WQ0002882_Permit Renewal__20161219

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
Date: 12/19/ 6 County: Moore
To: Aquifer Protection Section Central Office Permittee: Collin Webster.
Central Office Reviewer: A. Wessner Project Name: Webster Single Family S.I.
Regional Login No: ?? Application No.: W00002882
L GENERAL INFORMATION
1. This application is (check all that apply): ❑ New ® Renewal
❑ Minor Modification ❑ Major Modification
® Surface Irrigation❑ Reuse ❑ Recycle ❑ High Rate Infiltration ❑ Evaporation/Infiltration Lagoon
❑ Land Application of Residuals ❑ Attachment B included ❑ 503 regulated ❑ 503 exempt
❑ Distribution of Residuals ❑ Surface Disposal
❑ Closed -loop Groundwater Remediation ❑ Other Injection Wells (including in situ remediation)
Was a site visit conducted in order to prepare this report? ® Yes or ❑ No.
a. Date of site visit: 12/06/06
b. Person contacted and contact information: Colin Webster
c. Site visit conducted by: Jim Barber .
d. Inspection Report Attached: ❑ Yes or ® No.
2. Is the following information entered into the BIMS record for this application correct?
N Yes or ❑ No. If no, please complete the following or indicate that it is correct on the current application.
For Treatment Facilities:
a. Location: 1.40 S. Lakeshore Drive; Whisperina Pines, NC 28327.
b. Driving Directions: From Vass, NC take Vass -Carthage road to the intersedtion with Niagra-Carthage road
and turn left onto Niagra-Carthage Road. Go approx. 1 1/2 miles to S. Lakeshore drive and turn right. Take
S. Lakeshore past the Whispering Pines pool and bear right,staying on S Lakeshore Upon crossing the
bridge turn into the driveway of_140 S. Lakeshore. This is the only residence on this manmade island at the
western end of Thaggards Lake.
c. USGS Quadrangle Map name and number: Carthage, NC (F-21 W)
d. Latitude: 35.265193 Longitude: 79.377029 (approx. location behind residence, see attached ma
e. Regulated Activities / Type of Wastes (e.g., •subdivision, food processing, municipal wastewater):
residential, single family home spra irrigation system for domestic wastewater.
For Disposal and Infection Sites:
(If multiple sites either indicate whicht sites the information applies to, copv and paste a new section into the
document for each site, or attach additional pages for each site)
a. Location(s): same
b. Driving Directions: same
c. USGS Quadrangle Map name and number: same
d. Latitude: 35.265355 Longitude:-79.377395 (approx. center of spray irrigation area, see attached maps
FORM: APSARR webstersinglefamily WQ0002882 Dec 2016 renewal staff report.doc

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
II. NEW AND MAJOR MODIFICATIONAPPLICATIONS (this section not needed for renewals or minor
modifications, skip to next section)
Description Of Waste(S) And Facilities
1. Please attach completed rating sheet. Facility Classification:
2. Are the new treatment facilities adequate for the type of waste and disposal system?
❑ Yes ❑ No ❑ N/A. If no, please explain:
3. Are the new site conditions (soils, topography, depth to water table, etc) consistent with what was reported by
the soil scientist and/or Professional Engineer? ❑ Yes ❑ No ❑ N/A. If no, please explain:
4. Does the application (maps, plans, etc.) represent the actual site (property lines, wells, surface drainage)? ❑
Yes ❑ No ❑ N/A. If no, please explain:
5. Is the proposed residuals management plan adequate and/or acceptable -to the Division. ❑ Yes ❑ No ❑
N/A. If no, please explain:
6. Are the proposed application rates for new sites (hydraulic or nutrient) acceptable?
❑ Yes ❑ No ❑ N/A. If no, please explain:
7. Are the new treatment facilities or any new disposal sites located in a 100-year floodplain?
❑ Yes ❑ No ❑ N/A. If yes, please attach a map showing areas of 100-year floodplain and please explain
and recommend any mitigative measures/special conditions in Part IV:
8. Are there any buffer conflicts (new treatment facilities or new disposal'sites)? ❑ ,Yes or ❑ No. If yes, please
attach a map showing conflict areas or attach any new maps you have received from the applicant to be
incorporated into the permit: .
9. Is proposed and/or existing groundwater monitoring program (number of wells, frequency of monitoring,
monitoring parameters, etc.) adequate? ❑ Yes ❑ No ❑ N/A. Attach map of existing monitoring well
network if applicable.' Indicate the review and compliance boundaries. If No, explain and recommend any
changes to the groundwater monitoring program:
10. For residuals, will seasonal or other restrictions be required? ❑ Yes ❑ No ❑ N/A If yes, attach list of sites
with restrictions (Certification B?)
III RENEWAL AND MODIFICATIONAPPLICATIONS (use previous section for new or manor modification
s stems
Description Of Waste(S) And Facilities
Are there appropriately certified ORCs for the facilities? ® Yes or ❑ No.
Operator in Charge: Colin Webster (landowner) Certificate #:
Backup- Operator in Charge: Certificate #:
FORM: APSARR webstersinglefamily WQ0002882 Dec 2016 renewal staff report.doc 2

AQUIFER PROTECTION SECTION REGIONAL STAFF.REPORT
2. Is the design, maintenance and operation (e.g. adequate aeration, sludge wasting, sludge storage, effluent
storage, etc) of the treatment facilities adequate for the type of waste and disposal system? ® Yes or ❑ No.
If no, please explain:
3. Are the site conditions (soils, topography, depth to water table, etc) maintained appropriately and adequately
assimilating the waste? ® Yes or ❑ No. If no, please explain:
4. Has the site changed in any way that may affect permit (drainage added, new wells inside the compliance
boundary, new development, etc.)? If yes, please explain: NO
5. Is the residuals management plan for the facility adequate and/or acceptable to the Division?
® Yes or ❑ No. If no, please explain: According to Colin Webster, the solids chamber of.the septic tank is
pumped every three years or so.
6. Are the existing application rates (hydraulic or' nutrient) still acceptable? ® Yes or ❑ No. If no, please
explain:
7. Is the existing groundwater monitoring program (number of wells, frequency of monitoring, monitoring
parameters, etc.) adequate? ❑ Yes _❑ No ® N/A., Attach map of existing monitoring well network if
applicable. Indicate the review and compliance boundaries. If No, explain and recommend any changes to the
groundwater monitoring program:
8. Will seasonal or other restrictions be required for added sites? ❑ Yes ® No ❑ N/A If yes, attach list of sites
with restrictions (Certification B?)
9. Are there any, buffer conflicts (treatment facilities or disposal sites)? ❑ Yes or ® No. If yes, please attach a
map showing conflict areas or attach any new maps you have received from the applicant to be incorporated
into the permit:
10. Is the description of the facilities, type and/or volume of waste(s) as written in the existing permit correct?
Yes or ❑ No. If no, please explain:
11. Were monitoring wells properly constructed and located? ❑ Yes or ❑ No ® N/A. If no, please explain: _
12. Has a review of all self -monitoring data been conducted (GW, NDMR, and NDAR as applicable)? ❑ Yes or
❑ No ® N/A. Please summarize any findings resulting from this review: Single family spray irrigation
system is not required to submit NDMR)NDAR since no flow measurement available. The flow rate of 480 gpd
appears to be a design parameter based upon the system components and the home having four bedrooms.
13. Check all that apply: ® No compliance issues; ❑ Notice(s) of violation within the last permit cycle; ❑
Current enforcement action(s) ❑ Currently under SOC; ❑ Currently under JOC; ❑ Currently under
moratorium. If any items checked, please explain and attach any documents that may help clarify
answer/comments (such as NOV, NOD etc):
14. Have all compliance dates/conditions in the existing permit, (SOC, JOC, etc.) been complied with? ❑ Yes
❑ No ❑ Not Determined ® N/A.. If no, please explain:
15. Are there any issues related to compliance/enforcement that should be resolved before issuing this permit? ❑
Yes or ® No ❑ N/A. If yes, please explain:
FORM: APSARR webstersinglefamily WQ0002882 Dec 2016 renewal staff report.doc 3

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
IV. INJECTION WELL PERMIT APPLICATIONS (Complete these two sections for all systems that use injection
wells, including closed -loop groundwater remediation effluent injection wells, in situ remediation injection wells, and heat
pump injection wells.)
Description Of Well(S) And Facilities — New, Renewal, And Modification
I., Type of injection system:
❑ Heating/cooling water return flow (5A7)
❑ Closed -loop heat pump system (5QM/5QW)
❑ In situ remediation (5I)
❑ Closed -loop groundwater remediation effluent injection (5L/"Non-Discharge")
❑ Other (Specify: _�
2. Does system use same well for water source and injection? ❑ Yes ❑ No
3. Are there any potential pollution sources that may affect injection? ❑ Yes ❑ No
What is/are the pollution source(s)? What is the distance of the injection Well(s) from the pollution
source(s)? ft..
4. What is the minimum distance of proposed injection wells from the property boundary? ft.
5. Quality of drainage at site: ❑ Good ❑ Adequate ❑ Poor '
6. Flooding potential of site: ❑ Low ❑ Moderate ❑ High
7. For groundwater remediation systems, is the.proposed and/or existing groundwater monitoring program
(number of wells, frequency of monitoring, monitoring parameters, etc.) adequate? ❑ Yes ❑ No. Attach
map of existing monitoring well network if applicable. If No, explain and recommend any changes to the
groundwater monitoring program:
8. Does the map presented represent the actual site (property lines, wells, surface drainage)? ❑ Yes or ❑ No. If
no or no map, please attach a sketch of the site. Show property boundaries, buildings, wells, potential pollution
sources, roads, approximate scale, and north arrow.
Iniection Well Permit Renewal And Modification Only:
1. For heat pump systems, are there any abnormalities in heat pump or injection well operation (e.g. turbid water,
failure to assimilate injected fluid, poor heating/cooling)?
❑ Yes ❑ No.- If yes, explain:
2. For closed -loop heat pump systems, has system lost pressure or required make-up fluid since permit issuance
or last inspection? ❑ Yes ❑ No. If yes, explain:
3. For renewal or modification of groundwater. remediation permits (of any type), will 4
continued/additional/modified injections have an adverse impact on migration of the plume or management of
the contamination incident? ❑ Yes ❑ No. If yes, explain:
4. Drilling contractor: Name:
FORM: APSARR webstersinglefamily WQ0002882 Dec 2016 renewal staff report.doc 5

J
AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
Address:
Certification number:
5. Complete and attach Well Construction Data Sheet.
N
1)
Z
FORM: APSARR webstersinglefamily WQ0002882 Dec 2016 renewal staff report.doc 6

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
V. EVALUATIONAND RECOMMENDATIONS
1. Provide any additional narrative regarding your review of the application.:
2. Attach Well Construction Data Sheet- if needed information is available
3. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes ® No. If yes, please explain
briefly.
4. List any items that you would like APS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
Item Reason
5. List specific Permit conditions that you recommend to be removed from the permit when issued. Make sure
that you provide a reason for each condition:
Condition Reason
6. , List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
Condition Reason
7. Recommendation: ❑ Hold, pending receipt and review of additional information by regional office; 0 Hold,
pending review of draft permit by regional office; []'Issue upon receipt of needed additional information;
Issue; ❑ Deny. If deny, please state reasons%
8. Signature of report preparer(s): L�jQ
—_, n
Signature of APS regional supervisor: ��/� /2�%-, /� fL //ZI=�uT ✓J
Date: (�b
FORM: APSARR webstersinglefamily WQ0002882 Dec 2016 renewal staff report.doc 7

AQUIFER PROTECTION SECTION REGIONAL STAFF REPORT
ADDITIONAL REGIONAL STAFF REVIEW ITEMS
Application rates and site recommendations are adequate and consistent with State rules and guidelines.
According to the homeowner, the average daily water usage (approx. 200 gpd, based upon water bills received
over the last year) is below the daily application rate stated in the permit of 480 gpd.
The grass crop, centipeed in one section of the yard and fescue in another, is in good condition. The
homeowner is very diligent in maintaining the system and yard.
Since tablet chlorination is utilized for disinfection prior to spraying the effluent onto the homeowners yard-,
was recommended that he visit the Moore County soil conservation office.to'obtain sample boxes for sampling
the soils in his yard based upon the two distinct grass types if stressed vegetation becomes apparent.
In reviewing the file for permit W00002882, current buffers to homes and property. lines appear adequate with
no encroachments observed on the date of visit.
FORM: APSARR webstersinglefamily WQ0002882 Dec 2016 renewal staff report.doc 8

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State of North Carolina -
Department of Environmental Quality
Division of WaterResources
WATER QUALITY REGIONAL OPERATIONS SECTION
NON -DISCHARGE APPLICATION REVIEW REQUEST FORM
Divlston.of Water. Resources RYA r�
November,3, 2016 DEQ/®WR :
To: ERO;W,_QROS:_Bell inda-Henson-Lfli �, N10V 10 2016
From: Alice Wessner, Water Quality Permitting Section. - Non -Discharge. Permitting Unit. WQ)RC3
FAYETTEVILLE !-E! J0iVAL f FFICE
Permit Number: WQ0002882 Permit Type: Single=Family-Residence Wastewater Irrigation
Applicant: Colin. S. & Emiliana M. Webster Project.Type: Renewal
`Owner Type: Individual Owner in:BIMS? Yes
Facility Name: 14.0 S. Lakeshore Dr. SFR Facility in BIMS?-Yes
Signature Authority: ColinS. & Emiliana M. Webster Titles Owners
Address: 140 South Lakeshore Drive, Carthage,, North Carolina 28327 County: Moore
Fee Category: Single -Family Residence Wastewater Irrigiaton Fee Amount:- $0
Comments/Other Information:
Attached, you will, find all information submitted in .supportof the. above -'referenced: -application. for your review, .
comment, and/or. action. Within 45 calendar days, please take the following actions: .
® Return this form completed. �. Return a completed staff report.
❑ Attach an Attachment B for Certification: ❑ Issue an Attachment B Certification.
When you receive this request form, please write your name and dates in the spaces below, .make a copy of this sheet, and .
return it to the appropriate Central Office Water Quality Permitting Section contact person'listed above.
RO-WQROS Reviewer: f/j. Date:
T. X.
FORM:- WQROSNDARR 09-15 Page 1 of 1

Water Resources
ENVIRONMENTAL QUALITY
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
Secretary
S. JAY ZIMMERMAN
Director
November 3, 2016
COLIN S. & EMILIANA M. WEBSTER
140 SOUTH LAKESHORE DRIVE
CARTHAGE, NORTH CAROLINA 28327,
Dear Mr. and Mrs. Webster:
Subject: Acknowledgement of
Application No. WQ0002882
140 S. Lakeshore Dr. SIR
Single -Family Residence
Wastewater Irrigation System
Moore County
The Water Quality Permitting Section acknowledges receipt of your permit application and
supporting documentation received on November 3, 2016. Your application package has been assigned the
number listed above, and the primary reviewer is Alice Wessner.
Central and Fayetteville Regional Office staff will perform a detailed review of the provided
application, and may contact you with a request for additional information. To ensure maximum efficiency
in processing permit applications, the Division of Water Resources requests your assistance in providing a
timely and complete response to any additional information requests.
Please note that processing standard review permit applications may take as long as 60 to 90 days
after receipt of a complete application. If you have any questions, please contact
Alice Wessner at [phone] or [e-mail].
Sincerely,
Nathaniel D. Thornburg, Supervisor
Division of Water Resources
cc: y:ih'e_Regional"Office;_Vyater uali Reg>onalOperations=Section
Permit File WQ0002882
State of North Carolina I Environmental Quality I Water Resources I Water Quality Permitting I Non -Discharge Permitting
1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919 807 6464

of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
NON -DISCHARGE SYSTEM RENEWAL
FORM: NDSR 06-16
I. PE�MITTEE INFORMATION:
1: Permittee's name: Colin S. & Emiliana M. Webster
2 1 Signature authority's name:. Colin S. & Emiliana M. Webster per 15A NCAC 021.01.06(b) Title: Owner
3? : I Permittee's mailing address: 140 S Lakeshore Dr
i
{ City: Carthage State: NC Zip: 28327-
4: I Permittee's contact information: Phone number: Email Address:
II. F ALITY INFORMATION:
1 IFacility name: 140 S. Lakeshore Dr. SFR
i
2. ; !Facility's physical address: 140 S Lakeshore Dr
City: Carthage State: NC Zip: 28327-_ County: Moore
ri
III. PERMIT INFORMATION:
1,.Y lExisting permit number: WWQ0002882 and most recent issuance date: 6/18/2007
2 . i Existing permit type: Single Family Residence Wastewater Irrigation
341 Has the facility been constructed? ® Yes or ❑ No
pit
Applicai is Certification per45A NCAC 02T .0106(b): - - -
I, Colin ' S & Emiliana M Webster Owner, attest that this application for
(Signature Authority's name & title from Application Item I.2.)
i
140 S Eakeshore Dr. SFR
(Facility name from Application Item II.1.)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that any discharge of wastewater
from t ���is non -discharge system to surface waters or the land will result in an immediate enforcement action that may include civil
penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition
of this Hermit be violated. I also understand that if all required parts., of this application package are not completed and that if a require
suppor i' ig information and attachments are not included, this application package will be returned to me as incomplete. I further certify
that thjJXpplicant or any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility without
4:
proper Uosure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are compliant with any
active. compliance schedule, and do not have any overdue annual -fees per 15A NCAC 02T .0105(e).
In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement,
ation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may include a fine not to
10,000 as well as civil penalties up to $25,000 per violation.
Signature: Date:
-r's Signature: Date:
06-16 Page 1 of 1

State of North Carolina
Department of Environmental Quality
Division of Water Resources
'E v 15A NCAAC 02T .0600 — SINGLE-FAMILY RESIDENCE WASTEWATER IRRIGATION SYSTEMS
�.„4 � _., _ � �. OPERATION AND MAINTENANCE AGREEMENT
Divis on of Water Resources
z:
Permit 7+10. WQ0002882 County: Moore
Property owner(s) as appearing on the recorded deed: Colin S. & Emiliana M. Webster
I
Mailinaddress: 140 S Lakeshore Dr, Carthage NC 28327
Facilityaddress: 140 S Lakeshore Dr, Carthage, NC, 28327
Irrigation Method: EeSPRAY ❑DRIP
r
I-/Vid agree to operate and maintain the single-family residence wastewater treatment and irrigation system as follows:
1 ilThe Permittee is responsible for the operation and maintenance of the entire wastewater treatment and irrigation
€r€'system including, but not limited to, the following items:
l
` r �rs'a. The septic tank shall be checked annually and pumped out as needed.
Ei
}
1,b. The septic tank effluent filter shall be checked and cleaned annually. tJ I (i
�i
ac. Accessible sand filter surfaces shall be raked and leveled every six months and any vegetative growth shall,be
removed manually. pila
!d. -❑ The tablet chlorinator shall be checked weekly. Wastewater grade tablets (calcium hypochlorite) shall be
' added as needed to provide proper chlorination (pool chlorine tablets shall not be used), OR
❑ The ultraviolet disinfection unit shall be checked weekly. The lamp(s) and quartz sleeve(s) shall be cleaned
j or replaced as needed to ensure proper disinfection.
s
e. All pump and alarm systems shall be inspected monthly.
'Ef The irrigation system shall be inspected monthly to ensure that the system is free of leaks, that all irrigation
i equipment is operating as designed, that vegetative growth does not interfere with the system inspection or
operation, that the soil is assimilating the disposed treated wastewater with no visible runoff or ponding, and
i
that no objectionable odors are being generated.
2:IFailure to pay the annual fee shall be cause for the Division to revoke the permit pursuant to 15A NCAC 02T
}}.0105(e)(3).
u
3. The Permittee's failure to properly operate this system is subject to a penalty up to $25,000 per day.
4: Ii Failure to meet the permit conditions or violation of the States surface water or groundwater regulations may void
the permit.
8i _ __ ■__ ■___n__ _____a a __ .. .a.. a .,a ��,..n �,..,. +L.. (1■■n +:nn .G Main1fPnaure Agreement
I / Wei% }understand the above requirements and agree to these terms as part of the issued permit.
f f
Owner=;Signature: Date: 16 �161 i G
Owne (Signature: Date: i
FOR11rI, SFRVMS O&M 06-16 Page 1 of 1

r
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENTAL QUALITY
INVOICE
Annual Permit Fee
� I�YIGI�IIhYllVlltllllllll�'dII�HINIIII
Open
This annual fee is required by the North Carolina Administrative Code. It covers the administrative costs associated with
your permit. It is required of any person holding a permit for any time during the annual fee period, regardless of the facility's
operating status. Failure to pay the fee by the due date will subject the permit to revocation. Operating without a valid
permit is a violation and is subject to a $10,000 per day fine. If the permit is revoked and you later decide a permit is
needed, you must reapply, with the understanding the permit request may be denied due to changes in environmental,
regulatory, or modeling conditions.
Invoice Number: 2016PR003064
Permit Number: WQ0002882
Moore County
Colin and Emiliana Webster-SFR
Colin Webster
140 S Lakeeshore.Dr
Whispering Pines, NC 28327
Annual Fee Period: 2016-05-01 to 2017-04-30
Invoice Date: 04/06/2016
Due Date: 05/06/2016
Annual Fee: $60.00
Notes:
1. You may pay either by checklmoney order OR by electronic payment.
2. If payment is by checklmoney order, please remit payment to:
NCDEQ - Division of Water Resources
Attn: AnimailDischarge)Non-Discharge Billing
1617 Mail Service Center
Raleigh, NC 276994617
3. If payment is electronic, see http://portal.ncdenr.org/web/wo/hot-topics/epayment for additional details. See
htti)://portal.ncdenr.org/web/wa/epayment to pay electronically. Only eCheck transactions are allowed at this time. Credit card
transactions are not accepted.
4. Please include your Permit Number and Invoice Number on all correspondence.
5. A $25.00 processing fee will be charged for returned checks in accordance with North Carolina General Statute 25-3-512.
6. Non -Payment of this fee by the payment due date will initiate the permit revocation process.
7. Should you have any questions regarding this invoice; please contact the Annual Administering and Compliance Fee
8. ' e d),%V*16Wftt 3fflations using the following link: http•//portal ncdenr ora/web/wa/aos/lau/programs.