NCG551292_owner name change_20210719

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
S. DANIEL SMITH
Director
Richard Vickers
3916 NC Hwy 751
Apex, NC 27523
Dear Permittee:
NORTH CAROLINA
Environmental Quality
July 19, 2021
Subject: General Permit NCG550000
Certificate of Coverage (CoC)NCG551292
2912 Cheek Rd
Durham County
The Division has received and approved your request to transfer coverage under the subject General
Permit. Accordingly, the Division hereby issues you a revised version of NCG551272, along with a copy of
NCG550000. Discard any earlier versions of the permit and use this version until further notice. 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 October 15, 2007 [or
as subsequently amended].
PLEASE NOTE: Your facility discharges to a class WS-IV NSW waterbody. Therefore, you will use
the limits and monitoring frequencies found in Part I, section C. (3.) of NCG550000.
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.
This CoC is not transferable except after notice to the Division. The Division may require
modification or revocation and reissuance of the CoC. Contact the Raleigh 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 any other State, Federal, or Local
governmental permit that may be required. If you have any questions concerning the requirements of the
General Permit, please contact Derek Denard of the NPDES staff [[e-mail]].
cc: NPDES file
NORT
Department of Environmental Dual
Sincerely,
li V.7)7
.
for S. Daniel Smith
Director, Division of Water Resources
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 11617 Mail Service Center I Raleigh, North Carolina 27699-1617
919.707.9000

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG551292
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,
Richard Vickers
is hereby authorized to discharge <1000 gallons per day of domestic wastewater from a
facility located at
2912 Cheek Rd
Durham
Durham County
to receiving waters designated as Panther Creek, currently a class WS-IV NSW stream in
subbasin 03-04-01 of the Neuse River Basin in accordance with the effluent limitations, monitoring
requirements, and other conditions set forth in Parts I, II, and III hereof.
This certificate of coverage takes effect 7/19/2021.
This Certificate of Coverage shall remain valid for the duration of the General Permit.
Signed this day 7/19/2021
ii 144
for S. Daniel Smith
Director, Division of Water Resources
By Authority of the Environmental Management Commission

ROY COOPER
C;oremor
MICHAEL S. REGAN
Sccrewr'
S. DANIEL SMITH
Armor
NORTH CAROLINA
Environmental Quality
NPDES Certificate of Coverage (CoC)
--NCG550000 OWNERSHIP CHANGE FORM
I. Please enter the CoC number for which the change is requested.
Certificate of Coverage
1
1
5
l
2
2-
II. Please provide the following for the requested change (revised CoC).
a. Request for change is a result of: ❑ Change in ownership of the residence/property
2/Name change of the facility or owner
If other please explain:
b. CoC will be issued to (person's name
or company name, if applicable): 17/'r' tiers Land Co i C-
c. Owner: person legally responsible for y�
CoC:
i irsl MI Last
39/,
%-7740/7Cry
Title
y 751
Permit Holder Mailing Address
4-p -e x ,mac Z 7s"Z _3
City State /ip
(j/c) 7yo--L- 0e
Phone E-mail Address
d. Facility name (if applicable): VI ‘C kf rvs/aii deo lle- cid t'c) in
e. Facility address:
f. Facility contact person:
[if different from Owner]
q Addr ss
12_
City State
Zip
First MI Last
Phone E-mail Address
III. Contact person (if different from the person legally responsible for the CoC)
First
MI Last
Title
Mailing Address
City State Zip
( )
Phone E-mail Address
Revised 12/2018

IV.
V.
NCG550000 OWNERSHIP CHANGE FORM
Page 2 of 2
Will this permitted facility continue to discharge the same volume and type of wastewater as
prior to this ownership or name change?
❑ Yes
❑ No (please explain)
Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING:
❑ This completed application is required for both facility -name change and/or facility ownership
change requests.
❑ Legal documentation of the transfer of ownership (such as a property deed, relevant pages of a
contract, or a bill of sale) is required, for an ownership change request.
The certifications below must be completed and signed by the new applicant in the case of an ownership
change request.
APP IGATIAN
I, , attest that this application for a name/ownership change has been reviewed and is accurate and
complete to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if all required supporting information is not included, this application package will be
returned as incomplete.
Signature Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Mr. Charles H. Weaver
NC DEQ / DWR / NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
Revised 4/2020