatment systems whose detention time exceeds 24 hours shall collect effluent
grab samples at least every six hours; there must be a minimum of four samples during a 24-hour sampling
period.
Continuous flow measurement
Flow monitoring that occurs without interruption throughout the operating hours of the facility. Flow shall be
monitored continually except for the infrequent times when there may be no flow or for infrequent maintenance
activities on the flow device.
Daily Discharge
The discharge of a pollutant measured during a calendar day or any 24-hour period that reasonably represents the
calendar day for purposes of sampling. For pollutants measured in units of mass, the "daily discharge" is calculated as
the total mass of the pollutant discharged over the day. For pollutants expressed in other units of measurement, the
"daily discharge" is calculated as the average measurement of the pollutant over the day. (40 CFR 122.2; see also
"Composite Sample," above.)
Daily Maximum
The highest "daily discharge" during the calendar month.
Daily Sampling
Parameters requiring daily sampling shall be sampled 5 out of every 7 days per week unless otherwise specified in the
permit. Sampling shall be conducted on weekdays except where holidays or other disruptions of normal operations
prevent weekday sampling. If sampling is required for all seven days of the week for any permit parameter(s), that
requirement will be so noted on the Effluent Limitations and Monitoring Page(s).
DWQ or "the Division"
The Division of Water Quality, Department of Environment and Natural Resources.
Effluent
Wastewater discharged following all treatment processes from. a water pollution control facility or other point source
whether treated or untreated.
EMC
The North Carolina Environmental Management Commission
EPA
The United States Environmental Protection Agency
Facility Closure
Cessation of all activities that require coverage under this NPDES permit.' Completion of facility closure will allow this
permit to be rescinded.
Geometric Mean
The Nth root of the product of the individual values where N = the number of individual values. For purposes of
calculating the geometric mean, values of "0" (or "< [detection level]") shall be considered =1.
Grab Sample
Individual samples of at least 100 mL collected over a period of time not exceeding 15 minutes. Grab samples can be
collected manually. Grab samples must be representative of the discharge (or the receiving stream, for instream
samples).
Hazardous Substance
Any substance designated under 40 CFR Part 116 pursuant to Section 311 of the CWA.
Instantaneous flow measurement
The flow measured during the minimum time required for the flow measuring device or method to produce a result in
that instance. To the extent practical, instantaneous flow measurements coincide with the collection of any grab
samples required for the same sampling period so that together the samples and flow are representative of the discharge
during that sampling period.
Page 6 of 16 Pages

General Permit NCG550O00
Monthly Average (concentration limit)
The arithmetic mean of all "daily discharges" of a pollutant measured during the calendar month. In the case of fecal
coliform or other bacterial parameters or indicators, the geometric mean of such discharges.
Permit Issuing Authority
The Director of the Division of Water Quality.
Quarterly Average (concentration limit)
The arithmetic mean of all samples taken over a calendar quarter.
Severe prope , damage
Substantial physical damage to property, damage to the treatment facilities which causes them to become inoperable, or
substantial and permanent loss of natural resources which can reasonably be expected to occur in the absence 'of a
bypass. Severe property damage excludes economic loss caused by delays in production.
Toxic Pollutant:
Any pollutant listed as toxic under Section 307(a)(1) of the CWA.
Upset
An incident beyond the reasonable control of the Permittee causing unintentional and temporary noncompliance with
permit effluent limitations and/or monitoring requirements. An upset does not include noncompliance caused by
operational error, improperly designed treatment facilities, inadequate treatment facilities, lack of preventive
maintenance, or careless or improper operation.
Weekly Average (concentration limit)
The arithmetic mean of all "daily discharges" of a pollutant measured during the calendar week. In the case of fecal
coliform or other bacterial parameters or indicators, the geometric mean of such discharges.
Section B. General Conditions
Duty to Comply
The Permittee must comply with all conditions of this permit. Any permit noncompliance constitutes a violation of
the CWA and is grounds for enforcement action; for permit termination, revocation and reissuance, or
modification; or denial of a permit renewal application [40 CFR 122.41].
a. The Permittee shall comply with effluent standards or prohibitions established under section 307(a) of the'
CWA for toxic pollutants and with standards for sewage sludge use or disposal established under section
405(d) of the CWA within the time provided in the regulations that establish these standards or prohibitions or
standards for sewage sludge use or disposal, even if the permit has not yet been modified to incorporate the
requirement.
b. The CWA provides that any person who violates section[s] 301, 302, 306, 307, 308, 318 or 405 of the Act, or
any permit condition or limitation implementing any such sections in a permit issued under section 402, or any
requirement imposed in a pretreatment program approved under sections 402(a)(3) or 4O2(b)(8) of the Act, is
subject to a civil penalty not to exceed $37,500 per day for each violation. [33 USC 1319(d) and 40 CFR
122.41(a)(2)]
c. The CWA provides that any person who negligently violates sections 301, 302, 306, 307, 308, 318, or 405 of
the Act, or any condition or limitation implementing any of such sections in a permit issued under section 402
of the Act, or any requirement imposed in a .pretreatment program approved under section 402(a)(3) or
402(b)(8) of the Act, is subject to criminal penalties of $2,500 to $25,000 per day of violation, or
imprisonment of not more than 1 year, or both. In the case of a second or subsequent conviction for a negligent
violation, a person shall be subject to criminal penalties of not more than $50,000 per day of violation, or by
imprisonment of not more than 2 years, or both. [33 USC 1319(c)(1) and 40 CFR 122.41(a)(2)]
d. Any person who knowingly violates such sections, or such conditions or limitations is subject to criminal
penalties of $5,000 to $50,000 per day of violation, or imprisonment for not more than 3 years, or both. In the
case of a second or subsequent conviction for a knowing violation, a person shall be subject to criminal
penalties of not more than $100,000 per day of violation, or imprisonment of not more than 6 years, or both.
[33 USC 1319(c)(2) and 40 CFR 122.41(a)(2)]
e. Any person who b7owingly violates section 301, 302, 303, 306, 307, 308, 318 or 405 of the Act, or any permit
condition or limitation implementing any of such sections in a permit issued under section 402 of the Act, and
Page 7 of 16 Pages

General Permit
who knows at that time that he thereby places another person in imminent danger of death or serious bodily
injury, shall, upon conviction, be subject to a fine of not more than $250,000 or imprisonment of not more than
15 years, or both. In the case of a second or subsequent conviction for a knowing endangerment violation, a
person shall be subject to a fine of not more than $500,000 or by imprisonment of not more than 30 years, or
both. An organization, as defined in section 309(c)(3)(B)(iii) of the CWA, shall, upon conviction of violating
the imminent danger provision, be subject to a fine of not more than $1,000,000 and can be fined up to
$2,000,000 for second or subsequent convictions. [40 CFR 122.41(a)(2)]
f. Under state law, a civil penalty of not more than $25,000 per violation may be assessed against any person
who violates or fails to act in accordance with the terms, conditions, or requirements of a permit. [North
Carolina General Statutes § 143-215.6A]
g. Any person may be assessed an administrative penalty by the Administrator for violating section 301, 302,
306, 307, 308, 318 or 405 of this Act, or any permit condition or limitation implementing any of such sections
in a permit issued under section 402 of this Act. Administrative penalties for Class I violations are not to
exceed $16,000 per violation, with the maximum amount of any Class I penalty assessed not to exceed
$37,500. Penalties for Class II violations are not to exceed $16,000 per day for each day during which the
violation continues, with the maximum amount of any Class II penalty not to exceed $177,500. [33 USC
1319(g)(2) and 40 CFR 122.41(a)(3)]
2. Duty to Mitigate
The Permittee shall take all reasonable steps to minimize or prevent any discharge or sludge use or disposal in
violation of this permit with a reasonable likelihood of adversely affecting human health or the environment [40
CFR 122.41(d)].
3. Civil and Criminal Liability
Except as provided in permit conditions on 'Bypassing" (Part II.C.4), "Upsets" (Part II.C.5) and "Power Failures"
(Part II.C.7), nothing in this permit shall be construed to relieve the Permittee from any responsibilities, liabilities,
or penalties for noncompliance pursuant to NCGS 143-215.3, 143-215.6 or Section 309 of the Federal Act, 33
USC 1319. Furthermore, the Permittee is responsible for consequential damages, such as fish kills, even though the
responsibility for effective compliance may be temporarily suspended.
4. Oil and Hazardous Substance Liability
Nothing in thi&permit shall be construed to preclude the institution of any legal action or relieve the Permittee from
any responsibilities, liabilities, or penalties to which the Permittee is or may be subject to under NCGS 143-215.75
et seq. or Section 311 of the Federal Act, 33 USG 1321. Furthermore, the Permittee is responsible for
consequential damages, such as fish kills, even though the responsibility for effective compliance may be
temporarily suspended.
5. Property Rights
The issuance of this permit does not convey any property rights in either real or personal property, or any exclusive
privileges, nor does it authorize any injury to private property or any invasion of personal rights, nor any
infringement of Federal, State or local laws or regulations [40 CFR 122.41(g)].
6. Onshore or Offshore Construction
This permit does not authorize or approve the construction of any onshore or offshore physical structures or
facilities or the undertaking of any work in any navigable waters.
7. Severability
The provisions of this permit are severable. If any provision of this permit, or the application of any provision of
this permit to any circumstances, is held invalid, the application of such provision to other circumstances, and the
remainder of this permit, shall not be affected thereby [NCGS 150B-23].
8. Duty to Provide Information
The Permittee shall furnish to the Permit Issuing Authority, within a reasonable time, any information which the
Permit Issuing Authority may request to determine whether cause exists for modifying, revoking and reissuing, or
terminating this permit or to determine compliance with this permit. The Permittee shall also furnish to the Permit
Issuing Authority upon request, copies of records required'by this permit [40 CFR 122.41(h)].
9. Signatory Requirements
All applications, reports, or information submitted to the Permit Issuing Authority shall be signed and certified [40
CFR 122.41(k)].
Page 8 of 16 Pages

General Permit NCG550000
a. All permit applications shall be signed as follows:
(1) For a corporation: by a responsible corporate officer. For the purpose of this Section, a responsible
corporate officer means: (a) a president, secretary, treasurer -or vice president of the corporation in charge
of a principal business function, or any other person who performs similar policy or decision making
functions for the corporation, or (b) the manager of one or more manufacturing, production, or operating
facilities, provided, the manager is authorized to make management decisions which govern the operation
of the regulated facility including having the explicit or implicit duty of making major capital investment
recommendations, and initiating and directing other comprehensive measures to assure long term
environmental compliance with environmental laws and regulations; the manager can ensure that the
necessary systems are established or actions taken to gather complete and accurate information for permit
application requirements; and where authority to sign documents has been assigned or delegated to the
manager in accordance with corporate procedures .
(2) For a partnership or sole proprietorship: by a general partner or the proprietor, respectively, or
(3) For a municipality, State, Federal, or other public agency: by either a principal executive officer or
ranking elected official [40 CFR 122.22].
b. All reports required by the permit and other information requested by the Permit Issuing Authority shall be
signed by a person described in paragraph a. above or by a duly authorized representative of that person. A
person is a duly authorized representative only if:
(1) The authorization is made in writing by a person described above;
(2) The authorization specified either an individual or a position having responsibility for the overall operation
of the regulated facility or activity, such as the position of plant manager, operator of a well or well field,
superintendent, a position of equivalent responsibility, or an individual or position having overall
responsibility for environmental matters for the company. (A duly authorized representative may thus be
either a named individual or any individual occupying a named position.); and
(3) The written authorization is submitted to the Permit Issuing Authority [40 CFR 122.22]
c. Changes to authorization: If an authorization under paragraph (b) of this section is no longer accurate because
a different individual or position has responsibility for the overall operation of the facility, a new authorization
satisfying the requirements of paragraph (b) of this section must be submitted to the Director prior to or
together with any reports, information, or applications to be signed by an authorized representative [40 CFR
122.22]
d. Certification. Any person signing a document under paragraphs a. or b. of this section shall make the following
certification [40 CFR 122.22]. NO OTHER STATEMENTS OF CERTIFICATION WILL BE ACCEPTED:
U certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qual fed personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best ofrny
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility offrnes and imprisonmentfor knowing violations. "
10. Permit Actions
This permit may be modified, revoked and reissued, or terminated for cause. The filing of a request by the
Permittee for a permit modification, revocation and reissuance, or termination, or a notification of planned changes
or anticipated noncompliance does not stay any permit condition [40 CFR 122.41(f)].
11. Permit Modification, Revocation and Reissuance, or Termination
The issuance of this permit does not prohibit the permit issuing authority from reopening and modifying the permit,
revoking and reissuing the permit, or terminating the permit as allowed by the laws, rules, and regulations
contained in Title 40, Code of Federal Regulations, Parts 122 and 123; Title 15A of the North Carolina
Administrative Code; Subchapter 02H .0100; and North Carolina General Statute 143.215.1 et. al.
12. Annual Administering and Compliance Monitoring Fee Requirements
The Permittee must pay the annual administering and compliance monitoring fee within thirty days after being
billed by the Division. Failure to pay the fee in a timely manner in accordance with 15A NCAC 02H .0105(b)(2)
may cause this Division to initiate action to revoke the permit.
Page 9 of 16 Pages

General Permit
Section C. Operation and Maintenance of Pollution Controls
1. Certified Operator
For purposes of this permit, this requirement does not apply until the permittee receives a letter from the Division
notifying them of classification of the facility.
Owners of classified water pollution control systems must designate operators, certified by the Water Pollution
Control System Operators Certification Commission (WPCSOCC), of the appropriate type and grade for the
system, and, for each classification must [T15A NCAC 08G .0201]:
a. designate one Operator In Responsible Charge (ORC) who possesses a valid certificate of the type and grade
at least equivalent to the type and grade of the system;
b. designate one or more Back-up Operator(s) in Responsible Charge (Back-up ORCs) who possesses a valid
certificate of the type of the system and no more than one grade less than the grade of the system, with the
exception of no backup operator in responsible charge is required for systems whose minimum visitation
requirements are twice per year; and
c. submit a signed completed "Water Pollution Control System Operator Designation Form" to the Commission
(or to the local health department for owners of subsurface systems) countersigned by the designated certified
operators, designating the Operator in Responsible Charge (ORC) and the Back-up Operator in Responsible
Charge (Back-up ORC):
(1) 60 calendar days prior to wastewater or residuals being introduced into a new system; or
(2) within 120 calendar days following:
➢ receiving notification of a change in the classification of the system requiring the designation of a new
Operator in Responsible Charge (ORC) and Back-up Operator in Responsible Charge (Back-up ORC)
of the proper type and grade; or
➢ a vacancy in the position of Operator in Responsible Charge (ORC) or Back-up Operator in
Responsible Charge (Back-up ORC).
(3) within seven calendar days of vacancies in both ORC and Back-up ORC positions replacing or
designating at least one of the responsibilities.
The ORC of each Class I facility (or the Back-up ORC, when acting as surrogate for the ORC) must:
➢ Visit the facility as often as is necessary to insure proper operation of the treatment system; the treatment
facility must be visited at least weekly
➢ Comply with all other conditions of 15A NCAC 08G .0204.
Proper Operation and Maintenance
The Permittee shall at all times properly operate and maintain all facilities and systems of treatment and control
(and related appurtenances) which are installed or used by the Permittee to achieve compliance with the conditions
of this permit. Proper operation and maintenance also includes adequate laboratory controls and appropriate quality
assurance procedures. This provision requires the Permittee to install and operate backup or auxiliary facilities only
when necessary to achieve compliance with the conditions of the permit [40 CFR 122.41(e)].
NOTE: Properly and officially designated operators are fully responsible for all proper operation and maintenance
of the facility, and all documentation required thereof, whether acting as a contract operator [subcontractor] oi• a
member of the Permittee's staff.
3. Need to Halt or Reduce not a. Defense
It shall not be a defense for a Permittee in an enforcement action that it would have been necessary to halt or
reduce the permitted activity in order to maintain compliance with the condition of this permit [40 CFR 122.41(c)].
4. Bypassing of Treatment Facilities
a. Bypass not exceeding limitations [40 CFR 122.41(m)(2)]
Page 10 of 16 Pages

General Permit NCG550000
The Permittee may allow any bypass to occur which does not cause effluent limitations to be exceeded, but
only if it also is for essential maintenance to assure efficient operation. These bypasses are not subject to the
provisions of Paragraphs b. and c. of this section.
b. Notice [40 CFR 122.41(m)(3)]
(1) Anticipated bypass. If the Permittee knows in advance of the need for a bypass, it shall submit prior notice,
if possible at least ten days before the date of the bypass; including an evaluation of the anticipated quality
and effect of the bypass.
(2) Unanticipated bypass. The Permittee shall submit notice of an unanticipated bypass as required in Part
II.E.6. (24-hour notice).
c. Prohibition of Bypass
(1) Bypass from the treatment facility is prohibited and the Permit Issuing Authority may take enforcement
action against a Permittee for bypass, unless:
(A) Bypass was unavoidable to prevent loss of life, personal injury or severe property damage;
(B) There were no feasible alternatives to the bypass, such as the use of auxiliary treatment facilities,
retention of untreated wastes or maintenance during normal periods of equipment downtime. This
condition is not satisfied if adequate backup equipment should have been installed in the exercise of
reasonable engineering judgment to prevent a bypass which occurred during normal periods of
equipment downtime or preventive maintenance; and
` (C) The Permittee submitted notices as required under Paragraph b. of this section.
(2) Bypass from. the collection system is prohibited and the Permit Issuing Authority may take enforcement
action against a Permittee for a bypass as provided in any current or future system -wide collection system
permit associated with the treatment facility.
(3) The Permit Issuing Authority may approve an anticipated bypass, after considering its adverse effects, if
the Permit Issuing Authority determines that it will meet the three conditions listed above in Paragraph c.
(1) of this section.
5. Upsets
a. Effect of an upset [40 CFR 122.41(n)(2)]: An upset constitutes an affirmative defense to an action brought for
noncompliance with such technology based permit effluent limitations if the requirements of paragraph b. of
this condition are met. No determination made during administrative review of claims that noncompliance was
caused by upset, and before an action for noncompliance, is final administrative action subject to judicial
review.
b. Conditions necessary for a demonstration of upset: Any Permittee who wishes to establish the affirmative
defense of upset shall demonstrate, through properly signed, contemporaneous operating logs, or other relevant
evidence that:
(1) An upset occurred and that the Permittee can identify the cause(s) of the upset;
(2) The Permittee facility was at the time being properly operated; and
(3) The Permittee submitted notice of the upset as required in Part II.E.6.(b) of this permit.
(4) The Permittee complied with any remedial measures required under Part II.B.2. of this permit.
c. Burden of proof [40 CFR 122.41(n)(4)]: The Permittee seeking to, establish the occurrence of an upset has
the burden of proof in any enforcement proceeding.
6. Removed Substances
Solids, sludges, filter backwash, or other pollutants removed in the course of treatment or control of wastewaters
shall be utilized/disposed of in accordance with NCGS 143-215.1 and in a manner such as to prevent any pollutant
from such materials from entering waters of the State or navigable waters of the United States except as permitted
by the Commission. The Permittee shall comply with all applicable state and Federal regulations governing the
disposal of sewage sludge, including 40 CFR 503, Standards for the Use and Disposal of Sewage Sludge; 40 CFR
Part 258, Criteria For Municipal Solid Waste Landfills; and 15A NCAC Subchapter 2T, Waste Not Discharged To
Surface Waters. The Permittee shall notify the Permit Issuing Authority of any significant change in its sludge use
or disposal practices.
Page 11 of 16 Pages

General Permit
7. Power Failures
The Permittee is responsible for maintaining adequate safeguards (as required by 15A NCAC 02H .0124) to
prevent the discharge of untreated or inadequately treated wastes during electrical power failures either by means
of alternate power sources, standby generators or retention of inadequately treated effluent.
Section D. Monitoring and Records
1. Representative Sampling
Samples collected and measurements taken, as required herein, shall be representative of the permitted discharge.
Samples collected at a frequency less than daily shall be taken on a day and time that is representative of the
discharge for the period the sample represents. All samples shall be taken at the monitoring points specified in this
permit and, unless otherwise specified, before the effluent joins or is diluted by any other wastestream, body of
water, or substance. Monitoring points shall not be changed without notification to and the approval of the Permit
Issuing Authority [40 CFR 122.410)].
2. Reporting
Monitoring results obtained during the previous month(s) shall be summarized for each month and reported on a
monthly Discharge Monitoring Report (DMR) Form (MR 1, 1. 1, 2, 3) or alternative forms approved by the
Director, postmarked no later than the last calendar day of the month following the completed reporting period.
The first DMR is due on the last day of the month following the issuance of the permit or in the case of a new
facility, on the last day of the month following the commencement of discharge. Duplicate signed copies of these,
and all other reports required herein, shall be submitted to the following address:
NC DENA / Division of Water Quality / Surface Water Protection Section
ATTENTION: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
3. Flow Measurements
Appropriate flow measurement devices and methods consistent with accepted scientific practices shall be selected
and used to ensure the accuracy and reliability of measurements of the volume of monitored discharges. The
devices shall be installed, calibrated and maintained to ensure that the accuracy of the measurements is consistent
with the accepted capability of that type of device. Devices selected shall be capable of measuring flows with 'a
maximum deviation of less than 10% from the true discharge rates throughout the range of expected discharge
volumes. Flow measurement devices shall be accurately calibrated at a minimum of once per year and maintained
to ensure that the accuracy of the measurements is consistent with the accepted capability of that type of device.
The Director shall approve the flow measurement device and monitoring location prior to installation.
Once -through condenser cooling water flow monitored by pump logs, or pump hour meters as specified in Part I of
this permit and based on the manufacturer's pump curves shall not be subject to this requirement.
4. Test Procedures
Laboratories used for sample analysis must be certified by the Division. Permittees should contact the Division's
Laboratory Certification Section (919 733-3908 or http://portal.ncdenr.org/web/wq/lab/cert) for information
regarding laboratory certifications.
Facilities whose personnel are conducting testing of field -certified parameters only must hold the appropriate field
parameter laboratory certifications.
Test procedures for the analysis of pollutants shall conform to the EMC regulations (published pursuant to NCGS
143-215.63 et. seq.), the Water and Air Quality Reporting Acts, and to regulations published pursuant to Section
304(g), 33 USC 1314, of the CWA (as amended), and 40 CFR 136; or in the case of sludge use or disposal,
approved under 40 CFR 136, unless otherwise specified in 40 CFR 503, unless other test procedures have been
specified in this permit [40 CFR 122.41].
To meet the intent of the monitoring required by this permit, all test procedures must produce minimum detection
and reporting levels that are below the permit discharge requirements and all data generated must be reported down
to the minimum detection or lower reporting level of the procedure. If no approved methods are determined
capable of achieving minimum detection and reporting levels below permit discharge requirements, then the most
sensitive (method with the lowest possible detection and reporting level) approved method must be used.
Page 12 of 16 Pages

W.-
General Permit NCG550000
5. Penalties for Tampering
The CWA provides that any person who falsifies, tampers with, or knowingly renders inaccurate, any monitoring .
device or method required to be maintained under this permit shall, upon conviction, be punished by a fine of not
more than $10,000 per violation, or by imprisonment for not more than two years per violation, or by both. If a
conviction of a person is for a violation committed after a first conviction of such person under this paragraph,
punishment is a fine of not more than $20,000 per day of violation, or by imprisonment of not more than 4 years, or
both [40 CFR 122.41]. -
6. Records Retention
Except for records of monitoring information required by this permit related to the Permittee's sewage sludge use
and disposal activities, which shall be retained for a period of at least five years (or longer as required by 40 CFR
503), the Permittee shall retain records of all monitoring information, including:
➢ all calibration and maintenance records
➢ all original strip chart recordings for continuous monitoring instrumentation
➢ copies of all reports required by this permit
➢ copies of all data used to complete the application for this permit
These records or copies shall be maintained for a period of at least 3 years from the date of the sample,
measurement, report or application. This period may be extended by request of the Director at any time [40 CFR
122.41).
7. Recording Results
For each measurement or sample taken pursuant to the requirements of this permit, the Permittee shall record the
following information [40 CFR 122.41]: ,
a. The date, exact place, and time of sampling or measurements;
b. The individual(s) who performed the sampling or measurements;
c. The date(s) analyses were performed;
d. The individual(s) who performed the analyses;
e. The analytical techniques or methods used; and
f. The results of such analyses.
8. Inspection and Entry
The Permittee shall allow the Director, or an authorized representative (including an authorized contractor acting
as a representative of the Director), upon the presentation of credentials and other documents as may be required
by law, to;
a. Enter, at reasonable times, upon the Permittee's premises where a regulated facility or activity is located or
conducted, or where records must be kept under the, conditions of this permit;
b. Have access to and copy, at reasonable times, any records that must be kept under the conditions of this permit;
c. Inspect at reasonable times any facilities, equipment (including monitoring and control equipment), practices,
or operations regulated or required under this permit; and
d. Sample or monitor at reasonable times, for the purposes of assuring permit compliance or as otherwise
authorized by the CWA, any substances or parameters at any location [40 CFR 122.41(i)].
Section E Reaortine Requirements
1. Change in Discharge
All discharges authorized herein shall be consistent with the terms and conditions of this permit. The discharge of
any pollutant identified in this permit more frequently than or at a level in excess of that authorized shall constitute
a violation of the permit.
2. Planned Changes
The Permittee shall give notice to the Director as soon as possible of any planned physical alterations or additions
to the permitted facility [40 CFR 122.41(1)]. Notice is required only when:
a. The alteration or addition to a permitted facility may meet one of the criteria for new sources at 40 CFR
122.29(b); or
Page 13 of 16 Pages

General Permit
b. The alteration or addition could significantly change the nature or increase the quantity of pollutants
discharged. This notification applies to pollutants subject neither to effluent limitations in the permit, nor to
notification requirements under 40 CFR 122.42(a)(1); or
c. The alteration or addition results in a significant change in the Permittee's sludge use or disposal practices, and
such alteration, addition or change may justify the application of permit conditions that are different from or
absent in the existing permit, including notification of additional use or disposal sites not reported during the
permit application process or not reported pursuant to an approved land application plan.
3. Anticipated Noncompliance
The Permittee shall give advance notice to the Director of any planned changes to the permitted facility or other
activities that might result in noncompliance with the permit [40 CFR 122.41(l)(2)].
4. Transfers
This permit is not transferable to any person without prior written notice to and approval from the Director in
accordance with 40 CFR 122.61. The Director may condition approval in accordance with NCGS 143-215.1, in
particular NCGS 143-215.1(b)(4)b.2., and may require modification or revocation and reissuance of the permit, or
a minor modification, to identify the new permittee and incorporate such other requirements as may be necessary
under the CWA [40 CFR 122.41(1)(3), 122.61] or state statute.
5. Monitoring Reports
Monitoring results shall be reported at the intervals specified elsewhere in this permit [40 CFR 122.41(1)(4)].
a. Monitoring results must be reported on a Discharge Monitoring Report (DMR) (See Part ll.D.2) or forms
provided by the Director for reporting results of monitoring of sludge use or disposal practices.
b. If the Permittee monitors any pollutant more frequently than required by this permit using test procedures
approved under 40 CFR Part 136 and at a sampling location specified in this permit or other appropriate
instrument governing the discharge, the results of such monitoring shall be included in the calculation and
reporting of the data submitted on the DMR.
6. Twenty-four Hour Reporting
a. The Permittee shall report to the Director or the appropriate Regional Office any noncompliance that
potentially threatens public health or the environment. Any information shall be provided orally within 24
hours from the time the Permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the Permittee becomes aware of the circumstances. The written submission
shall contain a description of the noncompliance, and its cause; the period of noncompliance, including exact
dates and times, and if the noncompliance has not been corrected, the anticipated time it is expected to
continue; and steps taken or planned to reduce, eliminate, and prevent reoccurrence of the noncompliance [40
CFR 122.41(1)(6)].
b. The Director may waive the written report on a case; -by -case basis for reports under this section if the oral
report has been received within 24 hours.
c. Occurrences outside normal business hours may also be reported to the Division's Emergency Response
personnel at [phone], [phone] or [phone].
7. Other Noncompliance
The Permittee shall report all instances of noncompliance not reported under Part II.E.5 and 6. of this permit at the
time monitoring reports are submitted. The reports shall contain the information listed in PartIi.E.6. of this permit
[40 CFR 122.41(1)(7)].
8. Other Information
Where the Permittee becomes aware that it failed to submit any relevant facts in a permit application, or submitted
incorrect information in a permit application or in any report to the Director, it shall promptly submit such facts or
information [40 CFR 122.41(1)(8)].
Page 14 of 16 Pages

General Permit NCG550000
9. Noncompliance Notification
The Permittee shall report by telephone to either the central office or the appropriate regional office of the Division
as soon as possible, but in no case more than 24 hours or on the next working day following the occurrence or first
knowledge of the occurrence of any of the following:
a. Any occurrence at the water pollution control facility which results in the discharge of significant amounts of
wastes which are abnormal in quantity or characteristic, such as the dumping of the contents of a sludge
digester; the known passage of a slug of hazardous substance through the facility; or any other unusual
circumstances.
b. Any process unit failure, due to known or unknown reasons, that render the facility incapable of adequate
wastewater treatment such as mechanical or electrical failures of pumps, aerators, compressors, etc.
c. Any failure of a pumping station, sewer line, or treatment facility resulting in a by-pass without treatment of all
or any portion.of the influent to such station or facility.
i
Persons reporting such occurrences by telephone shall also file a written 'report within 5 days following first
knowledge of the occurrence. Also see reporting requirements for municipalities in Part IV.C.2.c. of this permit.
10. AvaiIability of Reports
Except for data determined to be confidential under NCGS 143-215.3 (a)(2) or Section 308 of the Federal Act, 33
USC 1318, all reports prepared in accordance with the terms shall be available for public inspection at the offices
of the Division. As required by the Act, effluent data shall not be considered confidential. Knowingly making any
false statement on any such report may result in the imposition of criminal penalties as provided for in NCGS 143-
215. 1 (b)(2) or in Section 309 of the Federal Act.
11. Penalties for Falsification of Reports
The CWA provides that any person who knowingly makes any false statement, representation, or certification in
any record or other document submitted or required to be maintained under this permit, including monitoring
reports or reports of compliance or noncompliance shall, upon conviction, be punished by a fine of not more than
$25,000 per violation, or by imprisonment for not more than two years per violation, or by both [40 CFR 122.41].
Page 15 of 16 Pages

General Permit
PART IlI
OTHER REQUIREMENTS
Section A. Construction
a. The Permittee shall not commence construction of wastewater treatment facilities, nor add to the planVs treatment
capacity, nor change the treatment process(es) utilized at the treatment plant unless (1) the Division has issued an
Authorization to Construct (AtC) permit or (2) the Permittee is exempted from such AtC permit requirements
under Item b. of this Section.
b. In accordance with NCGS 143-215.1(a5) [SL 2011-394], no permit shall be required to enter into a contract for the
construction, installation, or alteration of any treatment work or disposal system or to construct, install, or alter any
treatment works or disposal system within the State when the system's or work's principle function is to conduct,
treat, equalize, neutralize, stabilize, recycle, or dispose of industrial waste or sewage from an industrial facility and
the discharge of the industrial waste or sewage is authorized under a permit issued for the discharge of the
industrial waste or sewage into the waters of the State. Notwithstanding the above, the permit issued for the
discharge may be modified if required by federal regulation.
c. Issuance of an AtC will not occur until Final Plans and Specifications for the proposed construction have been
submitted by the Permittee and approved by the Division.
Section B. Groundwater Monitoring
The Permittee shall, upon written notice from the Director, conduct groundwater monitoring as may be required to
determine the compliance of this NPDES permitted facility with the current groundwater standards.
Section C. Changes in Discharges of Toxic Substances
The Permittee shall notify the Permit Issuing Authority as soon as it knows or has reason to believe (40 CFR 122.42):
a. That any activity has occurred or will occur which would result in the discharge, on a routine or frequent basis, of
any toxic pollutant which is not limited in the permit, if that discharge will exceed the highest of the following
"notification levels";
(1) One hundred micrograms per liter (100 µg/L);
(2) Two hundred micrograms per liter (200 µg/L) for acrolein and acrylonitrile; five hundred micrograms per liter
(500 µg/L) for 2,4-dinitrophenol and for 2-methyl-4,6-dinitrophenol; and one milligram per liter (1 mg/L) for
antimony;
(3) Five times the maximum concentration value reported for that pollutant in the permit application.
b. That any activity has occurred or will occur which would result in any discharge, on a non -routine or infrequent
basis, of a toxic pollutant which is not limited in the permit, if that discharge will exceed the highest of the
following "notification levels";
(1) Five hundred micrograms'per liter (500 µg/L);
(2) One milligram per liter (1 mg/L) for antimony;
(3) Ten times the maximum concentration value reported for that pollutant in the permit application.
Section D. Facility Closure Requirements
The Permittee must notify the Division at least 90 days prior to the closure of any wastewater treatment system covered
by this permit. The Division may require specific measures during deactivation of the system to prevent adverse
impacts to waters of the State. This permit cannot be rescinded while any activities requiring this permit continue at the
permitted facility.
Page 16 of 16 Pages

LE
NCDENR
- - - - -- - -North Caroline- Department of Environment and -Natural Resources -- - -
Pat McCrory Donald van der Vaart
Governor Secretary
June 22, 2015
Mr. Donald Brummitt
17632 Randalls Ferry Road
Norwood, NC 28128
Subject: Compliance Evaluation Inspection
Single Family Residence Wastewater Treatment System
NPDES General Wastewater Permit No./Certificate of Coverage NCG550095
Dear Mr. Brummitt:
Enclosed please find a copy of the Compliance Evaluation Inspection Report for the
inspection conducted at your residence on June 3, 2015 by Ms. Barbara Sifford and Mr. Barry
Love of this office. Thank you for your assistance and cooperation during the inspection. The
system appeared to be operational and maintained but no discharge was observed at the time
of the inspection.
A list of commercial labs is included with this letter. Annual analytical is required if the
system discharges to surface waters. To obtain a list in the future the web site is
http://Portal.nedenr.or web/wq/lab/cert/certlablists. This is required to be completed annually
and available for review during the inspection.
I have included the ownership/name change form that should be submitted if you sell the
house so that the new owners are aware of the permit and the requirements of this system, and
a copy of the general permit.
The report should be self-explanatory. If you have any questions, comments, or need
assistance with understanding any aspect of your permit or this report, please do not hesitate to
contact me at (704)-235-2196.
Cc: MSC-1617 Central Files
CEI- Report (BIMS)/PNOCF 08-13
NCG550000 General Permit
Sincerely,
Zia
Barbara Sifford
Water Quality Regional Operations Section
Mooresville Regional Office-NCDENR
Mooresville Regional Office
610 East Center Avenue, Suite 301, Mooresville, North Carolina 28115
Phone: [phone] / Fax: [phone]/Customer Service 1-877-623-6748
Internet: www.ncdenr.gov
An Equal Opportunity1 Affirmative Action Employer— Made in part by. recycled paper

Form 101
NC Division of Water Quality
Surface Water Protectjon Sectiop
OW r - ' W71
SINGLE FAMILY WASTEWATER TREATMENT/DISPOSAL SYSTEMINSPECTION
CHECKLIST
ecto Names Date of I pe tion: Arrival Time: Departure Time:
�„ 3
cZ � llf`tzi+`c� � c� a(V
[Add
rop y Ow a Nam Phone Nu b rCertificate of Cov rage #:
Gt� - �(s): NCG55
����
r ss: / city: Zip Code: County:' y
mInc 1 n Yes No N/A j N/E Re arks:
I. Residency/Ownership
Is the Permittee the current owner of the Single Family
1 Home? (Verify current ownership of the location
producing the discharge.)
II. System Layout/Permittee's Knowledge of System
1 Does permittee have a map showing the layout of the
treatment system?
2 Does permittee know where the septic tank is located?
Does permittee know where the sandfilter(s) is/are
3 located?
4 Does permittee know where the Chlorinator is located-?
Does permittee know where chlorine tablets go? If not, /
5 instruct them. = //
Does permittee know where the dechlorination unit is?
6 (Only new facilities constructed after August 1, 2007
{Effective date of latest general permit) are required to
i�Does
tll dechlorination.) ,
7 permittee know the location of the outlet/discharge? /
I
III. System History
d21 Has sewage ever backed up into the house?
Have there been any other sewage problems at all?
IV. Analytical Monitoring
1 Has the permittee conducted the required analytical
monitoring?
2 Does permittee have analytical monitoring results on site?
Is analytical monitoring conducted by a NC certified
3 laboratory?
Do analytical monitoring results show compliance with
4 permit limits? (Check for compliance with permit limits
using Form 102.)
V. Septic Tank
]Has
the septic tank been pumped in last 3 to 5 years? If
yeswhen?
VI. Chlorination
Are the chlorine tablets wastewater rated? (Inspect
original container for wastewater rating. If not, require
F1permittee
to get tablets rated for wastewater.)
'7/3j
P '�- 4P&, "'?,
Page 1 of 4 SFR Inspection Checklist.xls 6/16/2008, 3:32 PM

Form 101
E2Are
Question
there chlorine tablets in the chlorinator?
JII. Dechlorination
Are the dechlorination tablets wastewater rated? (Inspect
original container for wastewater rating. If not, require
permittee to get tablets rated for wastewater. Only new
1 facilities constructed after August 1, 2007 {Effective date
of latest general permit) are required to install
dechlorination.)
2 Are there dechlorination tablets in the dechlorinator?
Vill
1
4
3
X.
1
2
Ultraviolet (UV)
Is the UV disinfection system working?
Does permittee know how to_determine if the UV system
is working?
Do they know how to clean and replace UV bulbs?
Do they have extra UV bulbs on site?
Pump Systems
Is/are the pump(s) working?
Is the high water alarm in the pump tank operational?
Does the permittee know now to check the pump and
high water alarm to ensure operability?
Detecting Possible Problems/System Failure
Is there any evidence of sewage surfacing or ponding
anywhere on the grounds?
Is there any overflow or soggy soils on the property?
3
4
5
6
XI
!t1
12
Yes No I NIA NIE
Is there any sewage on the ground near the septic tank,
distribution box(es), sand filters or contact chambers,
indicating a possible failure of the system?
Does any area of the property appear to be greener with
vegetation growth than any where else on the property?
(Indicates a possible sandfilter failure.)
If standing sewage or possible system failure is observed,
are there signs of human and animal traffic in the area?
(Need to understand if human contact/vector concerns
are evident/prevalerIL)
If the system shows failure advise the owner that the
system must -be replaced. The system must be designed
for 120 gallons per bedroom. They should contact the
Mooresville Regional Office, Surface Water Protection at
704-663-1699.
Effluent Pipe & Discharge
Did you observe the end of the discharge pipe?
as the outlet discharging?
t4e
as the discharge clear and free of solids?
there any evidence of solids at the end of the pipe or in
arby ditches or creeks?
I/
NC Division of Water Quality
Surface Water Protection Section
Remarks:
oWu�
A
W
Page 2 of 4 SFR Inspection Checklist.xls
6/16/2008, 3:32 PM

Form 101
NC Division of Water Quality
Surface Water Protection Section
Page 3 of 4
SFR Inspection Checklist.xls 6/1612008, 3:32 PM

Form 102
PARAMETER
Page 4 of 4
NC Division of Water Quality
Surface Water Protection Section
EFFLUENT LIMITATION COMPLIANCE CHECKLIST
LIMITS MONITORING REQUIREMENTS Monitoring Results
�wl1AITL11 .. MA11v MFARIMFMENT SAMPLE SAMPLE q Vnar.i Year 3 Year 4 Year 5
SFR Inspection Checklist.xis
6/16/2008, 3:32 PM

RUM
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Mrs. J. Donald Brummitt
17632 Randalls Ferry Road
Norwood, NC 28128
Dear Ms. Br mmitt:
Division of Water Quality
Coleen H. Sullins
Director
September 23, 2009
Dee Freeman
Secretary
Subject: Compliance Evaluation
NPDES Permit No. NCG550095-9�ts��'
Stanly County `'b
Enclosed is a copy of the Compliance Evaluation Inspection (CEI) for the inspection conducted at the subject
facility on September 15, 2009, by Ms. Barbara Sifford with this Office. Thank you for your assistance and
cooperation during the inspection. The system appeared to be operational and maintained although there was
no discharge observed during the inspection.
Analytical data for the treatment system has not been documented but the owner has tried to complete
this information and has a letter stating that no discharge was observed during that visit also. The tank is
pumped on a regular basis and documentation was presented indicating the frequency. There are no drawings
for the system since it was installed prior to the homeowners purchase in 1979.
The chlorine tablet dispenser needs to be cleaned out of old tablet material so that a new tablet can be
placed in the flow of the water when the system is discharging. Since the outfall is located below the water.
surface of.Lake Tillery a sample port needs to be made in the piping or an opening in the lid after the chlorine
dispenser. -
The enclosed reports should be self-explanatory. If you have any questions, comments, or need
assistance with understanding any aspect of your permit or this report, please do not hesitate to contact me at
[phone],ext 2196.
Sincerely,
Barbara Sifford
Technical Consultant
Enclosure -report
Mooresville Regional Office
Location: 610 East Center Ave., Suite 301 Mooresville, NC 28115
Phone: [phone] Fax: [phone] Customer Service: 1-877.623-6748'wwT�7One 1'
Internet: w.ncwaterquality.org 1� OTthCar011na
An Equal Opportunity 1 Affirmative Action Employer —50% Recycled110 a Post Consumer paper Natimally.

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB Na. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 I NI 2 15I 11 NCG550095 Ill 121 09/09/15 117 1811 Cl 19I SI 20I
Remarks
2111111111 1111 IIII I 111 1111 111111111111 1111jIII lIIll
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA --------------Reserved----------
67 I 169 701 I 71 I_I 721 NJ 73 L1J 74 751 I I I I I I 180
Section B: Facility Data
Name and Location of Facility Inspected For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number'
17632 Randalls Ferry Road
03:30 PM 09/09/15
07/08/01
Exit Time/Date
Permit Expiration Date
17632 Randalls Ferry Rd
Norwood NC 28128
04.30 PM 09/09/15
12/07/31
Name(s) of Onsite Representative(s)fTitles(s)/Phone and Fax Number(s)
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
J Donald Brummitt,17632 Randalls Ferry Rd Norwood NC Contacted
28128//704-474-5476/ No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit Operations & Maintenance 0 Self -Monitoring Program 0 Sludge Handling Disposal
Facility Site Review Effluent/Receiving Waters
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Barbara Sifford MRO WQ//704-663-1699 Ext.2196/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

NPDES yr/mo/day Inspection Type 1
3I NCG550095 I11 12I 09/09/15 117 18ICI
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
The owner has tried to have a sample collected for analysis by the City of Salisbury commercial wastewater
lab. There was no flow at that time. During the iste visit there was noway to see if water was in the system
without separating the pipe, therefore a sample tap needs to be made to obtain a sample. The system has
been pumped on a regular basis to removed solids from the tank. This is scheduled for Wednesday
September 16, 2009 by A. L.. Lowder septic tank pumping company in Albemarle.
Page # 2

F
Permit: NCG550095
Inspection Date: 09/15/20o9
Owner - Facility: 17632 Randalls Ferry Road
Inspection Type: Compliance Evaluation
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? ■ ❑ ❑ n
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable Solids, pH, DO, Sludge ❑ M ❑ ❑
Judge, and other that are applicable?
Comment: SFR treatment system
Permit
Yes
No
NA
NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
■
❑
❑
❑
Is the facility as described in the permit?
■
❑
❑
❑
# Are there any special conditions for the permit?
❑
■
Cl
❑
Is access to the plant site restricted to the general public?
❑
■
❑
❑
Is the inspector granted access to all areas for inspection?
■
❑
❑
❑
Comment: Chlorine dispenser is in front yard. It has residual tablet cake material in
the tube that may be interfering with the contact of waste water with the tablets. This
should be cleaned out so that the water can pass over the tablet to dissolve the
chlorine.
Page # 3

A'
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality,
Michael F. Easley, Governor January 5, 2006 William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
J. Donald Brummitt
17632 Randalls Ferry Road
Norwood, NC 28128
Subject: NPDES Permit NCG550095
Stanly County .
Dear Mr. Brummitt <or> Current Occupant:
Our files indicate that a domestic wastewater discharge permit was issued to J. Donald
Brummitt for a domestic wastewater discharge from the subject single family residence. The
Surface Water Protection Section requests that you contact our staff if you do not have a copy of
the current permit, if a change in property ownership has occurred, or should you have -any
questions regarding system operations and monitoring requirements.
Pursuant to the conditions of North Carolina General Permit NCG550000' the following
documentation is required to be maintained, and'readily available for inspection for a period of at
least three. (3) years:
• All operation and'maintenance activities relating to the wastewater treatment system
0 Analytical monitoring results for the parameters listed in Part I, Section A — "Effluent
Limitations and Monitoring Requirements — Final" to be performed annually by a North
Carolina Certified Laboratory
® Inspections of septic tank and disinfection/dechlorination apparatus (if applicable)
Thank you in advance for your cooperation. Should you have any questions concerning
this matter, please contact me at [phone].
Sincerely,
ames B. Bealle III
Environmental Technician
enclosures .
cc: Stanly County Environmental Health Division
Mooresville Regional Office
610 East Center Avenue, Suite 301, Mooresville, North Carolina 28115
Phone: [phone] / Fax: [phone] / Internet: h2o.enr.state.nc.us
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper
NorthCarolina
Naturally,

Q- /�1cQ
�'ll�� y ���.�s � 2

3" REGIONAL OFFICE
NCDEh,� -
North Carolina Department of Environment and6tural Resources
.Division of Water Qu4l.1ty
Michael F. Easley; Governor , William :, Ross, Jr., Secretary , Coleen H. Sullins, Director
July 27,2007WATER
QUALITY SECTIM
J. Donald Brummitt
17632 Randalls Ferry Rd
Norwood, NC 28128
Subject: Renewal of coverage / General Permit NCG550000
17632 Randalls Ferry Road
Certificate of Coverage NCG550095
Stanly County
Dear Permittee:
In accordance with your renewal application [received on January 19, 20071, the Division is renewing
Certificate of Coverage (CoC) NCG550095 to discharge under NCG55000.0. This CoC is issued pursuant to the
requirements of North Carolina General Statue 143-215.1 and the Memorandum of Agreement between North
Carolina and the US Environmental Protection agency dated May 9, 1994. [or as subsequently amended].
If any parts, measurement frequencies or sampling requirements contained in this General Permit. are
unacceptable to you, you have the right to request an individual permit by submitting an individual permit
application. Unless such demand is made, the certificate of coverage shall be final and binding.
Please take notice that this Certificate of Coverage is not transferable except after notice to the
Division. The Division may require modification or revocation and reissuance of the certificate of coverage.
Contact the Mooresville Regional Office prior to any saleor transfer of the permitted facility.
Regional Office staff will assist you in documenting the transfer of this CoC.
This permit does not affect the legal requirements to obtain other permits which may, be required. by
the Division of Water Quality or permits required by the Division of Land Resources, Coastal Area
Management Act or any other. Federal or. Local governmental permit.that may be required.,
If you have any questions concerning the requirements of the General Permit, please contact Toya .
Fields [919 733-5083, extension 551 or [e-mail] or Susan Wilson [919 733-5083, extension 510
or [e-mail]:
Sincerely,
for Coleen H. Sullins
cc: Central Files
ooresviille Re oval OO ffce /Surface Water Protectio
NPDES file
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 One
512 North Salisbury Street, Raleigh, North Carolina 27604 NOfthCarohna
Phone: [phone] /, FAX [phone] /Internet: www.ncwaterquality.org /�
An Equal Opportunity/Affirmative Action Employer -50% Recycled/10% Post Consumer Paper ;Vahoal`

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG550095
DISCHARGE OF DOMESTIC WASTEWATER FROM SINGLE FAMILY RESIDENCES AND
OTHER 100010 DOMESTIC DISCHARGES WITH SIMILAR CHARACTERISTICS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1; other lawful standards and
regulations promulgated and adopted by.the North Carolina Environmental Management Commission, and
the Federal Water Pollution Control Act, as amended,
J. Donald Brummitt
is hereby authorized to discharge domestic wastewater [450 GPD] from a facility located at
1-7632 Randalls Ferry Road
Norwood
Stanly County
to receiving waters designated as PEE DEE RIVER (including Lake Tillery below normal
operating levels) in subbasin 03-07-08 of the Yadkin River Basin in accordance with the
effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II;
III and IV hereof.
This certificate of coverage shall become effective August 1, 2007.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 27, 2007.
for Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management .Commission

NCDENR
North Carolina_ . Department of Environment.and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
January 9, 2007
J. Donald Brunimitt
17632 Randalls Ferry Rd
Norwood, NC 28128
DJul S
rrJAN1
k, P.E.,
2007
- \ uiter Protection
Subject: Renewal Notice [General Permit NCG550000
.Certificate of Coverage NCG550095
Stanly.County
Dear Permittee:
You are receiving this notice because you currently own a property covered under the subject
General Permit for the discharge of domestic wastewater.. NCG550000 will expire on July 31, 2007.
Federal (40 CFR 122.41) and North Carolina (15A NCAC 2H.0105(e)) regulations require
that permit renewal applications be filed at least. 180 days prior to expiration of the current permit.
To satisfy this requirement, the Division must receive a renewal request postmarked no later than
February 1, 2007.
The Certificate of. Coverage (CoC) specific to your property was last issued on August 1, 2002.
The. Division. needs information from you to deter -mine if coverage under NCG550000'is still
necessary.
➢ . If your property still has a wastewater system like the ones described in the enclosed
Technical Bulletin, you must renew the subject CoC. Complete the enclosed form and
submit it to the address on the form.
➢ If you are not sure what type of system your property has, contact James Bealle in the
NC DENR Mooresville Regional Office at. That person [or' other staff members] can help
you determine if you should renew your CoC.
➢ If you know that your property no longer discharges wastewater, contact me at the
address or phone number listed below to request rescission of the CoC.
➢ This information reauest-does not reertain to the Annual Fee of $50:00 billed
separately by the Division's Budget Office. No money is reauired for this
procedure.. The Annual Fee is like the fee you annually pay the DMV'for the sticker on
your vehicle's license plate.. Renewal of your CoC is. like the renewal of your Driver's
License [ca. every five years]:
➢ If you have already mailed a renewal request; you may disregard this notice.
1617 Mail Service Center, Raleigh, North.Carolina 27699-1617 One
512 North Salisbury'Street; Raleigh, North Carolina 27604 NO thCarolina
Phone: [phone], extension 511 % FAX [phone] / [e-mail] Aa
An Equal Opportunity/Affirmative Action Employer —50% Recycled/10% Post:Consumer Paper., tut ally

NCG550095 renewal notice
January 9, 2007
The attached application form shows the information the Division has on file for your.
property. Please verify that the provided information is correct, or make corrections .on the form. .
Complete the additional questions, then sign and date the form.
The completed form should be submitted to the address. listed below the signature block.
If you have any questions concerning this matter, please contact meat -the telephone number
or. a -mail address listed below: (If it'is difficult to reach me, please be aware that your facility is,one
of over 1100 ,that I am contacting regarding the renewal of.NCG550000.)
Thanks for your attention to this matter.
Sincerely,
Charles H. Weaver, Jr.
NPDES Unit
cc: ' Central Files
ooresville Re � onal ©.fiice /James Beall
NPDES file

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Gregory J. Thorpe, Ph.D., Acting
J DONALD BRUMMITT
BRUMMITT J D- RESIDENCE
17632 RANDALLS FERRY RD
NORWOOD, NC 28128
Director
11 /26/01
1�•
A IL
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: NPDES Wastewater Permit Coverage Renewal
Brummitt J D- Residence
COC Number NCG550095
Stanly County
Dear Permittee:
Your residence or facility is currently covered for wastewater discharge under General Permit NCG550000. This
permit expires on July 31, 2002. Division of Water Quality (DWQ) staff is in the process of rewriting this permit
with a scheduled reissue in the summer of 2002. Once the permit is reissued, your residence or facility would be
eligible for continued coverage under the reissued permit.
In order to assure your continued coverage under the general permit, you must apply to the DWQ for renewal of
your permit coverage. To make this renewal process easier, we are informing you in advance that your permit will
be expiring. Enclosed you will find a general permit coverage renewal application form. This will serve as
your application for renewal of your permit coverage. The application must be completed and returned with the
required information by February 01, 2002 in order to assure continued coverage under the general permit. There is
no renewal fee associated with this process.
Failure to request renewal within this time period may result in a civil assessment of at least $250.00. Larger
penalties may be assessed depending on the delinquency of the request. Discharge of wastewater from your
residence or facility without coverage under a valid wastewater NPDES permit would constitute a violation of
NCGS 143-215.1 and could result in assessments of civil penalties of up to $10,000 per day.
If the subject wastewater discharge to waters of the state has been terminated, please complete the enclosed
rescission request form. Mailing instructions are listed on the bottom of the form. You will be notified when the
rescission process has been completed.
If you have any questions regarding the permit coverage renewal procedures please contact the Mooresville
Regional Office at 704-663-1699 or Mack Wiggins of the Central Office Stormwater Unit at [phone], ext.
542
Sincerely,
Bradley Bennett, Supervisor
Stormwater and General Permits Unit
cc: Central Files
Stormwater and General Permits Unit Files
Mooresville Regional Office
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
MOORESVILLE REGIONAL OFFICE
DIVISION OF WATER QUALITY
June 3,1999
J. Donald Brummitt
17632 Randalls Ferry Road
Norwood, North Carolina 28128
1
Subject: Wastewater Discharge Permit
J. Donald Brummitt Residence
NPDES Permit No. NCG550000
Cert. of Coverage No. NCG550095
Stanly County, NC
1�7M. Xa: r_3rO $TO 7
Our files indicate that the subject wastewater discharge permit was issued to J.
Donald Brummitt for a wastewater discharge from the subject residence. The Mooresville
Regional Office requests that you contact this Office if you do not have a copy of the
subject permit, if a change in property ownership has occurred, or if you have any
questions regarding this matter.
Pursuant to conditions of North Carolina General Permit Number NCG550000,
the following documentation must be kept and readily available for inspection for a period
of at least three years:
► required maintenance activities relating to the wastewater treatment system
► yearly sample analyses results for the parameters listed on the effluent
limitation/monitoring page of the permit
► required inspections of disinfection apparatus and septic tanks
Please do not hesitate to contact Linda Love at [phone] if you have any
questions.
Sincerely,
D. Rex Gleason, P.E.
Water Quality Regional Supervisor
cc: Stanly County Health Department
LL 919 NORTH MAIN STREET, MOORESVILLE, NORTH CAROLINA 2B1 15
PHONE [phone] FAX [phone]
AN EQUAL OPPORTUNITY /AFFIRMATIVE ACTION EMPLOYER - SO% RECYCLED/10% POST -CONSUMER PAPER

State of North Carolina
Department of Environment,
Health and Natural Resources A4• •
Division of Water Quality 1 PR 5 1999
James B. Hunt, Jr., Governor IZITITR e-Y
Wayne McDevitt, SecretaryC) E H N Fl
A. Preston Howard, Jr., P.E., Director July 21,1997
J. Donald Brummitt
17632 Randalls Ferry Road
Norwood, NC 28128
Dear Permittee:
Subject: Certificate of Coverage No. NCG550095
Renewal of General Permit
Brumm9tt, J.D. - Residence
Stanly County
In accordance with your application for renewal of the subject Certificate of Coverage, the Division is forwarding
the enclosed General Permit. This renewal is valid -from the effective date on the permit until July 31, 2002. This
permit is issued pursuant to the requirements of North Carolina General Statute 143-215 .1 and the Memorandum of
Agreement between North Carolina and the U.S. Environmental Protection Agency dated' December 6,1983. If any
parts, measurement frequencies or sampling requirements contained in this permit are unacceptable to you, you have
the right to request an individual permit by submitting an individual permit application. Unless such demand is
made, this Certificate of Coverage shall be final and binding.
The Certificate of Coverage for your facility is not transferable except after notice to the Division. Use the enclosed
Permit Name/Ownership Change form to notify the Division if you sell or otherwise transfer ownership of the
subject facility. The Division may require modification or revocation and reissuance of the Certificate of Coverage.
If your facility ceases discharge of wastewater before the expiration date of this permit, contact the Regional
Office listed below at [phone]. Once discharge from your facility has ceased, this permit may be rescinded.
This permit does not affect the legal requirements to obtain other permits which may be required by the Division of
Water Quality, the Division of Land Resources, Coastal Area Management Act or any other Federal or Local
governmental permit that may be required.
If you have any questions concerning this permit, please contact the NPDES Group at the address below.
cc: Central Files _
CMooresyille_Regional _Office_
NPDES Group
Facility Assessment Unit
Sincerely,
y A. Preston Howard,
P.O. Box 29535, Raleigh, North Carolina 27626-0535 [phone] FAX [phone] p&[e-mail]
An Equal Opportunity Affirmative Action Employer 50% recycled / 10% post -consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG550000
CERTIFICATE OF COVERAGE NO. NCG550095
TO DISCHARGE DOMESTIC WASTEWATERFROM SINGLE FAMILY RESIDENCES
AND OTHER DISCHARGES WITH SIMILAR CHARACTERISTICS UNDER THE
NATIONAL POLLUTANTDISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards
and regulations promulgated and adopted by the North Carolina Environmental Management
- Commission, and the Federal Water Pollution Control Act, as amended,
J. Donald Brummitt
is hereby authorized to operate a wastewater treatment facility which includes a septic tank, sand filter
and associated appurtenances with the discharge of treated wastewater from a facility
located at
Brunun tt, J.D. - Residence
17632 Randalls Ferry Road
Norwood
Stanly County
to receiving waters designated as subbasin 30708 in the Yadkin River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth
in Parts I, II, III and IV of General Permit No. NCG550000 as attached.
This certificate of coverage shall become effective August 1, 1997.
This certificate of coverage shall remain in effect for the duration of the General Permit.
Signed this day July 21, 1997. -
�f /A: Preston Howard, Jr., P.E., Director
Division of Water Quality
By .Authority. of the Environmental Management Commission

WDeDpa
f North Carolina
iment 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
J. DONALD BRUMMITT
BRUMMITT RESIDENCE (J. DONALD)
ROUTE 3, BOX 273
NORWOOD NC 28128
Dear Permittee:
G mod'. pF WATQRA � Rcv.� ANDSeptember 30,1993`
SEP 2 8 1993
low
►� �AFfN>
Subject: BRUM TT RESIDENCE (J. DONALD)
Certificate of Coverage NCG550095
General Permit NCG550000
Formerly NPDES Permit NCO042366
Stanly County
The Division of Environmental Management has recently evaluated all existing individual permits for potential
coverage under general permits currently issued by the Division. 15A N.C.A.C. 2H .0127 allows the Division to
evaluate groups of permits having similar discharge activities for coverage under general permits and issue
coverage where the Division finds control of the discharges more appropriate in this manner. The Division has
determined that the subject discharge qualifies for such coverage. Therefore; the Division is hereby issuing the
subject Certificate of Coverage under the state-NPDES general permit no. NCG550000 which shall void NPDES
Permit NC0042366. This Certificate of Coverage is issued pursuant to the requirements of North Carolina and the
US Environmental Protection Agency Memorandum of Agreement dated December 6,1983 and as subsequently
amended.
If any parts, measurement frequencies or sampling requirements contained in this general permit are unacceptable to
you, you have the right to submit an individual permit application, associated processing fee and letter requesting
coverage under an individual permit. Unless such demand is made, this decision shall be final and binding. Please
take notice this Certificate of Coverage is not transferable. Part II, EA. addresses the requirements to be followed
in case of change of ownership or control of this discharge.
In the event that the facilities fail to perform satisfactorily, including the creation of nuisance conditions, the
Permittee shall take immediate corrective action, including those as may be required by this Division, such as the
construction of additional or replacement wastewater treatment or disposal facilities. Construction of any
wastewater treatment facilities will require issuance of an Authorization to Construct from this Division.
Failure to abide by the requirements contained in this Certificate of Coverage and respective general permit may
subject the Permittee to an enforcement action by the Division of Environmental Management in accordance with
North Carolina General Statute 143-215.6A to 143-215.6C. Please note that the general permit does require
monitoring in accordance with federal law. The monitoring data is not required to be submitted to the Division
unless specifically requested, however, the permittee is required to maintain all records for a period of at least
three (3) years.
Post Office Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled -10% post -consumer paper

MR
PW.2'.
Ji.DONAL' ID BRUMMITT
BRUMMITT RESIDENCE (J. DONALD)
Certificate: of Coverage No. NCG550095
The. issuance.- of this Certificate of Coverage is an administrative action initiated by the Division of
Environmental Management and therefore, no fees are due at this time. In accordance with current rules, there
are -no -annual administrative and compliance monitoring fees for coverage under general permits. The only fee
you: will` be responsible for is a renewal fee at the time of renewal. The current permit expires July 31,1997.
This, coverage. will remain valid through the duration of the attached general ,permit. The Division .will be
responsible for the reissuance of the general permit and at such time, you will be notified of the procedures to
follow to continue coverage under the reissued permit. Unless you fail to follow the procedures for continued
coverage, you will continue to be permitted to discharge in accordance with the attached general permit.
The issuance'of this Certificate of Coverage does not preclude the Permittee from complying with any and all
statutes, rules, regulations, or ordinances which may be required by the Division of Environmental Management
or permits required by the Division of Land Resources, the Coastal Area Management Act or any Federal or
Local: other governmental permit that may be required.
If you have any questions or need additional information regarding .this matter, please contact either the
Mooresville Regional Office, Water Quality Section at telephone number 704/ 663-1699, or a review engineer
inithe NPDES Group in the Central Office at telephone number 919/733-5083.
S' erely,
A. Preston Howar , P.E.
cc: Mooresville Regional Office
Central Files

MR
STATE OF NORTH CAROLINA r
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL REURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
C b�, or
RE�� �A
�1VZ.
GENERAL PERMIT NO. NCG550000
CERTIFICATE OF COVERAGE No. NCG550095 E'p 8 1993
, f ��D4fNT41 If
TO DISCHARGE TREATED DOMESTIC WASTEWATERS FROM SINGLE FAMILY RESIDENCES , D
SIMILIAR WASTEWATERS UNDER THE
NATIONAL POLLUNTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
BRUMMITT RESIDENCE (J. DONALD)
is hereby authorized to discharge treated domestic wastewater from a facility located at
BRUMMITT RESIDENCE (J. DONALD)
Stanly County
to receiving waters designated as the LAKE TILLERY/YADKIN-PEE DEE RVR BASN
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I,11,
III and IV of General Permit No. NCG550000 as attached.
This certificate of coverage shall become effective November 1, 1993.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day, September 30, 1993.
A. Preston Howar3, Jr., P.E.,Director
Division of Environmental Management
By Authority of the Environmental Management Commission
0

State of North Carolina
Department of Environment, Health, . and Natural Resources
Mooresville Regional Office
James S. Hunt, Jr., Governor Jonathan B. Howes, Secretary
DIVISION OF ENVIRONMENTAL MANAGEMENT
March 3, 1993
Mr-J. Donald Brummitt
Route 3, Box 273
Norwood, North Carolina 28128
Subject: NPDES-Permit No. NCO042366
Brummitt Residence
Stanly County, NC
Dear Mr. Brummitt:
Our records indicate that NPDES Permit No. NC0042366_was
issued on February 26, 1993 for the discharge of wastewater to the
surface waters of the State from your facility. The purpose of
this letter is to advise you of the importance of the Permit and
the liabilities in the event of failure to comply with the terms
and conditions of the Permit. If you have not already done so, it
is suggested that you thoroughly read the Permit. Of particular
importance is Page 4.
Page 4 sets forth the effluent limitations and monitoring
requirements for your discharge(s). Your discharge(s) must not
exceed any of the limitations set forth. The section headed
".Monitoring Requirements" describes the measurement frequencies,
sample types and sampling locations. Upon commencement of your
discharge (or operation), you must initiate the required
monitoring. The monitoring results must be entered on the
reporting forms furnished to you by this Agency. If you have not
received these forms, they should be arriving shortly. If you fail
to receive the forms, please contact this Office as quickly as
possible. I have enclosed a sample of the "Effluent" reporting
form (DEM Form MR-1), plus instructions for completing the form.
It is imperative that all applicable parts be completed, and the
original and one copy be submitted as required.
The remaining Parts of the Permit set forth definitions,
general conditions and special conditions applicable to the
operation of wastewater treatment facilities and/or discharge(s).
PO. Box 950, 919 North Main Street, Moorewffie, N.C. 28113-0930 • Telephone [phone] • FAX [phone]M
An Equal Opportunity Affirmative Action Employer

Mr. J. Donald Brummitt
Page Two
March 3, 1993
The conditions include special reporting requirements in the event
of noncompliance, bypasses, treatment unit/process failures, etc.
Also addressed are requirements for a certified wastewater
treatment plant operator if you are operating wastewater treatment
facilities. Any changes in operation of wastewater treatment
facilities, quantity and type ,of wastewater being treated or
discharged, expansions and/or upgrading of wastewater treatment
facilities must be permitted or approved by this Agency.
Failure to comply with the terms and conditions of an NPDES
Permit subjects the Permittee to enforcement action pursuant to
Section 143-215.6 of the North Carolina General Statutes. A civil.
penalty of up to $10,000 per violation plus criminal penalties may
be assessed for such violations. If you find at any time that you
are unable to comply with the terms and conditions of the Permit,
you should contact this Office immediately. A Consent Order may be
necessary while pursuing action to obtain compliance.
As a final note, an NPDES Permit is normally issued for a
five-year period. Permits are not automatically renewed. Renewal
requests must be submitted to this Agency no later than 180 days
prior to expiration. Please make note of the expiration date of
-your Permit. This date is set forth on Page 1 of the Permit. Also
note that NPDES Permits are not transferable. If you, as the
Permittee, cease to need this Permit, then you should request that
the Permit be rescinded.
As mentioned previously, the purpose of this letter is to
advise you of the importance of your NPDES Permit. Please read the
Permit and contact this Office at 704/663-1699 in Mooresville if
you have any questions or need clarification. We look forward to
providing any assistance.
Sincerely,
(Z),
�4�
D. Rex Gleason, P. E.
Water Quality Regional Supervisor
Enclosure
DRG:s1

SOC PRIORITY PROJECT: Yes No X
If Yes, SOC No.
To: Permits.and Engineering Unit
Water Quality Section
Attention: Mack Wiggins
Date: December 2, 1992
NPDES STAFF REPORT AND RECOMMENDATION
County: Stanly
Permit No. NCO042366
PART I - GENERAL INFORMATION
1. Facility and Address: J. Donald Brummitt Residence
Rt. 3, Box 273
Randalls Ferry Road
Norwood, North Carolina 28128
2. Date of Investigation: 12-01-92
3. Report Prepared By: G. T. Chen
4. Persons Contracted and Telephone Number: Mrs. J. D. Brummitt;
[phone]
5. Directions to Site: From the junction of Highway 24/27/73 and
SR 1740 (Indian Mound Road) approximately 3.8 miles southeast
of the City Limits of Albemarle, Stanly County, travel south
on SR 1740 about 3.5 miles to the junction with SR 1743
(Randalls Church Road). Turn left and travel on SR 1743 about
1.1 miles to the junction with SR 1802 (Randalls Ferry Road).
Turn left and proceed on SR 1802 about 0.2 mile, The Brummitt
residence is the fifth house on the left (north) side of the
road.
6. Discharge Point(s). List for all discharge points:
Latitude: 350 15' 45" Longitude: 800 06' 05"
L
Attach a U.S.G.S. map extract and indicate treatment facility
site and discharge point on map.
USGS Quad No.: F 18 SE USGS Name: Morrow -Mountain, NC
7. Site size and expansion are consistent with application?
Yes X No If No, explain:
8. Topography (relationship to flood plain included): The
terrain is hilly with slopes generally 5 to 30 %. The

existing site appears to be well above any potential flood
plain.
9. Location of nearest dwelling: A number of dwellings within
100 feet'.
10. Receiving stream or affected surface waters: Lake Tillery
(Pee Dee River)
a. Classification: Ws -III and B
b. River 'Basin and Subbasin No.: Yadkin -Pee Dee & 03-07-08
C. Describe receiving .stream features and pertinent
downstream uses: The receiving . stream is a hydro-
electric impoundment that is used extensively for primary
and secondary recreation. The treated wastewater is
piped several hundred feet from the shore towards the
main channel.
PART II - DESCRIPTION OF DISCHARGE AND TREATMENT WORKS '
1. a. Volume of wastewater to be permitted: 0.00045 MGD
(Ultimate Design.Capacity)
b. What is the current permitted capacity of the wastewater
treatment facility? 0.00045 MGD
C. Actual treatment capacity of the current facility
(current design capacity)? 0.00045 MGD
d. Date(s) and construction activities allowed by previous
Authorizations to Construct issued in the previous two
years: 'N/A
e. Please provide a description of existing or substantially
constructed wastewater treatment facilities: The
existing facility consists . of a septic tank,
nitrification field followed by a subsurface sand filter
and effluent chlorination.
f. Please provide a description of proposed wastewater
treatment facilities: N/A
g. Possible toxic impacts to surface waters: None
h. Pretreatment Program (POTWs only):
in development: approved:
should be required: not needed:
NPDES Permit Staff Report
Version 10/92
Page 2

2. Residuals handling and utilization/disposal scheme:
a. If residuals are being land applied, please specify DEM
permit no.:
Residuals Contractor:
Telephone No.:
b. Residuals stabilization: PSRP:
RFRP:
Other:
C. Landfill:
d. Other disposal/utilization scheme (specify): Septage is
periodically removed by a septage hauler (A. L. Lawder,
Inc.) and transported to a municipal wastewater treatment
plant for final disposal.
3. Treatment plant classification (attach completed rating
sheet): Single family dwelling, no rating-
4. SIC Code(s): 9999
Wastewater Code(s) of actual wastewater, not particular
facilities, i.e., non -contact cooling water discharge from a
metal plating company would be 14, not 56.
Primary:, 04 Secondary: _
Main Treatment Unit Code: 44007
PART III - OTHER PERTINENT INFORMATION
1. Is this facility being constructed with Constructiop Grant
Funds or are any public monies involved (municipals only)?
N/A
2. Special monitoring or limitations (including. toxicity)
requests: N/A
3. Important SOC, JOC or Compliance Schedule dates: (please
indicate) N/A
Date
Submission of Plans.and Specifications
Begin Construction
Complete Construction
4. Alternative Analysis Evaluation: Has the facility evaluated
NPDES Permit Staff Report
Version 10/92
Page 3

all of the non -discharge options available. Please provide
regional perspective for each option evaluated.
Spray Irrigation: Insufficient land area for a spray
irrigation system
Connection to Regional Sewer System: Area -wide system is not
available
Subsurface: Existing facility was converted from a subsurface
disposal system.
Other Disposal'Options: N/A
5. Other Special.Items: N/A
PART IV - EVALUATION AND RECOMMENDATIONS
It is recommended that the NPDES discharge Permit -be renewed.
Signat
of Report Preparer
ice• 1 11-
Water Quality
Date
onal Supervisor
Z—
NPDES Permit Staff Report
Version 10/92
Page 4

17' F
71
71
5500
FE
F 18,5E
106
_
•,\ 11
zz
°°4�
``__
4'
3so
Creek a I1j
oat
rnp
N
\
Jr
05
II �
VY
�'
4 •.BM n
v
II
o
04
�
�``��3p0
0
• ,.
r1 '1 h
o,
—
1
,1
�r
w al
•';, : � 0
03
!
�.
�
1
17
�
/,�,'w
�/f
,$'�1
02
�;Sdg
eel
BM
0
r e
��
, .
E+
, 580
i/
581
� .
• • • 1 670 000 FEET 582
�,\;
583
` 5'
35° 1
80°07 30"
P�0 Mapped, edited, and published by the Geological Survey
oJ+ Control by USGS, NOS/NOAA and North Carolina Geodetic Survey
\P
Topography by photogrammetric methods from aerial photographs
taken 1977. Field checked 1978. Map edited 1981.
Projection and 10,000-foot grid ticks: North Carolina coordinate
system (Lambert conformal conic) •
1000-meter Universal Transverse Mercator grid, zone 17
1927 North American Datum
MN
GN
5°
89 MILS L
10 MILS
t
E

C. DEPT. of NATMUS
�a�p4
RESOURCES AND
v IMAIMUNITY DEVELOPMEDMAir/ 4�'
J �
,,I . A\x'j' V;I NORM 1 2.1992 �� ���• G
44 k)
,yia,:,�..,F r ;::.,,:;. �.. �..r,�El�� State of North Carolina
li�Q4'sE�on-IMW6F Environment, Health and Natural Resources
1 Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27604'
James G. Martin, Governor A. Preston Howard, Jr., P.E. .
William W. Cobey, Jr„ Secretary Acting Director
November 6, 1992
J. Donald Brummitt Subject: NPDES Permit Application
Rt. 3, Box .273, Randall Ferry Road NPDES Permit No.NC0042366
Norwood, NC 28128
Brummitt Residence
Dear Mr. Brummitt Stanly County
This is to acknowledge receipt of the following documents on November 6, 1992:
Application Form
Engineering Proposal (for proposed control facilities),
Request for permit renewal,
Application Processing Fee of $120.00,
Engineering Economics Alternatives Analysis,
Local Government Signoff,
Source Reduction and Recycling,
Interbasin Transfer,.
Other ,
The items checked below are needed before review can begin:
Application Form ,
Engineering proposal (see attachment),
Application Processing Fee of
Delegation of Authority (see attached)
Biocide Sheet (see attached)
Engineering Economics Alternatives Analysis,
Local Government Signoff,
Source Reduction and Recycling,
Interbasin Transfer;
Other
Pollution Prevention Pays
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

If the application is not made complete within thirty (30) days, it will be
returned to you and may be resubmitted when complete.
This -application has been assigned to Mack_ Wiggins
(919/733-5083) of our Permits Unit for review. You wili JDe.advisedof any
comments recommendations, questions or other information necessary for the
review of the application.
I am, by copy of this letter, requesting that our Regional Office
Supervisor prepare a staff report and recommendations regarding this
discharge. If you have any questions regarding this applications,
please contact the .review person listed above.
Sincerely,
G/
C -een H. Sulli , P.E.
CC: Mooresville Regional Office
y

MK I rl LAKULIMA IJLF ' I.- OF NATURAL RESOURCES AND MMUNITY-DEVELOPMEW .
VIRONMENTAL, MANAGEMENT.- CO.WISSION
Y Al
.1 LM rVLLUIMI UIZOWIMKtat tLIMMI-JUM SYSTEM
APPLICATION FOR .PERMIT.; :DISCHARGE SNORT. FORM D
FOR
AGENCY
To be filed only by services, wholesale and retail trade, USE:
and other commercial establishments incIuding'ytgseI$
OPL I W I ON WOW R
xd
CID
I o-11
flA
DATE RECEIVED
1717A
Mu. DAY
C/7
Do, not attempt to complete this form without reading t Y1/1?0
he accompanying instructions
Please print or type
L'Aame, address and telephone number of -facility producing discharge
rAald .—Wr
Name"LLV­ -o
B. Street ad ress, x'c}'3 7� T41/7 Wd ''load
C. Cityn
'r U)n rl D. State
E. County F. ZIP
G.- Telephone No4 , �ZA
Area
Co do
2. SIC
(leave blan­ k)
3. Number of employees
-"1"de17 'e)
4. Nature of business /I/M We S
5. (a) Check here if discharge occurs all year or
(b) Check the month(s) discharge occurs:
1.0 January 7 2.'13February 3. a Ka rch 4.0 Apri I
6.93 June 7.13July _8i:0 August 9.0 September
11. a Novem, btr 12. 0 Dkerber
(c) How many days per week:
. 5. a may.
10.0october
1.01 2. D 2 4 3.04.5 4
6. Types of waste water discharged to surface waters only (check as eoplicable)
Flow, 041 . Ions per operating -day
Volume,. treated before
discharging (pe.r�cent)
Discharge per
0.1-999
1000-4999
5000_5999
.10,000.
50,000,-
Mono
0.1- .
30-
65-
95-
.operating day
49,999
.or more
29.9..
64.9
94.9
100
2)
3)
(4)
(6)
(7),
(0)
(9).
10)
A. Sanitary, daily...,.,
..average
B. Cooling water, etc.,,
daily :average
C. Other-discharge(s)i
.daily average;
LL
Spec i f y
D. Maximum per operat-
ing day for. combined:
discharge (all types)
N

..-.« ...+rnaI.Iry on .aAM o, wiver treatea Or• un-
treated; are discharged to.places-.other than:surface waters, check bele+
as applicable.
Haste water.is.discharged to: 0.1-999 1000-4M 5000-9M 10,00049,199 50;000 or more
0 ) c�j ... cj� l4"i is)
A. Kin itIpaI Stwpr Sys ter
. N; IIiuM�►•gram►1 wI I .
C. 5elitir tank .:
V. Evaporation lagoon or pond
E. Other, specify:.......
B. Number of separate discharge points:
A. I S. 02-3 C.0*4-5 D.0 6 or wore /
9. Name of receiving water or waters / / ll
.1-0. Does your discharge contain or is it possible for. your discharge to contain
one or more of the following substances 1g#t as &.result of your operations,
activities,. or processes: ai"Mia, cyani , a uminum, beryllium, cadmium,
chromium, c cad, mercu nlckal, selenium, lint, phenols, Oil aed
grease, -7�andrine (residuall.
A. yt6 !!.0 no
1 certify that 1 am familiar with the information contained in the application and
that to the best of my knowledge and belief such information is true, complttt, and
accurate.
Printed KaaLe of. Person .Signing
Title
Date pplic #ion Sign. .
S rti f Applicant
forth Carolina General Statute 143-215,6(b (2) provides .that: Airy person who knowingly mak,3.s
cny false. statement representat on, or certification in any applicat�on,'iecord, report., plan,
)r other"document' files"or required to. be:.maintained under Articla'21 or regulations -of the
:nvironmental Management Commission i=plvm*n4n9 that Article, 'or who falsifies, taarpers yith,
)r knowlp renders " inaccurate. any- xecordina- or--nonitor-JUS 4jmice or t3ethod required to be
+perated- or main%ained under Aft;tQ1e 2 —. ot- regulations •of .the Lnviromaent'al 'Management Cocrsis�i
.rnplementfng that Article, ahal•i''be';j%iitTQf i.•misdemeanor punishable by a fine not to exceed
;10,nn0, or by impr.isonmouat•ribt to exceed six. months, or by both, (18 U.S.C. Section 1�01 prmr_
punishment by a fine of iiot more than $10,000 or impriaoaament not tore. than. S ye .3 or both,
'c,r a similar offense.)