WQ0031599_Application_20210602

DWR
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Division of Water Resources
15A NCAC 02T .0600 — SINGLE-FAMILY RESIDENCE
WASTEWATER IRRIGATION SYSTEM — RENEWAL
FORM: SFRWWIS-R 02-21
Pursuant to 15A NCAC 02T .0107(b), if the application does not include all required information and the necessary supporting
documentation, the application shall be returned. The application and attachments shall be prepared in accordance with 15A
NCAC 02T .0100, 15A NCAC 02T .0600, and Division Policies. For more information, visit the Water Quality Permitting
Section's Non -Discharge Branch website. The Applicant shall submit an electronic copy of the application and attachments
uploaded as a single Portable Document Format (PDF) file to htti)s://edocs.deci.nc.p-ov/Forms/NonDischarp-e-Branch-Submittal-
Form-Ver2, or emailed to Non-Discharp-e.Regorts(&ncdenr.p-ov if less than 20 megabytes (MB).
SECTION I
— APPLICANT INFORMATION
1.
Applicant: Western Wake Investments, Inc.
2.
Permit No.: WQ0031599
3.
Signature authority: David Ferrell
Title: President
4.
Mailing address: 1600 Morrisville Carpenter Rd
City: Cary
State: NC Zip: 27519-
5.
Contact person: David Ferrell
Primary phone number: (919) 380-559 Office
Email: [e-mail]
Secondary phone number: ( ) - Select
6.
Secondary Contact person:
Primary phone number: ( ) - Select
Email:
Secondary phone number: ( ) - Select
SECTION II — FACILITY INFORMATION
1. Physical address: 120 Lexington Drive County: Chatham
City: Apex
State: NC Zip: 27523-
SECTION III — BILLING INFORMATION
1. Billing address: 1600 Morrisville carpenter Rd
City: Apex State: NC Zip: 27523-
2. Verify the Applicant does not have any overdue annual fees:
https:Hdeg.nc. gov/about/divisions/water-resources/water-resources-permits/Wg-epUments
Pursuant to 15A NCAC 02T .0120(c), permits for renewing facilities shall not be granted if the Applicant or any affiliation has
an unpaid annual fee.
FORM: SFR)VWIS-R 02-21 Page 1 of 4

SECTION IV I OPERATION AND MAINTENANCE
Pennit No.: WQ0031599
Pennittee: Western Wake
The Permittee agrees to operate and
follows:
1. Inspect the septic tank annually,
2. Inspect and clean the septic tank
3. Inspect the tablet chlorinator w,
Swimming pool grade chlorine
4. Inspect the ultraviolet disi
applicable)
5. Inspect all storage tanks, pumps,
when pumping the septic tank so.
6. Inspect the spray irrigation system
that vegetative growth does not ob;
off the designated irrigation area; a
7. Inspect the drip irrigation system n
vegetative growth does not obstruc
the designated irrigation area; and 1
8. Maintain a set of Division-annrnvP,
9. Pay the required annual fee.
10. Request renewal of this permit on I
11. Sign andprovide a Change of Own
treatment and irrigation system for
I/We understand the above renuiremeni
Signature:
Signature:
' Signature:
Signature:
Inc. (i.e., all deeded property owners)
the single-family residence wastewater
pump out solids as needed.
cent filter annually. (if applicable)
Add wastewater grade chlorine tablets (e.g.,
:s are not acceptable. (if applicable)
unit weekly. Clean or replace the lamps
I alai -ins monthly. Remove the floating scum
out.
County. Chatham
and irrigation system as
hypochlorite) as needed.
quartz sleeves as needed. (if
in all pump/storage tanks
)nthly to verify: proper operation of the spra heads; that there are no leaks;
ict the spray heads; that the irrigated wastewa er is not ponding in or running
that there are no objectionable odors. (if applicable)
thly to verify: proper operation of the drip 11 es; that there are no leaks; that
e drip emitters; that the irrigated wastewater ' not ponding in or running off
there are no objectionable odors. (if applica le)
engineering plans and specifications.
forms no later than 180 days drior to expiration.
application to any future owner of the single-family residence wastewater
completion and submission to the Division hf Water Resources.
and agree to these terms as part of the issued
Date: 1'! 170LI
Date:
Date:
Date:
FORM: SFRWWIS-R 02-21 Page 2 of

ATTACHMENT A — SITE MAP
Was the facility originally permitted or had a major modification issued after September 1, 2006?
® Yes —Pursuant to 15A NCAC 02T .0105(d), submit a site map pursuant to the requirements in 15A NCAC 02T .0604(d). These
requirements are:
® A scaled map of the site with topographic contour intervals not exceeding 10 feet or 25 percent of total site relief and showing
all facility -related structures and fences within the wastewater treatment, storage, and irrigation areas.
® Soil mapping units shown on all irrigation sites.
® The location of all wells (including usage and construction details if available), streams (ephemeral, intermittent, and
perennial), springs, lakes, ponds, and other surface drainage features within 500 feet of all wastewater treatment, storage,
and irrigation sites.
® Delineation of the compliance and review boundaries per 15A NCAC 02L .0107 and .0108, and 15A NCAC 02T .0601.
® Setbacks as required by 15A NCAC 02T .0606.
® Site property boundaries within 500 feet of all wastewater treatment, storage, and irrigation sites.
® All habitable residences or places of public assembly within 500 feet of all treatment, storage, and irrigation sites.
❑ No — Skip Attachment A.
ATTACHMENT B — SIGNATURE AUTHORITY DELEGATION
Does the signature authority in Section I, Item 3 meet the requirements pursuant to 15A NCAC 02T .0106(b)?
® Yes — Skip Attachment B.
❑ No — Submit a delegation letter pursuant to 15A NCAC 021.0106(c) authorizing the signature authority to sign.
TTACHMENT C — FLOW REDUCTION
Does the existing permit include an approved flow reduction?
❑ Yes — Submit a copy of the flow reduction approval letter, as well as the measured monthly average amount of wastewater flow
contributed per unit for the 12 months prior to permit renewal. If any of these monthly averages are within 20% of the approved
flow reduction value, the Permittee shall provide a reevaluation of the reduced flow value pursuant to the requirements in 15A
NCAC 02T .0114(f).
® No — Skip Attachment C.
ATTACHMENT D — EASEMENT, ENCROACHMENT, AND LEASE AGREEMENTS
Does the Permittee own all of the land associated with the wastewater collection, treatment, conveyance, and irrigation system?
® Yes — Skip Attachment D.
❑ No — Pursuant to 15A NCAC 02T .0116(c), provide a copy of all easements, lease agreements, and encroachment agreements
allowing the Permittee to operate and maintain the wastewater collection, treatment, conveyance, and irrigation system on
property not owned by the Permittee.
ATTACHMENT E — AFFILIATIONS
Are the Permittee's affiliations of record correct? Check affiliations.
❑ Yes — Skip Attachment E.
® No — Provide the corrected affiliations and their contact information.
ATTACHMENT F — COMPLIANCE SCHEDULES
Does the existing permit include any Compliance Schedules? (See Section I of the most recently issued permit)
❑ Yes — Submit documentation that the compliance schedules have been met.
® No — Skip Attachment F.
FORM: SFRWWIS-R 02-21 Page 3 of 4

ATTACHMENT C — CIVIL PENALTIES AND OUTSTANDING VIOLATIONS
Does the Permittee have any existing civil ienalties or outstanding violations?
❑ Yes (civil penalties) — Submit paymen for the civil penalty, or proof of remission request.
❑ Yes (violations) — Submit a copy of yo r response to the Notice of Violation.
® No — Skip Attachment G.
ACHMENT H-- SETBACK WAIVERS
Does the existing permit include setback w fivers?
❑ Yes — Pursuant to 15A NCAC 02T .Of 06f 0, provide setbacks waivers that have been wril ten, notarized, signed by all parties
involved, and recorded with the county Register of Deeds. Waivers involving the compliance boundary shall be in accordance
with 15A NCAC 02L .0107.
® No — Skip Attachment H.
(Signature authorit,
has been reviewed by me and is accurate a
application package are not completed, a
application package will be returned as inc(
parent, subsidiary, or other affiliate of the of
a wastewater treatment facility without prof
schedule in a permit, settlement agreement,
Note: The Applicant's Certification shall b
the signing official if a letter is provided pi
person who kno gly makes any false state
2 misdemeanor w lich 4iay iUude a fine n
Signature:
THE COMPLETED APPLICATION
Email:
APPLICANT'S CERTIFICATION
name as noted in Section I, Item 3)
1 complete to the best of my knowledge. I enders
that if all required supporting information and
plete. I further certify pursuant to 15A NCAC '02'
icant has: not been convicted of environmental crir
ly closing the facility, not paid a civil penalty; not'
order; not paid an annual fee.
signed pursuant to 15A NCAC 02T .0106(b). An
,uant to 15A NCAC 02T .0106(c). Pursuant to §
ent, representation, or certification in any applicati
to exceed $10,000 as well as civil penalties up to
r
Date:
ATTACHMENTS SHALL BE SUBMITTED
attest that this application
I that if all required parts of this
achments are not included, this
120ib1, that the applicant, or any
under; not previously abandoned
a compliant with any compliance
:mate person may be delegated as
3-215.6A and § 143-215.6B, any
package shall be guilty of a Class
5,000 per violation.
A SINGLE PDF FILE VIA:
Upload:
FORM: SFRWWIS-R 02-21
Page 4 of 4

LEGEND
ADJACENT BOUNDARY
BOUNDARY (PROPERTY)
NOTES
1. ALL SURVEY INFORMATION SHOWN HEREON
PROVIDED BY:
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INITIAL DRIP LINES
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RETURN LINES
RETURN MANIFOLD
BUILDING SETBACK
RIGHT OF WAY
SOIL BORING
EPHEMERAL STREAM
SUPPLY LINES
SUPPLY MANIFOLD
SOLENOID VALVE
BALL CHECK VALVE
CLEAN OUT
CONTROL PANEL
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SEPTIC TANK
HYDRAULIC UNIT
ULTRAVIOLET UNIT
Map Unit Symbol
Map Unit Name
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Creedmoor-Green Level complex, 2
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CrC
Creedmoor-Green Level complex, 6
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REVIEW BOUNDARY AT MIDWAY (0 .7 ,' �a
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---� BOUNDARY AND WASTE BOUNDARY
PER 15A NCAC 02L .0108 IV)
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G 3/0 120 C 180--
NC ONE MAP
CHATHAM COUNTY GIs
RESIDENTIAL LAND SERVICES, PLLC
2. LOCATION OF ALL UTILITIES IS
APPROXIMATE. CONTRACTOR SHALL VERIFY
AT THE SITE PRIOR TO CONSTRUCTION.
3. NO CONSTRUCTION WILL BE ALLOWED
WHEN THE GROUND IS WET.
4. NOTIFY UNDERGROUND UTILITIES LOCATOR
PRIOR TO ANY EXCAVATION. CONTRACTOR
IS RESPONSIBLE FOR COORDINATION OF
ALL TRADES AND SUBCONTRACTORS.
CONTRACTOR IS RESPONSIBLE FOR FIELD
VERIFYING ALL DIMENSIONS, ELEVATIONS,
AND LOCATION OF ALL EXISTING
CONDITIONS AND UTILITIES.
5. AREA DISTURBED IS LESS THAN ONE ACRE.
A FORMAL EROSION AND SEDIMENT
CONTROL PLAN IS NOT REQUIRED.
HOWEVER, CONTRACTOR SHALL PROVIDE
ALL MEANS NECESSARY TO MAINTAIN
CONTROL OF ONSITE SEDIMENT AND
EROSION.
6. CONTRACTOR SHALL COMPLY WITH ALL
APPLICABLE OSHA AND BOISE CASCADE
SAFETY REQUIREMENTS.
7. CONTRACTOR IS RESPONSIBLE FOR
REPAIRING ALL CONSTRUCTION DAMAGE
EXPEDITIOUSLY AND AT NO ADDITIONAL
COST TO THE OWNER.
8. CONTRACTOR SHALL FIELD STAKE
LOCATIONS OF SYSTEM COMPONENTS FOR
ENGINEER'S APPROVAL PRIOR TO
INSTALLATION. EXISTING INVERTS SHALL BE
VERIFIED AT THIS TIME TO ENSURE A MIN.
2% SLOPE IS PROVIDED.
REVISIONS
NO. DATE DESCRIPTION
1 10/05/20 REV. PER STATE COMMENTS
2 06/04/21 PERMIT RENEWAL
PROJECT MANAGER: PROJECT ENGINEER:
GSM AVF
DRAWN BY: CHECKED BY:
HGM GSM
DATE:
OCTOBER 05, 2020
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06 /0[
MacCONNELL
& Associates, P. C.
501 CASCADE POINTE LANE, SUITE 103
CARY, NORTH CAROLINA 27513
P.O. BOX 129
LICENSE MORRISVILLE, NORTH CAROLINA 27560
No. C-1039 TEL: [phone] FAX: [phone]
WESTERN WAKE
INVESTMENTS
SURFACE SYSTEM
LEXINGTON LOT 12
CHATHAM COUNTY, NC
EXISTING CONDITIONS
PROJECT NUMBER I DRAWING NUMBER
A35201.12 C-101
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A55301.00 - BUILDERS FIRST SOURCE - WASTEWATER EXPANSION

North Carolina Department of Environmental Quality
Division of Water Resources
Permit Number: WQ0031599
Permit Type: Single -Family Residence Wastewater Irrigation
Facility Name: 120 Lexington Dr. SFR
Facility Addressi: 120 Lexington Dr
Facility Address2:
City, State & Zip: Apex, NC 27523
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: Western Wake Investments Inc
Owner Type: Non -Government Owner Type Group: Organization
*** 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: Baivd S Ferrell Title: President
Addressi: David
Address2:
City, State & Zip:
Work Phone: Fax:
Email Address:
*** Permit Annual Fee Billing ***
Billing Month: December
Invoice Number Invoice Date Invoice Due Date Invoice Amount Invoice Status
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
Western Wake 1600 Morrisville Carpenter Rd, Cary, NC 919-380-0559 m
Investments Inc 27519 david(a)omerferrell.com
Persons with Signatory Authority
Type Contact Name Title Address Phone Fax Email
5/14/2021

Permit Number: WQ0031599
Permit Type: Single -Family Residence Wastewater Irrigation
Facility Name: 120 Lexington Dr. SFR
Facility Addressi: 120 Lexington Dr
Facility Address2:
City, State & Zip: Apex, NC 27523
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 Designadon Form). Please provide specific details as to the changes requested, A
the addition/removal of designated operators. For a// other operator questions or issues, please call 919-807-6353.
Facility Classification:
Operator Name
Role Cert Type Cert Status Cert # Effective Date
5/14/2021 Page 2