WQ0035474_Application_20210604

Division of Wmef ResOurcts
State of North Carolina
Department �.�' �Jr��Firorjrrir:r:[�1 oua,11tv
D I IVI S 10 n "0,;4 t t r c: % o u rces
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M/A S "I P.'.ttiVA'fFk i k R I G'A 1 P_'vl — Rf:`N f. WAL
k,0104_ SFRWWJS_k 02-21-01
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Pursuant U) 15A NYCA(.' 020'1' .W 0`7(b if the �ippficadon (Jov.s not inchifle. all rc,111111 1 -1
r(.fj "nf,ormation %nd ffie nece-s�ar�- ijprj�)r
documentat'
ion s
h ical, d ffaeli r�u)(s fill I)e� _ �� a (-• t Iion', he, applicat liall I)c returned. �.
NCAC 021" 00100.1 ISA NCAC 02-1 .0600, and Division polici e S laor more inform;jtion, visN th(. Water Qualltv Ve_-rrrjj F r 0 r) 0
Section's Non -Discharge Branch website, F lie Appli'cant halll submit an a lectronk- copy of the a PHuition and
uploaded yin le PortaOleDocument I� orm(11DF) ih .Hefjocs.�C. �� � � ,• ;r-,--i )ia"ttal-w
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(_ SECTION I — APPL-ICANT 1�'FORNIAT ION
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2.
3.
441
Applicant: W'11he E. Breeze
I)cri-nIt No.: WQ0035474
S,irgnature ItAt hors . w"Ume F-,,. Breeze
7
Mailing arddrc.ss,,: 105 Breezchne ilk ra d
Title-, Oviner
City: Hillsborourrh
State. NC Zip,-
27278-
5. Contact person. - Emaij
� -i � rphone n ber-P -selecl �� � � .
6-0 Secondary Contact PUSOM E M a,1 1,
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Primary pho n number.- S C I C�I
SECTION T I — FACIL
Phys'Ical adclE-cs5: 2908 Moorefields Rd.
City: H'll Isborougli
Secondary phone n
I�IJAN�Y rf
C C} tI n Iy: Ora i7 Sri:
S i.a tc: NC
zlpf- .2-7 271 8-
SECTIOYid — BIL) 1:\� G E-IN iDAN I A710_N
1. Billing address:. I k n -0 7Pj
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C i I Y: f., G 1S tale. Z I P J
2. 'Verily the Applic(-111( does not haveai,iy overdue annual fees--
P
wn r
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Flursuaw to 1_ A_NICAU 02_T 10 1 � pc lus for rcntwing faci lin Shall not b,- ,rdii,'Lcd il' the Applicant or ariv affiliation.-,
an unpaid CMIMUM f'CCr
FORM: SFRWWIS-K 02-2.-1 Pagc 1 of

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TENANCE
AC*1RF,,.FjNt1FNT
I 0111d I)LI1111) OL11S011*dLSas needed.
t. 111spect 111c,%;eplic Ulink annLikoffl)1, -C
Inspect 0,11111d CICI'Lln the Septic tirr-ink effluent filter annually. fapplicrible)
1
~ 1 c �i t 01� lAdd wagrade4calciumhypochlorite) � ncedc(
SN\ F 1`1111111 x1(y pool gTade cliloi-I'lle14.1blets ivire not -ac hall . 1`(ipp1ie(_th1e)
4. Inspect the ultraviolet disint'ection unit weekly.
applrc.�al}1c)
Clean or replace the I-Crinips aquariz sleevesneeded., bj
all Stor�1 0 e tanks., pumps, and alai-i3s iiaonthl}r. Rcmovc the floatina scum layer ire all punip/storaac [a.nks
When Plinipma tlic septic tank solids out.
G. iiispcct the Spray irriEyation system monthly to verify: proper operation of the spray heads; that tficre arc no Jkelaks-;
that ve�etati�e �ruwth does not obstruct the spray h�a&s; that the irFiLlated -�Nrastewater is not p�r�di��� ire or runrung
offtlie desianated i.n-i�atian area: and that there are no ah�zctionable odors. (r'fapj.-,)1icab1e)
7. hispect the it ilTigation system nionthly to ' f . pi-oper- operationlines,,, that there ai- leaks,-, that
� i ��•r t does not i the dnp �� �iidated •R � r i nog ina i r i-�� ���A,,
the dcsi'gnaled ir6oation area: and diat ther- are no ob)'ectionable odors. (ITapplic(i
8. Maintain a sci of Divi sion -a P proved
9. Pay the required annual t-cc,,
10. Requesi r ncwal ol'this pemw on 1),invisi on- -Fd fomis iio latcr th'.11 I SSO clays i-'101- to C i' ma"Oli.
l . Sngip-j 1 `han o oONN-m Cal 0 ' � c- �� -Y [c- fani" 1 ros'd once wti l t r
o the Di\,isioti ofWa-ic%i- Resources.
treatnient irind H-i-illation System for their conipletion and submiss'1011 I
1ANIC di cabo\l Sri ; 1 a - �l �� I LIAI)CF111it.
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