WQ0023179_More Information (Requested)_20230112

DocuSign Envelope ID: 9FD47273-7AF6-4851-A41D-E9E8F1400C2D
ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
PATRICK E. AND NICKI L. FLORENCE
7209 CAVINESS JORDAN ROAD
CEDAR GROVE, NORTH CAROLINA 27231
Dear Mr. and Mrs. Florence:
NORTH CAROLINA
Environmental Quality
January 12, 2023
Subject: Application No. WQ0023179
Additional Information Request
7215 Caviness Jordan Rd. SFR
Single -Family Residence
Wastewater Irrigation System
Orange County
Division of Water Resources' Central and Regional staff has reviewed the application package
received December 14, 2022. However, additional information is required before the review may be
completed. Please address the items below no later than the close of business on Monday, February 27,
2023.
➢ Section IV: Operation and Maintenance Agreement. All single-family residence
wastewater irrigation system renewal applications must include a properly executed Operation
and Maintenance Agreement pursuant to 15A NCAC 02T .0604(h).
The signatures for both Patrick Florence and Nicki Florence on the Operation and Maintenance
Agreement provided in this application could not be verified as legitimate. Please resubmit the
Operation and Maintenance agreement with either physical signatures or digital signatures
applied through a verified e-signature service.
➢ Applicant Certification. The Applicant's certification shall be signed pursuant to 15A NCAC
02T .0106(b). The signature for Patrick Florence could not be verified as legitimate. Please
resubmit the application form with either a physical signature or a digital signature applied
through a verified e-signature service.
Please be aware that you are responsible for meeting all requirements set forth in North Carolina
rules and regulations. Any oversights that occurred in the review of the subject application package are still
the Applicant's responsibility. In addition, any omissions made in responding to the outstanding item
above, or failure to provide the additional information on or before the above requested date may result in
your application being returned as incomplete pursuant to 15A NCAC 02T .0107(e)(2).
D E -QQ North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
NORM CAROLINA -
oePemmeatoie�o�me�iQuar\ /� 919.707.9000

DocuSign Envelope ID: 9FD47273-7AF6-4851-A41D-E9E8F1400C2D
Mr. and Mrs. Florence
January 12, 2023
Page 2 of 2
Please reference the subject application number when providing the requested information. All
revised and/or additional documentation shall be signed, sealed and dated (where needed), with an
electronic response submitted to my attention at: hLtps://edocs.deq.nc.gov/Forms/NonDischarge-Branch-
Submittal-Form-Vert.
If you have any questions regarding this request, please contact me at [phone] or
alys.hannum&ncdenr.gov. Thank you for your cooperation.
Sincerely, �DocuSigned by:
Na.
4C22170C5AA04F3...
Alys Hannum, Environmental Specialist II
Division of Water Resources
cc: Raleigh Regional Office, Water Quality Regional Operations Section (Electronic Copy)
Laserfiche File (Electronic Copy)