NCG550092_Owner (Name Change)_20221019

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR. NORTH CAROLINA
Director Environmental Quality
October 19, 2022
Rhonda Baxley & Brian Baxley
5959 Holder Rd
Clemmons, NC 27012
Subject: General Permit NCG550000
Certificate of Coverage (CoC) NCG550092
5959 Holder Rd
Forsyth County
Dear Permittee:
The Division has approved your request to transfer coverage under the subject General Permit.
Accordingly, the Division hereby issues you a revised version of NCG550092, 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 C waterbody. Therefore, you will use the limits
and monitoring frequencies found in Part I, section C. (1.) 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 Winston-Salem 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
Sincerely,
li V.7)7
.
for Richard E. Rogers, Jr.
Director, Division of Water Resources
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 11611 Mail Service Center I Raleigh, North Carolina 27699-1611
919.707.9000

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG550092
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,
Rhonda Baxley & Brian Baxley
is hereby authorized to discharge <1000 gallons per day of domestic wastewater from a
facility located at
5959 Holder Rd
Clemmons
Forsyth County
to receiving waters designated as an unnamed tributary to Muddy Creek, currently a class C
stream in subbasin 03-07-04 of the Yadkin -Pee Dee 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 10/19/2022.
This Certificate of Coverage shall remain valid for the duration of the General Permit.
Signed this day 10/19/2022
ii 144
for Richard E. Rogers, Jr.
Director, Division of Water Resources
By Authority of the Environmental Management Commission