NCG551794_Certificate of Coverage (COC)_20230504

DocuSign Envelope ID:CA56DFC3-CFD6-4C9C-BADO-B72354028583
d��4r
ROY COOPER
Governor �' n
ELIZABETH BISER l
Secretary
RICHARD E. ROGERS JR.
Director NORTH CAROLINA
Environmental Quality
5/4/2023
Karen Springer, Owner
Single Family Residence (SFR)
4216 Oak Hill Road
Chapel Hill,North Carolina 27514
Subject: Issuance of Authorization to Construct (ATC)
Certificate of Coverage (COC)NCG551794
under General Permit NCG550000
Single Family Residence (SFR)
4216 Oak Hill Road, Chapel Hill
Orange County
Ms. Springer:
In accordance with your application for discharge (dated October 10, 2022) for discharge under the
subject NPDES General Permit, the Division of Water Resources (DWR) herewith forwards an
Authorization to Construct (ATC)permit for new facilities. We issue this ATC pursuant to the
requirements of North Carolina General Statue 143-215 .1, the Memorandum of Agreement
between North Carolina and the US Environmental Protection Agency (EPA) dated October 15,
2007 (or as subsequently amended).
DWR understands that the Permittee has authorized a consultant, Agi-Waste Technologies (AWT)
Engineers and Soil Scientists of Apex,NC to replace an existing permitted failing septic system.
The new wastewater treatment system, herein presented with plans and specifications signed by
the engineer, is designed to comply with rules and regulations governing 100%-domestic
discharges to Surface Waters of the State.
Your permit package includes:
13 Authorization to Construct (ATC)
El Operation &Maintenance Instructions
A copy of Wastewater Discharge General Permit NCG550000
A copy of the plans and specifications approved (03May2023).
Engineer's Certification form(to be returned to DWR upon project completion).
REMINDER: To maintain your Certificate of Coverage (COC)you must remit an annual fee of
$60, due each year on the issuance date of the COC (see above),paid to the Division of Water
Resources. Please include the COC number NCG551794 on your check. Mail your Annual Fee to:
NCDEQ/DWR/NPDES / SFR Permitting
Attn. Wren Thedford
1617 Mail Service Center
Raleigh,NC 27699-1617
North Carolina Department of Environmental Quality I Division of Water Resources
��(/�� disbury Street 11617 Mail Service Center I Raleigh,North Carolina 27699-1617—919.707.9000

DocuSign Envelope ID:CA56DFC3-CFD6-4C9C-BADO-B72354028583
Compliance under General Permit NCG550000 restricts discharge flow, not to exceed 1,000
gallons per day. This ATC covers treatment facilities for a three (3)bedroom single-familX
residence estimated to discharge 360 gpd (120 gallons per bedroom).
Please note that the Permittee must provide regular treatment-system operation; also maintenance
and inspections in accord with manufacturer's recommendations and this ATC; all records, water
analyses, and logs to be kept onsite available for DWR inspection [NCG550000, Section A. (2.)].
Operation and Maintenance. The Permittee shall maintain all components of the approved
treatment system, designed to meet Surface Water-Quality Standards. Compliance, for the
duration of this COC, including following the manufacturer's guidelines; conducting and
documenting system inspections; establishing sources for OEM spare parts and supplies; taking
samples for analyses; making necessary repairs; and documenting said maintenance.
Please note that your system discharges to an existing roadside ditch under zero-flow receiving
stream conditions, thence to an unnamed tributary (UT) to Church Branch (16-41-1-9). This
stream is currently classified and governed as WS-IV; NSW (Water Supply; Nutrient Sensitive
Waters).
If DWR determines that your discharge contributes to future degradation or impairment of this
waterbody, an individual NPDES permit may be mandatory. Upon DWR's request, the Permittee
must provide records and demonstrate regular efforts to maintain the approved treatment system.
The Division recommends that the Permittee solicit manufacture-certified training or engage a
certified contractor or service to regularly inspect and maintain this treatment system.
Authorization to Construct (ATC) Permit. This ATC details the conditions of installation and
operation. Before startup, activation requires notice to the Raleigh Regional Office (Phone: 919-
791-4200) attention Vanessa Manual, a minimum of three 3) dqys in advance of discharge. Such
notification shall be made during normal office hours from 8:00 a.m. until 5:00 p.m. Monday
through Friday, excluding State holidays.
The attached Engineer's Certification form must be returned to DWR by the Engineer,
documenting compliance "as built" in accord with this ATC and approved plans and specifications
dated October 10, 2022, or as amended. No changes may be made without prior approval.
Therefore, in accord with the application and the attached approved plans and specifications, DWR
hereby authorizes the installation of a new surface-water discharge treatment system described as:
• Existing Septic Tank with Effluent Filter
• Existing Pump Tank as Recirculation Tank with Pump Vault
• AdvanTex AX-20 Treatment Pod
• UV Disinfection
• Discharge Point with Rip-Rap erosion control
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DocuSign Envelope ID:CA56DFC3-CFD6-4C9C-BADO-B72354028583
Compliance with the above shall include a leakage test performed on reused tanks and proposed
new tanks, or leak-certified new by the manufacture not to exceed an exfiltration rate of twenty
(20) gallons per twenty-four(24)hours per 1,000 gallons of tank capacity. The Engineer's
Certification shall serve as proof of compliance with this condition. Mail the completed Engineer's
Certification to:
DEQ/DWR/NPDES Program
1617 Mail Service Center
Raleigh,NC 27699-1617
❖ The Permittee shall, for the life of the treatment facility, maintain on site a
copy of the approved plans and specifications available for DWR
inspection.
All elbow piping must conform to the long-sweeping type. All cleanouts must be housed in meter
boxes below grade. This treatment system shall be located at least 15 feet away from a dwelling, at
least 100 feet from any water-supply well either on- or off-site. The system shall also be located
and constructed above any applicable 100-year flood line and maintain a 50-ft setback from
property lines [hereby waved to 10 feet on the east property line due to restrictive lot size].
Upon completing construction and prior to operating this permitted facility, a North Carolina-
registered engineer shall sign and submit to DWR the attached Engineer's Certification form,
thereby certifying that the permitted facility has been installed in accordance with the NPDES
Permit, the existing Certificate of Coverage, this Authorization to Construct, and the approved
plans and specifications.
This ATC permit is issued in accordance with Part III, Paragraph 2 of NPDES General Permit
NCG550000, and is subject to revocation unless wastewater treatment facilities are constructed in
accordance with the conditions and limitations specified in this General Permit.
In the event that the facilities fail to perform satisfactorily, including creating nuisance conditions,
the Permittee shall take immediate corrective action as may be required by this Division, such as
the construction of additional or replacement wastewater treatment(s) or disposal facilities. Failure
to abide by the requirements of this ATC permit may subject the Permittee to an enforcement
action by the Division of Water Resources in accordance with North Carolina General Statute 143-
215.6A to 143-215.6C.
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 ATC is not transferable except after notice to the Division of Water Resources. The Division
may modify or revoke and reissue this ATC. This ATC does not affect your legal obligation to
obtain other permits that may be required by the Division of Water Resources, the Division of
Land Resources, the Coastal Area Management Act, or any other Federal or Local government.
Page 3 of 7

DocuSign Envelope ID:CA56DFC3-CFD6-4C9C-BADO-B72354028583
NPDES Contact. If you have any questions concerning the requirements of this Authorization to
Construct (ATC)permit, please email Joe R. Corporon, P.G. [e-mail]].
Sincerely,
EDocuSig�n°ed by:
8328B44CE9EB4A1..
for Richard E. Rogers, Director
Division of Water Resources
Attachments [see page 1) Engineer's Certification form (to be signed and returned to DWR)
ec: Raleigh Regional Office (RRO), Vanessa Manual
NPDES General Permit Files
AWT -Kevin Davidson [kdavidsongagriwaste.com]
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DocuSign Envelope ID:CA56DFC3-CFD6-4C9C-BADO-B72354028583
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
CERTIFICATE OF COVERAGE - NCG551794
Under GENERAL PERMIT NCG550000
TO DISCHARGE 100%-DOMESTIC AND SIMILAR WASTEWATERS
UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
(NE DES)
In compliance with the provisions 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,
Karen Springer, Owner
is hereby authorized to operate a wastewater treatment facility consisting of a septic tank with effluent filter,
AdvanTex AX-20 RT pod with UV disinfection, and control panel, effluent discharge pipe and sample port;
outfall with riprap(erosion protection/aeration);these discharge facilities located at the
Single Family Residence (SFR)
4216 Oak Hill Road,
Chapel Hill, North Carolina 27514
to receiving waters designated as an unnamed tributary to Church Branch[stream segment 16-41-1-9] a
waterbody currently Classified WS-IV;NSW located within hydrological Unit 03-06-06 [HUC: 0303000206]
of the Cape Fear River Basin, in accordance with the effluent limitations,monitoring requirements, and other
conditions set forth in Parts I, II, III and IV of General Permit NCG550000 as attached.
This Certificate of Coverage/Authorization to Construct shall become effective Tune 1, 2023
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
DocuSigned by:
Signed this day May 4, 2023 E'�(�'
8328B44CE9EB4A1...
for Richard E. Rogers, Jr., Director
Division of Water Resources
By Authority of the Environmental Management Commission
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DocuSign Envelope ID:CA56DFC3-CFD6-4C9C-BADO-B72354028583
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DocuSign Envelope ID:CA56DFC3-CFD6-4C9C-BADO-B72354028583
d��4r
ROY COOPER '
Governor �' n
ELIZABETH BISER l
Secretary
RICHARD E. ROGERS JR.
Director NORTH CAROLINA
Environmental Quality
Single Family Residence Karen Springer, Owner
COC Number NCG551794
County Orange
Engineer's Certification
1, , a duly registered Professional Engineer in the State of North Carolina,
having been authorized by the Property Owners to observe [daily, full time,part time] the construction of:
Project Name Location
do hereby state that,to the best of my abilities, I practiced due care and diligence to oversee the construction of
said project, such that it was advanced and completed in accordance and in compliance with the approved plans
and specifications, as specified in the Authorization to Construct(ATC)permit and Certificate of Coverage
(COC)issued by the Division of Water Resources.
Signature
Registration No.
Date
[Professional Stamp]
[Any person who knowingly makes any false statement,representation, or certification in any application,record,
report,plan or other document filed or required to be maintained under Article 21 or regulations of the
Environmental Management Commission implementing that Article, or who falsifies,tampers with or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under
Article 21 or regulations of the Environmental Management Commission implementing that Article, shall be
guilty of a misdemeanor punishable by a fine not to exceed$10,000, or by imprisonment not to exceed six
months, or by both. (18 U.S.C. Section 1001 provides a punishment by a fine of not more than$10,000 or
imprisonment not more than 5 years, or both, for a similar offense.)]
D EQ� North Carolina Department of Environmental Quality I Division of Water Resources
zz- 512 North Salisbury Street 11617 Mail Service Center I Raleigh,North Carolina 27699-1617--919.707.9000

DocuSign Envelope ID:CA56DFC3-CFD6-4C9C-BADO-B72354028583
Outfall 001
(flows S via roadside ditch) •
fY►.
Oak Hill Rd.
t ++�r
r _ �
UT to Church Branch
(flows E) t�
Hwy I-40
in Pf
Karen Springer, Owner
Single-Family Residence (SFR) Facility
4216 Oak Hill Rd, Chapel Hill Location
• not to scale
Drainage Basin: Cape Fear River Basin Stream Class: WS-Iv;NSW
HUC: 030300020601 Latitude: 35'58'22"N
Stream Seement 16-41-1-9 LonEitude: 79' 1'26"W
State Grid/USGS Quad: D22NE/Chapel Hill Hvdroloaical Unit: 03-06-05 • NPDES COC NCG551794
Receivine Stream: Oak Hill roadside ditch to UT to Church Branch
North Orange Count

DocuSign Envelope ID:CA56DFC3-CFD6-4C9C-BADO-B72354028583
Raleiqh Reqional Office - SWP SFR (NCG55) Staff Report Form
Verify permit Information against BIMs Information. Note any corrections required.
Date 6-Jan-23
To:(Permit Writer's Name) RO Contact Person: Jane Bernard
Regional Office RRO
Permit Number NCG551794
Permittee Karen Springer
Facility Name/Address 4216 Oak Hill Road, Chapel Hill, NC
Facility County Orange
Maximum permitted flow 1360 gallons/day
Date of Last inspection 20-May-22
Why is the permit needed? What is triggering the need for a Permit?
Unpermitted properly functioning sandfilter discharge system
Unpermitted failing sandfilter
Permitted failing system
X Failed subsurface system
Expanding capacity of existing discharging system
Building a new single-family home, requesting a new coverage under NCG55
Functioning existing subsurface system: Owner can't expand existing system due to site constraints.
new discharging system to accommodate existing and new flow.
Other:
Possible alternatives: spray irrigation sewer subsurface discharge none other
Describe alternatives: NONE
Location of proposed/new Discharge Point(s): Latitude 1 35-58'19.38" W JApproximate
Longitude 1 78°01'26.01" W
0
Describe the outfall point in detail using information from the Addendum
Outfall will be located on the applicants property discharging to a roadside ditch (public right-of-way) then directly
to an unnamed tributary to Church Branch. Effluent will be pumped to riprap (post aeration) prior to entering the
roadside ditch (public right-of-way).
Outfall drains to: River Basin Cape Fear Receiving Stream Church Branch
Sub-basin CPF05 (03-06-05) Stream Classification WS-V;NSW
Stream Index 16-41-1-9
Review Special Conditions/suggested changes/additional information needed/setback violations
RO Recommendation: This is a failing system that will be upgraded. The RRO does not object to upgrading
the facility and the issuance of this permit in accordance with the current policy of
Single Family NPDES Discharge.
DocuSigned by:
Supervisor approval: l/&lAXSSa f. k,aWkd Date: 1/10/2023
B2916HAB32144F...