NCG551095_Complete File-Historical_20190617

NPDES DOCUMENT !;CANNING COVER SHEET
NPDES Permit:
NCG551095
Document Type:
Permit Issuance
Wasteload Allocation
Authorization to Construct (AtC)
Permit Modification
Complete File - Historical
Monitoring Report
Instream Assessment (67B)
Environmental Assessment (EA)
Permit
History
Document Date:
June 17, 2019
Thies document is printed on reuse paper - ignore any
content on the resrerse side

Weaver, Charles
From: Weaver, Charles
Sent: Monday, June 17, 2019 8:48 AM
To: [e-mail]
Cc: Graznak, Jenny; DiMatteo, Paul; Pope, Antoine R
Subject rescission of NCG51095 / Rockingham County
Importance: High
Tracking: Recipient Delivery
[e-mail]
Graznak, Jenny Delivered: 6/17/2019 8:48 AM
DiMatteo, Paul Delivered: 6/17/2019 8:48 AM
Pope, Antoine R Delivered: 6/17/2019 8:48 AM
The Division received your request to rescind the subject Certificate of Coverage (CoC), based on
your possession of a permit from Rockingham County for an on -site disposal system. We do not
object to this request.
NPDES CoC NCG551095 is hereby rescinded, effective immediately. This message is to close the
file for the Division, and for your records.
Unpaid fees for this CoC will be waived.
If in the future you wish to discharge wastewater to the State's surface waters, it must first
apply for and receive a new NPDES permit.
If you have any questions concerning this matter, simply reply to this message.
PLEASE NOTE: as part of the Division's conversion to paperless communication, this email is the
only notification you will be sent regarding the permit rescission. No hard copy will be mailed.
Charles H. Weaver
Environmental Specialist
N.C. Division of Water Resources
N.C. Department of Environmental Quality
919-707-3616
charles.weaver(c�ncdenr.gov
(mailing address) 1617 Mail Service Center, Raleigh, NC 27699-1617
Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed
to third parties.
1

01010 Page 1
SECTION 01010
SUMMARY OF WORK
PART 1 GENERAL
101. WORK COVERED BY CONTRACT DOCUMENTS
A. WORK of this CONTRACT comprises general construction of sanitary sewer improvements for
the Town of Farmville in Pitt County, North Carolina.
B. WORK under this CONTRACT includes, but is not specifically limited to, the construction and
replacement of approximately 6,200 linear feet of sanitary sewer in various sizes, associated
manholes, services, fittings, casings, drybores, appurtenances, demolition, clearing and other
WORK as shown on the PLANS or specified in the SPECIFICATIONS.
C. Refer to the BID SCHEDULE, PLANS and SPECIFICATIONS for a detailed scope of WORK.
102. CONTRACT METHOD
A. The WORK shall be performed under a single UNIT PRICE CONTRACT with the OWNER.
B. The WORK has been divided into sections for accounting purposes as shown in the BID
SCHEDULE.
C. The OWNER reserves the right to award a CONTRACT for all WORK, or portions thereof, as
deemed by the OWNER to be in his best interest. Final award shall be made to the lowest
responsive, responsible BIDDER based on the combination of BID ITEMS as selected by the
OWNER.
103. SCHEDULING OF THE WORK
A. The CONTRACTOR shall submit a proposed construction schedule for approval by the
OWNER prior to beginning work. This schedule shall specifically identify each segment of
work and the order in which each segment is to be performed. WORK shall not proceed until
the OWNER has approved the CONTRACTOR'S proposed schedule.
104. CONTRACTOR USE OF PREMISES
A. The CONTRACTOR shall limit his use of the premises for work, storage, and access in order
to allow for simultaneous use by the OWNER, the public, and other contractors, and to:
1. Allow continuous public usage of roads.
2. Minimize interruption of services to customers.
B. Coordinate use of premises under direction of the ENGINEER.
C. Assume full responsibility for protection and safekeeping of products under this CONTRACT.
D88018 108 11:08 AM
FARMVILLE-18-BASIN-5-CN3-SAN-SEW-IMP-DOC-006.wpd 190218

Attention: Charles Weaver
NCDENR
Water QualityPermitting - NPDES
1617 Mail Service Center
Raleigh, NC 27699 - 1617
Dear Mr Weaver
Re: James Scott SFR, Permit # NCG551095
RECEIVED/NCoEQ/DIN,
JUN = Z019
Water Quality
l'ermittin o
9 Section
In July of 2016 my previous septic system (which was a discharge system and was failing) had
to be replaced. It has been replaced by a non discharge system, permitted by the Rockingham
County Department of Health and Human Services. I have included documentation from the
county department.
I am requesting recission of the annual fees for the previous system since it is no longer
functional.
Sincerely,
James R Scott, Jr
Home. 336.342.3805
Cell 336.616.2489
jimscottl8©gmail.com
,6b ' '

ROCKINGHAM COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES Permit Number 1U 27WI f- I
1/4/Improvement Permit 7(101 202.0 Expiration Date —Transferable
orixation for iN st water System Construction (Expires five years from date of issuance of Improvement Permit)
T AX P I N �i �°n �Kjt 0 g eg1¢Iassificatigp LTl1ReZ W T NAME : Ailettlii2Ption to Connect to Wattgater System
PROPERTY INFORMATION OWNER INFORMATION
Road Name: CANTERBURY RD 180
Subd/Park: SHANNON PARK
Section
Lot # : Al2
Lot Size :
87 S LT WENTWORTH ST LF SALEM
ON RT RS072015-1
✓ House
S- inglewide
_Doublewide
_Commercial
_Food Service
Seats
O- ther
360 GPD Design
3 #bedrooms
_#people
basement
✓ basement w/
plumbing
addition
Wastewater Flow
TYPE SYSTEM
_New ✓ Repair _Expansion
_Conventional _Existing
_LP.P V/ Pump
Saprolite.1956(6)
_Innovative
%/ Other 2S°lam ALI. Sy1.
SCOTT JIM
180 CANTERBURY RD
REIDSVILLE
336 342 3805
NC 27320
Water Supply : DAN RIVER
CHURCH RT
ON CANTERBURY RD 3RD HOUSE
IMP Name DATE
INSTALLER l
I//N�STALLATIO, CONDITIONS
UP Adl CAA. or {�I( sus.] in
seific area Divert-
9 tiw c. # -F./bey\
tfi�A.e
44 . L44l c_ ¢a
pAG�V�^ 2 'wI1 v /n
10 D A- AS 0 fixer (:
INSTALL ON CONTOUR
LANDSCAPE PROMPTLY
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
.See /4 Acke /JIc,f v\
Poly 514 •eC5
Si•ned:
Date:
4-
LAYOUT SPECIFICATIONS INSTALLED
1000 Jc Septic Tank i 0 i•)0
io00 g Pump Tank i e: i.; 0
too Ef 1 Dra infield sq ft & 0 0-1"
AA i9;er Water Supply 'Dam l! OA,
c #of lines
300' Total length of lines - 17i '
te“mc-t Trench depth K4
36 Trench width If,"
NA Depth of rock below pipe
NA Total rock depth
2LS' Distance to foundation 7tT,
a 10' Distance to property lines ;
ISO i Distance to well t `
ploA-WS Watershed v160. _ irg
OPERATION PERMIT
7 Aa
Si • ned.
APPEALS: -' written petition to the Office of Administrative Hearings, 6714
accordance with GS.150B-23(a). THIS PERMIT may be suspended or revo
upon the permit has occurred...Also upon a finding that its issuance was base
Septic Tanks require effluent filters, and access devices...GS.130A-335.1.
t` (4
RECEIVED/NCDEQ/DWR
JUN 1 1 2019
Water Quality
Permitting Section
/0/Q2c4/6,
Sefvice CIT., Raleigh, North Carolina 27699-6714. In
n a finding that a violation...or a condition imposed
incorrect or inadequate information—GS,130A-23(a)(c)(d).

RECEIVED/NCDEQ/DWR
`RQNRYRD
64ft
2 INCH SCH 40 PVC
SUN 1 1 2019
W • = r Quality
Permitt . Section
216
A 13 to"t 6
ROCKINGHAM COUNTY ENVIRONMENTAL HEALTH
fhsclaims. Rockingham County shill not be liable for any error in this data. This includes moss of omission, commission, mecca
erranconcerning the content of the dam. and relative d positional accuracy of the data. Primary sources of this dam must be consultedfor
seti6cation ofdala
1 inch = 40 feet
7996048141364
180 Canterbury Rd
Shannon Park Lot 11-12
Operation Permit

Ala,
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory John E. Skvarla, III
Governor Secretary
August 22, 2014
Mr. James R. Scott
180 Canterbury Road
Reidsville, NC 27320
Subject: Compliance Evaluation Inspection
Certificate of Coverage: NCG551095
180 Canterbury Road, Reidsville
Rockingham County
Dear Mr. Scott:
RECEIVED►DENRIDWR
AUG 2 9 2014
Water Quality.
on
Permitting
On August 21, 2014, Jenny Graznak of this office performed a Compliance Evaluation Inspection on the
wastewater treatment system for the single family residence located at 180 Canterbury Road in Reidsville,
NC, for which you are the owner. You hold a Permit to discharge domestic wastewater from this system.
No issues were detected during the inspection. Ms. Graznak observed two chlorinator tubes and the
discharge pipe. No discharge was observed at the pipe. Should you ever detect a discharge from the pipe,
permit text Part I Section A (attached to this report) specifies the monitoring requirements.
The Permit also requires that the septic tank contents be pumped out every five years to prevent solids
from clogging the sandfilter. The Permit requires that the chlorinator be adequately supplied with chlorine
tablets for proper operation. If you have any questions regarding this permit, please contact Ms. Graznak
at [phone].
Sincerely,
Sherri V. Knight, P.E., Assistant Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDENR
cc: WSRO
Charles Weaver, NPDES Unit
Division of Water Resources
585 Waughtown Street, Winston-Salem, North Carolina 27107
Phone: [phone] Internet: www.ncwater.org
An Equal Opportunity l Affirmative Action Employer — Made in part by recycled paper

71.
United States Environmental Protection Agency
EPA Washington, D.C. 20460
Water Compliance Inspection Report
Form Approved.
OMB No. 2040-0057
Approval expires 8-31-98
Section A: National Data System Coding (Le., PCS)
Transaction Code NPDES yr/mo/day Inspection
1 ILIJ 2 LI 3 I NCG551095 111 121 14/08/21 117
Type
18 I r• I
I I I I I
Inspector Fac Type
19 12.1 20 ( I
66
21 LLI I I I I I I I I I I I I I I I I I I I I I I I I I I
I I I
l l l i l
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA
67 I I 70 LI 71 Li 72 Li
Reserved
73I 1 I7475�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
POTW name and NPDES permit Number)
180 Canterbury Road ' I o: '
180 Canterbury Rd
Reidsville NC 27320
Entry Time/Date
10:OOAM 14/08/21
Permit Effective Date
13/08/01
Exit Time/Date
10:45AM 14/08/21
Permit Expiration Date
18/07/31
Name(s) of Onsite Representative(s)lritles(s)/Phone and Fax Number(s)
///
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
James R Scott,180 Canterbury Rd Reidsville NC 27320///
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit
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
Jennifer F Graznak WSRO WQ//336-771-5000/
a4/1/405rilt-- ei-si.iwri
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
- -- g/ 22 / L{
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page# 1

Michael F. Easley, Governor
William.G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
7 October 2008
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
7008-0150-0002-7876-7891
James R. Scott
180 Canterbury Road
Reidsville, NC 27320
Subject: Compliance Evaluation Inspection
Single Family Residence Wastewater Treatment System
NPDES General Wastewater Permit NCG550000
Certificate of Coverage NCG551095, Issued: 08/31/2007
Rockingham County
Dear Mr. Scott:
1. Ron Boone of the Winston-Salem Regional Office of the NC Division of Water Quality (DWQ) conducted a compliance
evaluation inspection (CEI) at the subject facility on 30 September 2008. Your assistance and cooperation was
greatly appreciated. An inspection checklist is attached for your records and the inspection findings are summarized
below.
2. The facility is located at 180 Canterbury Road, in Reidsville, Rockingham County, North Carolina. The facility
discharges treated domestic wastewater to Wolf Island Creek, which is currently classified as a Class C water in the
Roanoke River Basin.
Documentation & Monitoring Review
3. Some required documentation is not being kept or was not available for review during the inspection as detailed
below:
a. Records of septic tank pumping could not be located at the time of the inspection.
b. Records of system inspection and maintenance are not being kept as required. You must begin keeping these
records as required by Part 1, Section A and Part II, Sections D and E of the permit.
c. Although you stated during the inspection that analytical sampling is being conducted, the records could not be
located.
Please note that in accordance with Part II, Section E, Paragraph 1 of the permit, you must keep all records required
by the permit on site and readily available for inspection for at least three years.
Site Review
4. The facility• is clean and appears to be functioning properly. Operation/maintenance issues noted during the
inspection are detailed below:
a. The chlorine tablets you are currently using are not rated for use with wastewater treatment systems. Please
refer to attachment #3 for suppliers of the proper tablets. Also note that there may be other local suppliers who
can provide you with the correct tablets.
There were no outstanding signs of imminent system failure.
o One
NCarolina
J1 aturafly
North Carolina Division of Water Quality 585 Waughtown Street Winston Salem, NC 27107 Phone [phone] Customer Service
Internet: ncwaterquality.org FAX [phone]
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper

Mr. James R. Scoot
7 October 2008
Page 2
5. Please reply to this letter in writing within 30 business days of receiving it. Your response should include an action
plan and implementation schedule for the correction of the issues listed above in paragraphs 3 and 4. Please also
include copies of records of septic tank pumping and analytical monitoring results that you have completed since the
date of issuance of the certificate of coverage (08/31/2007).
6. Please be aware that the Division may assess civil penalties of up to $25,000 per day, per violation for failure to
comply with the requirements of NCG550000. Please review the NCG550000 general permit in detail to familiarize
yourself with all requirements and to ensure you maintain future compliance.
7. Thank you for your cooperation in this matter. Should you have any questions, please feel free to contact Mr. Boone
or me at [phone].
Since; ly,
Steve W. Tedder
Water Quality Regional Supervisor
Winston-Salem Region
Division of Water Quality
Attachments:
1. BIMS Inspection Checklist
2. Field Inspection Checklist
3. List of Chlorine Tablet Suppliers
cc: SWP — WSRO
Central Files
NPDES West Unit

AT&
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Coleen H. Sullins, Director
James R. Scott, Jr.
180 Canterbury Road
Reidsville, NC
Dear Permittee:
27320
August 31, 2007
Subject: Renewal of coverage / General Permit NCG550000
180 Canterbury Road
Certificate of Coverage NCG551095
Rockingham County
In accordance with your renewal application [received on January 23, 2007], the Division is renewing
Certificate of Coverage (CoC) NCG551095 to discharge under NCG550000. This CoC is issued pursuant to the
requirements of North Carolina General Statue 143-215.1 and the Memorandum of Agreement between North
Carolina and the US Environmental Protection agency dated May 9, 1994 [or as subsequently amended].
If any parts, measurement frequencies or sampling requirements contained in this General Permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual permit
application. Unless such demand is made, the certificate of coverage shall be final and binding.
Please take notice that this Certificate of Coverage is not transferable except after notice to the
Division. The Division may require modification or revocation and reissuance of the certificate of coverage.
Contact the Winston-Salem Regional Office prior to any sale or transfer of the permitted facility.
Regional Office staff will assist you in documenting the transfer of this CoC.
This permit does not affect the legal requirements to obtain other permits which may be required by
the Division of Water Quality or permits required by the Division of Land Resources, Coastal Area
Management Act or any other Federal or Local governmental permit that may be required.
If you have any questions concerning the requirements of the General Permit, please contact Toya
Fields [919 733-5083, extension 551 or [e-mail]] or Susan Wilson [919 733-5083, extension 510
or [e-mail].
Sincerely,
for Coleen H. Sullins
cc: Central Files
Winston-Salem Regional Office / Surface Water Protection
NPDES file
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
512 North Salisbury Street, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Internet: www,ncwaterquality.org
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper
NorthCarolina
Naturally

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG551095
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,
James R. Scott, Jr.
is hereby authorized to discharge domestic wastewater [360 GPI)] from a facility located at
180 Canterbury Road
Reidsville
Rockingham County
to receiving waters designated as an unnamed tributary to Wolf Island Creek in subbasin 03-02-03
of the Roanoke 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 31, 2007.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day August 31, 2007.
Ag--- d/tio
for Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

North Carolina Department of Environment and Natural Resources
Division of Water Quality
RENEWAL FORM FOR EXISTING PERMITTED FACILITIES
NPDES renewal application for continued coverage under General Permit NCG550000:
Certificate of Coverage NCG551095
(Please verify the information in items 1 & 2 as correct, or note any corrections that should be made.)
(Please print or type all other answers)
1) Mailing address* of property owner:
Owner Name James R Scott, Jr. /
Street Address 180 Canterbury Rd
Address Reidsville, NC 27320
Telephone (Home)33 (-/o-2 5"-0,_3-' (Mobile) 336 6/t v
(e-mail address) -. J ('0 T / rJ. t/ (Ti) 7 K (I c rr, . c O/Yi
* Address to which all permit correspondence will be mailed
2) Location of facility producing discharge*:
Facility ID
Address:
James R Scott Jr - Residence
180 Canterbury Rd,
Reidsville, NC 27320 (Rockingham County)
Telephone (Home).336 3 (/ 3 (Mobile) 336 (i'/t' (757
* If the facility is not yet constructed, give the street address or lot number where the structure will be
built.
3) Description of Discharge:
a) Type of facility producing waste (please check one):
$ Primary residence
❑ Vacation/second home
❑ Undeveloped property
❑ Other [describe]:
4) Please check the components that comprise the wastewater treatment system:
II Septic tank ❑ Dosing tank ® Primary sand filter Fl Secondary sand filter
❑ Recirculating sand filter(s) @1 Chlorination 0 Dechlorination
O Other form of disinfection: ❑ Post Aeration (describe)
Page 1 of 2

NCG550000 renewal form
5) Other Information:
a) When was the septic tank last pumped out? / .k7h/ 7' , c e
NOTE: the septic tank must be pumped out at least once every 3-5 years
J
b) Is the facility [home] occupied year-round, or only seasonally? )ear /je7 L/4 0
c) Approximately how many people use the facility when it is occupied? �J
d) When was the wastewater system installed? tlti r R.l S 1 ,��n.-�
6) Certification:
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing: --J 1. i ')
CaPui) e i y& / s(v7
(Signature of Applicant) (Date Signed)
North Carolina General Statute 143-215.6 b (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any
application, record, report, plan or other document filed or required to be maintained under Article
21 or regulations of the Environmental Management Commission implementing that Article, or who
falsifies, tampers with or knowingly renders inaccurate any recording or monitoring device or
method required to be operated or maintained under Article 21 or regulations of the Environmental
Management Commission implementing that Article, shall be guilty of a misdemeanor punishable
by a fine not to exceed $25,000, or by imprisonment not to exceed six months, or by both. (18 U.S.C.
Section 1001 provides a punishment by a fine of not more than $25,000 or imprisonment not more
than 5 years, or both, for a similar offense.)
Mail this completed form and a copy of the receipt for your last septic service to:
Mr. Charles H. Weaver, Jr.
NC DENR / DWQ / NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
Page 2 of 2

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State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Alan W. Klimek, P.E., Director
July 26, 2002
JAMES R SCOTT JR.
JAMES R SCOTT JR - RESIDENCE
180 CANTERBURY RD
REIDSVILLE, NC 27320
AlicwA
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: Reissue - NPDES Wastewater Discharge Permit
James R Scott Jr - Residence
COC Number NCG551095
Rockingham County
Dear Permittee:
In response to your renewal application for continued coverage under general permit NCG550000, the Division of
Water Quality (D'WQ) is forwarding herewith the reissued wastewater general permit Certificate of Coverage
(COC). This COC is reissued pursuant to the requirements of North Carolina General Statute 143-215.1 and the
Memorandum of Agreement between the state of North Carolina and the U.S. Environmental Protection Agency,
dated May 9, 1994 (or as subsquently amended).
The following information is included with your permit package:
* A copy of the Certificate of Coverage for your treatment facility
* A copy of General Wastewater Discharge Permit NCG550000
* A copy of a Technical Bulletin for General Wastewater Discharge Permit NCG550000
Your coverage under this general permit is not transferable except after notice to DWQ. The Division may require
modification or revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal
requirements to obtain other permits which may be required by DENR or relieve the permittee from responsibility
for compliance with any other applicable federal, state, or local law rule, standard, ordinance, order, judgment, or
decree.
Please note that effective January 1, 1999 the fees for all permits issued by DWQ were changed. This changed the
fee for your wastewater general permit coverage from a $240 fee paid once every five years to a yearly fee of $50.
If you have not already been billed this year for the yearly fee, you will receive a bill later this year.
If you have any questions regarding this permit package please contact Bill Mills of the Central Office Stormwater
and General Permits Unit at [phone], ext. 548
Sincerely,
B,z4iLLe1 r-f—
for Alan W. Klimek, P.E.
cc: Central Files
Stormwater & General Permits Unit Files
Winston-Salem 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

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG550000
CERTIFICATE OF COVERAGE No. NCG551095
TO DISCHARGE DOMESTIC WASTEWATERS FROM SINGLE FAMILY RESIDENCES
AND OTHER DISCHARGES WITH SIMILAR CHARACTERISTICS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
JAMES SCOTT JR
is hereby authorized to operate a domestic wastewater treatment facility which includes a septic tank, sand filter,
and associated appurtenances with discharge of treated domestic wastewater from the facility located at
JAMES R SCOTT JR - RESIDENCE
180 CANTERBURY RD
REIDSVILLE
ROCKINGHAM COUNTY
to receiving waters designated as a ut to Wolf Island Creek, a class C water, in the Roanoke 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 If coverage shall become effective August 1, 2002.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 26, 2002.
B4Attelley Sv,1144-64---
for Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

State of North Carolina
Department of Environment,
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
November 17, 2000
Mr. James R. Scott, Jr.
180 Canterbury Road
Reidsville, NC 27320
AVA
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AN D NATURAL RESOURCES
Subject: General Permit NCG550000
Cert. of Coverage NCG551095
Authorization to Construct
James R. Scott, Jr. Residence
Rockingham County
Dear Mr. Scott:
In accordance with your application for an NPDES discharge permit received October 16, 2000
by the Division, we are herewith forwarding the subject Certificate of Coverage under the state-NPDES
general permit for James R. Scott, Jr. Authorization is hereby granted for the construction of a 360 GPD
wastewater treatment system consisting of an existing 1000 gallon septic tank, propose primary
distribution box, 420 square foot (6'X 70) primary sandfilter, with a loading rate of not more than 1.15
GPD/square foot, 210 square foot (3'X 70) secondary sandfilter with a loading rate of not more than
2.30 GPD/square foot, chlorinator, contact tank and cascade aeration with a discharge of treated
wastewater into an unnamed tributary to Wolf Island Creek classified C waters in the Roanoke River
Basin. All elbow piping must be of the long sweeping type. All cleanouts are to be housed in meter
boxes below the surface. This system must be at least 10 feet from the dwelling and property lines and
at least 100 feet from water supply wells on and off the site. The system must also be contructed and
located above a 100 year flood.
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 and letter
requesting coverage under an individual permit. Unless such demand is made, this decision shall be
final and binding. Please take notice this permit is not transferable. Part II, E.4. addresses the
requirements to be followed in case of change of ownership or control of this discharge.
The Authorization to Construct is issued in accordance with Part III, Paragraph 2 of NPDES
Permit No. NCG550000, and shall be subject to revocation unless the wastewater treatment facilities are
constructed in accordance with the conditions and limitations specified in Permit No. NCG550000.
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] FAX [phone]
an Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer pape

Permit No. NCG551095
Authorization to Construct
James R. Scott, Jr.
November 17, 2000
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.
The Winston-Salem Regional Office, telephone number 919/771-4600, shall be notified at least
forty-eight (48) hours in advance of operation of the installed facilities so that an in -place inspection can
be made. Such notification to the regional supervisor shall be made during the normal office hours from
8:00 a.m. until 5:Q0 p.m. on Monday through Friday, excluding State Holidays.
Upon co pletion of construction and prior to operation of this permitted facility, a certification
must be received certifying that the permitted facility has been installed in accordance with the NPDES
Permit, the Certificate of Coverage, this Authorization to Construct and the approved plans and
specifications. Mail the Certification to the Stormwater and General Permits Unit, 1617 Mail Service
Center, Raleigh, NC 27699-1617.
A copy off the approved plans and specifications shall be maintained on file by the Permittee for
the life of the facility.
The sand media of the sandfilters must comply with the Division's sand specifications. The
engineer's certification will be evidence that this certification has been met.
A leakage test shall be performed on the septic tank and dosing tank to insure that any
exfiltration occurs at a rate which does not exceed twenty (20) gallons per twenty-four (24) hour per
1,000 gallons of tank capacity. The engineer's certification will serve as proof of compliance with this
condition.
Failure to abide by the requirements contained in this Authorization to Construct may subject the
Permittee to an enforcement action by the Division of Water Quality in accordance with North Carolina
General Statute 143-215.6A to 143-215.6C.
The issuance of this permit does not preclude the Permittee from complying with any and all
statutes, rules, regulations, or ordinances which may be required by the Division of Water Quality or
permits required by the Division of Land Resources, the Coastal Area Management Act or any Federal
or Local other gorrnmental permit that may be required.

Permit No. NCG$51095
Authorization to Construct
James R. Scott, Jr.
November 17, 2000
If you have any questions or need additional information, please contact Mack Wiggins,
telephone number 919/733-5083.
Sincerely,
ORI(4I11!1 SIGNEL 13Y
WILLAM C MILLS
Kerr T. Stevens.
cc: Central Files
Winston-Salem Regional Office, Water Quality
Roosevelt, Childress, EPA
Point Source Compliance Enforcement Unit
Rockingh4m County Health Department

f:
r
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
CERTIFICATE OF COVERAGE
GENERAL PERMIT NO. NCG551095
TO DISCHARGE DOMESTIC WASTEWATERS FROM SINGLE FAMILY RESIDENCES AND OTHER
DISCHARGES WITH SIMILAR CHARACTERISTICS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
James R. Scott, Jr.
is hereby authorized to construct and operate a wastewater treatment facility that consists of an existing septic tank,
distribution box, primary sandfilter, secondary sandfilter, chlorinator, chlorine contact tank, cascade aeration and
associated ap urtenances with the discharge of treated wastewater from a facility located at the
•
James R. Scott, Jr. Residence
180 Canterbury Road
northwest of Reidsville
Rockingham County
to receiving waters designated as an unnamed tributary to Wolf Island Creek in the Roanoke 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 November 17, 2000
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day November 17, 2000
()RI(aill SIGNE F Y
Kerr T. Stevens, Director
Division of Water Quality
By Authority of the Environmental Management Commission

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Markers
Name: Discharge point-NCG551095
Short Name: Dschrg
Coordinates: 036° 23' 15.7" N, 079° 40' 52.4" W
Comment: James Scott Residence, Subbasin-030203, Roanoke River Basin,Rockingham County,
UT to Wolf Island Creek, Class-C, Quad B2ONW