NCG550988_Owner (Name Change)_20220216

DocuSign Envelope ID: BAF61383-D089-46A6-AD69-233AB1353DD6
ROY COOPER
Governor
ELIZABETH S. BISER
Secretory
S. DANIEL SMITH NORTH CAROLINA
Director Environmental Quality
February 16, 2022
Chatham County Habitat for Humanity
467 West St.
Pittsboro, NC 27312-8228
Subject: Permit Name/Ownership Change Request
Single Family Wastewater Treatment System
NPDES General Permit NCG550000
Certificate of Coverage NCG550988
Facility Name: 696 Jeremiah Drive
Chatham County
Dear Property Owner:
This letter is to inform you that the subject facility is operating a wastewater treatment system without a valid permit. The
Division of Water Resources records indicate Chatham County Habitat for Humanity currently owns the above subject
facility. As the property owner, you are also the owner of the existing single-family wastewater treatment system, which
treats the domestic wastewater from the residence and releases the effluent to waters of the state. According to Division
records, a Permit Name/Ownership Change Form has not been submitted for the subject facility. The permit issued for
this facility still belongs to the facility's former owner, Joseph Kulash.
This places Chatham County Habitat for Humanity in violation of North Carolina General Statute § 143-215.1(a)(2),
which states that no person may operate a treatment works or disposal system unless that person has received a permit
from the Commission. Failure to request a change of ownership for the subject permit may result in the assessment of
civil penalties of up to $25,000 per violation.
To prevent further action, please submit a Permit Name/Ownership Change Form within fifteen (15) days receipt of this
letter. If you have documentation proving that this record is in error, please forward them to our office.
We appreciate your assistance in this matter. If you have any questions about this letter, please contact Cheng Zhang at
919-791-4259 or via email at [e-mail].
Respectfully,
EDocuSigned by:
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B2916E6AB32144F...
Vanessa E. Manuel
Assistant Regional Supervisor
Water Quality Regional Operations Section - Raleigh Regional Office
Division of Water Resources, NCDEQ
Attachment: Permit Name/Ownership Change Form
cc: Laserfiche
Charles Weaver, NPDES Permitting Unit w/o attachments
Chatham County Health Department w/o attachments
North Carolina Department of Environmental Quality 1 Division of Water Resources
Raleigh Regional Office 13800 Barrett Drive Raleigh, North Carolina 27609
919.7914200

ROY COOPER
ELIZABETH S. BISER
S. DANIEL SMITH
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
N
G
5
5
0
9
8
8
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
❑ 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):
c. Owner: person legally responsible for
CoC:
d. Facility name (if applicable):
e. Facility address:
f. Facility contact person:
[if different from Owner]
First
MI Last
Title
Permit Holder Mailing Address
City State Zip
Phone E-mail Address
Address
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:
in
The certifications below must be completed and signed by the new applicant in the case of an ownership
change request.
APPLICANT CERTIFICATION
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