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Home My WebLink AboutWQ0023427_Application_20220831State of North Carolina Department of Environmental Quality Division, of Water Resources Division of Water Resources 15A NCACO2T.0600 - SINGLE-FAMILY RESIDENCE WAS'r FEWATEIR IRRICATION'SYSTUM -- RENEWAL FORM: SFRWW'[S-R 02-21 fluirswant to 15A NCAC 02T 0"7 � application does not include all required infoirit aflon and the necessary supporting — . ..... -�U, if the I docurnentation, the application shall be returned, 'rhe applical ' ion and attachments shall be, prepared in accordance with 1j,N jN 0 1,11 t7l-'- AAC' 02T ,0100 15A NGkC� 1""'01 00 and Divisk"al floficies. For more information, visit the Water Quality P r i t . ....... . fig Section's Non -Discharge Branch wivb%ile. T'he Applicant sliall submit an electronic copy of the ap,plication and attachments, ms/Nonf uploadedas a single Portable Document ormat (PDF) life to hi /For *Cha -Bra nch-subadtial- k-krm- Ver2, or emailed to, Non-Dis rLt,,j_ jjijL!�� nCd m ULIL(, 1, if Bess titan 201 naegabytes (MB). jtg , A— 1. Physical addrew 448 Blue Vik)pet Way C'ity: DUrham 1. Billing address:448 Blue Violet Way City: Dia-harn 2. Verify theApplicant does mart haveany overdLic,111110,11 CS County: Chathatri State: NC Zip: 27713- State: NC Zip: 27713- PLU-SLIZUlt [0 15A NCACOII Q L2 c��, perniils f6r renewing fiacflities, shAl not be,�,;ranted if the AppHcant or any affifiation has all LHIpaid MUlUal tee, FORNf� SFRWWIS-R 02-21 Page 1 of'4 PcrinitNo.: \VQ0023427 Cbunty!d Chatham PeruiJAIce: John David Sclifiernan RevocableTrust (i.e., all deeded property owners) The Permittee agrees tag operate and maintain -the single-family residence wastewalertreatrilent arld irrigatiorl systern as f6flows: I Inspectflic septic tank alnWally, and purrip out solids as needed. 2. Inspect and clean the septic tank effluent filter annually, Ql'al'yVicable) 3. Inspect the tablet chlorinator weekly. Add wastewater grade chlorine tafflets (e,g., calcium hYPOCILlorite) as needed. Swimming pool grade chlorine tablets are not acceptable. (i # 'applicable) 4. Inspect the ultrm,iolct disirifeCtiOn Urlit weekly, Clean or replace the lailips and quartz sleeves as needed. (if apj)Ucc,i,b1e) 5. Inspect all storage tanks, purrips, and alamrs nionthly. Remove the floating scurn layer in all purrip/storagetarlks when purnping (lie septic tank solids out. 6. Inspect the spray irrigation system monthly, to verifyproper operation of the sprauy heads; that there are no leaks', that vegetative growth does not obstruct tire spray heads; that the irrigated wastewater is not ponding in or runnuig offthe designated irrigation area; and that there are tio obJectionable odors. tip 'ajyVicabbe) 7. Inspect the drip irrigation systern nionthly to verifyproper operalion of the drip lines; that there are rlo leaks, that %,rege(atjve growth does not obstruct the drip emitters; that the irrigated waste%,ater is riot ponding in or running off the designated irrigation area; and that flicreare no ohiectionable odors. Qfqpplic°able) 8, Mairria in a set ol"Division-approved engineering plans and speeif 1cations. 9, Pay the required annual I`ee. 10. Request renewal of` this permit on Division-a,pproved forms no later than 180 days parr iorIca expiration. 11. Sign and provide as C]14, 1,_)swum gE�jjip iA.rnjic ' �I - !uOfl: to any future owner of the single-family residence waslewater treatment and irrigition s.ystetn for their - C)r ( 11pletion and submission 1.0 the Division ofWater Resources. I/WC Lill derstarid the bove requirernents and agree to these terms as part ofthe issued perrnit. Signature: — ---------- Signature: . . . ... . ...... .... - — ----- Dale: signature� Date: Signature: . ....... Date:� All deededpr(merty owners shiall s,ign this Operation and Maintenance Agreement FOM SFRWWIS-R 02-21 Page 2 of,'-t Was the facility odgmffly Permitted or had a major niodificmion issued after September I , 2006? Yes Pursuant to k..iA N('A(" 0 1 2 1 .0105 d.), subm it a site inap pursualit to the requirements in 15A,NCAC' Wit" 1060-4( . These requirements are". El A scaped nial) ofthe site with topographic contour intervals ni:)t exceeding 110 Ia�et ot-25 percent oftotal site reliefand showing ad fiicilfty-related structures and kmces %viihin the wastewater treatment, storage, and ii-ilgation areas. Soil mapping Lini�ts shown oil kill irrigation sites, C3 "J"he locationj of all WCHS (irICILiclkig usage and consit'LiCti011 details if available), streams (epherneral, interritiftells, and Perennial), springs, lakes,, ponds, and other surface drainage featUres within, 500 feet ail" all wasteNvater treatinenl, storage, and irrigation sites, EJ Delineation ofthe comphaliCe and review boundaries per k 5A NCAC OR, () �.07 and 011 08, arid 15,�,\ NCAC 02T 060 1 D Setbacks as required by NC'iV,',' I J 0606. Cj Site property boundaries within 500 feel of alp wastewater Wealment, storage, and irrigation `cites, El All ha'bitaMe residences or places of public 'a'ssellibly w4hin 500 feet ofall Irealtnent, storage, and irrigation sites, Z No Skip Attachment A. Does (lie signature authority hi Sedion I., heiiii 3 ineet the requiretnents, pursuant to 15A NCAC 021 _.(t 1 61 Z Yes Skip Attachment B, El No .- Suba'di a aia VG galji j Uer purstiatit to j 5A NCAC' 02 V 011,1( �igtiature mithority to sigm aUth()I'iAug the s Does the existing perriiii inciude an apprmed flow reduction'? Yes -' SLINvit as copy ofthe flow redt[etion approval letter, as well as the measured monilily average amount ofwastewater flow corittibuted, per unit f<or time 12 nionths prior to permit renemit, If arly ofthese rrionthly averages are within 209,E ofthe approved "o," rechrMiOu value, the Peirtnitlee shall provide as reevaluation ofthe reduced f1c)", value pursuant to OIC I-CqUiremcrits in V5611 CAC 021 Z No Skip Attachment C. Does [lie I'lermitlee own d�! I of the land associated with the %vastewater collection, treatnient, coriveyance, and irrigation systetti? Z Yes - Skip Attachment D, No -- PLINUant to 5,), f It 01" F 01 p 6( ),, Provide a copy ofall easements, lease agreernents. and ericroachn'tent agrelenlents . . ....... . allowing the Permittee to operate and [j'j&jjrj'jajrj (Ile W�,SteWkjler CO l JeCtio 11, treatment., conveyance, and irrigation, systern on prOpefly nol owneid by the Perrilittee. Are the Perinittee's affiliations of'record correct? Chod,,,' affihafjui-ns,, Z Yes Skip Attachment E, El No - provide tile corrected affiliations and their contact injbnmvtiorl. Does the existing permit include auY CoMplhince Schedules? (See Section I oftfie most recently issued perinit) El Yes - Submit &xtinientacion that die cotapliance sc licid Lites, hdve been Met, Z No - Skip Attachment F, FORM: SFMkIWlS-R, 02-21 Page 3 of 4 Does the Permintee have any existing civil penalties or outstanding violations? [] Yes (civil Penalties) SUbinit payment for the civil poialty, or proof'of'remission request, El Yes (violations) - Submit a copy, of your response to the Notice (A'Violation, Zi No - Skip Attachirrent G, DOCS the eXiSting PCITIlit h)ClUdc setback wvaivers? El Yes Pursuant to �5.,A N( I AC.,02 _,0506 c), provide setbacks waivers that have been writlen, notarized, signed by all parties involved, and recorded with the counly Register of Deeds, Waivers involving the corripliance, boundar, y, shall be ill accordance with 1I 5A Pit, AL( 02L (HOT Z! No -- Skip Attachment H. 1flv,5 bltA,�J 11 It e MA do 7. P- attest that this application - - — ------------- . . ....... (Signature authority's narric as noted in Section 1, Itern 3) has been reviewed by inn and is accurate and coniplete to the best (O"my knoMedge. I understand that if all required parls cif dais , : pp d ;upporlng inibi-malion and attaclurrents are riot included, this I lication package are not completed, and that it' all requij-e application package will be returned as incomplete. I farther certify pill'SLMilt tO � 51-k N( 11 A(021' 0 1 2Q(j2j, that the applicant, or any parent, subsidiary, or other affiliate ofthe applicant has: nor been convicted of eriviromilental crillICS Under, not previously abandoned a,vy,istewat,ei*Greatiiieiitfzicillt)/ without 1,,)roperly clk�)Singtlle facility-, riot paid a civil penaltynot been cornpliaritwith arrycompliance schedule in a permit. settlement agreement, or order; riot paid ari annual feQ. Nate; The Applicant's Certification shall be signed pursuant to 1 5 A NCAC ' '_0 2'J', () I(R)((al. An alternate person may be delegated as the signing official if a letter is provided pursuant to 15'A NCAl.' OTT ,0106(aL). Pursuant to § 15,6\ and § any person who knowingly makes any ralse statement, representation, t.�)r certification in any application package shall be guilty ofa Class 2 inisderneanor, iucluclep 1-ine riot to exceed S 10,000 as well as civil penalties Lip to $25,000 per violation. Signature: Date: THE COMPLUED APPLICA"TION' AND ATTACHMENT'S SDALL BE SUBMIT'rED AS A SINGLE PDF F'ILE VIA: Email: Laserfiche Upload: lit K%Lic ggltl os rqs/NoLi1ji N on- Disc h ALMAE�� Submftlall-Forlrn-'�'er2 FORM: SFRWWlS-R 02-21 Page 4 off