WQ0005440_Additional Information Requested_20210216

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. ❑ANIEL SMITH
Director
TIMOTHY J. PARKER
523 EAGLES WAY
MEBANE, NORTH CAROLINA 27302-9822
Dear Mr. Parker:
NORTH CAROLINA
£nvironmen(aI Quality
February 16, 2021
Subject: Application No. WQ0005440
Additional Information Request
3520 Laws Store Rd. SFR
Single -Family Residence
Wastewater Irrigation System
Orange County
Division of Water Resources' Central and Regional staff has reviewed the application package
received January 14, 2021. However, additional information is required before the review may be
completed. Please address the items on the attached pages no later than the close of business on March
18, 2021.
Please be aware that you are responsible for meeting all requirements set forth in North Carolina
rules and regulations. Any oversights that occurred in the review of the subject application package are
still the Applicant's responsibility. In addition, any omissions made in responding to the outstanding items
listed herein, or failure to provide the additional information on or before the above requested date may
result in your application being returned as incomplete.
Please reference the subject application number when providing the requested information. All
revised and/or additional documentation shall be signed, sealed and dated (where needed), with one
electronic copy submitted to my attention at the address below.
If you have any questions regarding this request, please do not hesitate to contact me at (919) 322-
9624 or [e-mail]. Thank you for your cooperation.
Sincerely,
Poonam Giri, Hydrogeologist II
Division of Water Resources
cc: Raleigh Regional Office, Water Quality Regional Operations Section (Electronic Copy)
Permit Application File WQ0005440
EQ,- North Carolina Department of Environmental Quality I Division of Water Resources
4��A512 North Sal ishury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
r:r�i:�rrr_-.::yin ft '-
oepvu.en�cr 919,707.9004

Mr. Timothy J. Parker
February 16, 2021
Page 2 of 2
Payment of Annual Fees:
Records show that this facility has overdue fees. Please see the attached fee report.
Pursuant to 15A NCAC 02T .0120(c), permits for renewing facilities shall not be granted if the applicant has not
paid an annual fee.
Please submit payment of the overdue annual fees.
• Annual fees may be paid using ePayment, or
Mail payment (made payable to the North Carolina Department of Environmental Quality to:
NCDEQ - Division of Water Resources, Attn: Non -Discharge Billing, 1617 Mail Service Center, Raleigh
NC 27699-1617

North Carolina Department of Environmental Quality
Division of Water Resources
Permit Number: WQ0005440
Permit Type: Single -Family Residence Wastewater Irrigation
Facility Name: 3520 Laws Store Rd. SFR
Facility Addressl: 3520 Laws Store Rd
Facility Address2:
City, State & Zip: Hurdle Mills, NC 27541
Owner Information Details:
MUST submit a Change of Name/Ownership form to DWR to make any changes to this Owner information.
(Click here for "Change of Name/Ownership"form)
Owner Name: Timothy Joel Parker
Owner Type: Individual Owner Type Group: Individual
*** Legally Responsible for Permit ***
(Responsible corporate officer/principle executive officer or ranking elected official/general partner or proprietor;
or any other person with delegated signatory authority from the legally responsible person.)
Owner Affiliation: Timothy Joel Parker Title:
Addressl: 3520 Laws Store Rd
Address2:
City, State & Zip: Hurdle Mills, NC 27541
Work Phone: [phone] Fax:
Email Address: [e-mail]
*** Permit Annual Fee Billing ***
Billing Month: October
Invoice Number Invoice Date Invoice Due Date Invoice Amount Invoice Status
2020PR008539 9/2/2020 10/2/2020 $60.00 Overdue
2018PR008688 9/7/2018 10/7/2018 $60.00 Overdue
Owner Contact Person(s)
Contact Name Title Address Phone Fax Email
Facility Contact Person(s)
Contact Name Title Address Phone Fax Email
Permit Contact Person(s)
Contact Name Title Address Phone Fax Email
Permit Billing Contact Person(s)
Contact Name Title Address Phone Fax Email
Timothy Joel 3520 Laws Store Rd, Hurdle Mills, NC 919-732-4360 [e-mail]
Parker 27541 m
2/16/2021

Permit Number: WQ0005440
Permit Type: Single -Family Residence Wastewater Irrigation
Facility Name: 3520 Laws Store Rd. SFR
Facility Addressl: 3520 Laws Store Rd
Facility Address2:
City, State & Zip: Hurdle Mills, NC 27541
Persons with Signatory Authority
Type Contact Name Title Address Phone Fax Email
Designated Operators
If the designated operators listed below are incorrect or no longer associated with the collection system, the information can be updated by su
a completed "Operator Designation Form" (Click Here for ORC Designation Form). Please provide specific details as to the changes requested,,
the addition/removal of designated operators. For all other operator questions or issues, please call 919-807-6353.
Facility Classification:
Operator Name
Role Cert Type Cert Status Cert # Effective Date
2/16/2021