NCG551804_Permit Renewal_20230518

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
Elston Scott
Carli Brown
547 Elk Park Dr Unit 611
Asheville, NC 28804
Subject: Permit Renewal
Application No. NCG551804
70 Teague Road
Buncombe County
Dear Applicant:
NORTH CAROLINA
Environmental Quality
May 18, 2023
The Water Quality Permitting Section acknowledges receipt of your application for a new NPDES WW permit, including
supporting documentation and your check number 5413 in the amount of $60.00 as payment of the application fee. These
items were received in our offices on May 18, 2023. Your application will be assigned to a permit writer within the
Section's NPDES WW permitting branch. The permit writer will contact you if additional information is required to
complete evaluation of your application. Your timely and direct response to any such request will help to expedite the
review process. Please note that acceptance of the application does not guarantee a NPDES permit will be issued for the
proposed activity. A permit will only be issued following a complete review of the application, concluding the proposed
discharge is allowable per applicable statutes and rules.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https•//deq nc-gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
ZT
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
cc: Mark Brooks, PE -Brooks Engineering Associates
ec: WQPS Laserfiche File w/application
North Carolina Department of Environmental Quality I Division of Water Resources
Asheville Regional Office 1 2090 US. Highway 70 1 Swannanoa, North Carolina 28778
rwc7T:."`y .ror� 828.296.4500

BROOKS
E N G I N E E R I N G ASS ❑ C I AT E S
17 Arlington Street ) Asheville NC n801 ! w .hrooksea.corn 1 828-232-4700
Letter of Transmittal
To:
From:
Date.
NCDEQ/DWR/NPDES
Mark Brooks, PE
May 16, 2023
Attention: John Hennessy, Supervisor
Compliance and Expedited Permitting Unit
cc: (need telephone no. if Fedex, no P.O. Box)
1617 Mail Service Center
File
Raleigh, NC 27699-1677
(need telephone no. if Fedex, no P.O. Box
Project Name:
70 Teague Rd SFR NPDES
Project No:
581922
❑ Mail ® Deliver
❑ Overnight* ❑ Other
*must use street address & include phone number
Document Description:
Date:
Copies:
$60 Fee Check (previously sent and received per Dan
Boss in Regional Office
1
Cover Letter with Attachments
2
Engineering Plans
1
Application Form for COC under NCG550000
2
Comments:
17 Arlington Street, Asheville, NC 28801 9 Phone [phone] • Fax [phone]

BROOKS
ENGINEERING ASSOCIATES
February 16, 2023
Planning & Project Management / Civil Engineering
Surveying / Environmental Engineering & Services
17 Arlington Street / Asheville NC 28801
www.l)rooksea.com / 828-232-4700
NC DENRIDWR/Water Quality Permitting Section
1617 Mail Service Center
Raleigh, NC 27699-1617
Attention: Charles Weaver
Regarding: Cover Letter & Alternatives Analysis
Scott & Brown Residence SFR NPDES Application
70 Teague Rd
Buncombe County
BEA Project No. 581922
Dear Mr. Weaver:
On behalf of Scott & Carli Brown, BEA is submitting the attached Notice of Intent for coverage
under NCG550000. This Cover Letter is intended to provide a narrative description of the
project and serve as the request for the Authorization to Construct.
Project Description
The property is a 1.0 acre tract a located at the intersection of Teague Rd. and Fern Gully Rd. in
Buncombe County County. There is an existing two bedroom home with a failing septic system
and the application is for a three bedroom single family residence. The existing septic system
was identified as failing by the County Health Department and has been on a temporary pump
and haul. No options were identified as part of the investigation and the site deemed Unsuitable
for installation of a subsurface system by the project soil scientist and the county health
department.
Proposed is an EZ Treat recirculating fixed media system unit with UV disinfection to treat the
wastewater from his park model for discharge in to Sandy Mush Creek. The discharge location
is in to an existing NCDOT culvert and that discharges in to Sandy Mush Creek.
Alternatives Feasibility
a) This area of Buncombe County is not served by any public or private sewer systems. The
nearest collection system is over 5 miles away. This is derived from a review of the
MSD website depicting their sewer line service areas. It would be impossible from a
permitting standpoint and economically infeasible to connect to any of the existing
permitted sewer treatment plant systems.
b) The County Environmental Health Department has evaluated the site and found the soils
Unsuitable. Report is provided as Attachment A.
c) Provided as Attachment B is a report from a NC Licensed Soil Scientist that the site does
not have suitable soil conditions.
Receiving Waters
The receiving water is a Class C stream. There are no know restrictions for Sandy Mush Creek
in this area. The 7Q10 report from the USGS is provided as Attachment C.

Enclosed with this Cover Letter and request for the Authorization to Construct are three sets of
sealed plans and specifications and a fee check for $60. We appreciate your review of this
application. We look forward to working with you on this project.
Sincerely,
Brooks Engineering Associates, P.A.
Mark C. Brooks, P.E.
Enclosed: Fee Check for $60
3 sets of Engineering Plans
Attachments: A — Documentation from NCDHHS Regional Soil Scientist
B — Letter for Licensed Soil Scientist
C — 7Q10 documentation

ATTACHMENT A
County Denial Letter

Buncombe County Health and Human Services
Public Assistance & Work Support Strategies —Public Health — Social Work Services — Veterans Services
Stoney Blevins
Health and Human Services Director
Re: Application for Expansion for 3 Bedroom House
Parcel Identification No. #8793887122 - 70 Teague Rd.
Dear Elston Scott Brown,
The Buncombe County Health and Human Services, Environmental Health Division on 8/8/2022 evaluated the above -
referenced property at the site designated on the plat/site plan that accompanied your application. According to your
application the site is to expand a 2-bedroom residence into a 3-bedroom residence a design wastewater flow of 360
gallons per day. The evaluation was done in accordance with the laws and rules governing wastewater systems in
North Carolina General Statute 130A-333 and related statutes and Title 15A, Subchapter 18A, of the North Carolina
Administrative Code, Rule. 1900 and related rules.
Based on the criteria set out in Title 15A, Subchapter 18A, of the North Carolina Administrative Code, Rules .1940
through .1948, the evaluation indicated that the site is UNSUITABLE for a ground absorption sewage system.
Therefore, your request for an improvement permit is DENIED. The site is unsuitable based on the following:
Unsuitable soil topography and/or landscape position (Rule .1940)
X Unsuitable soil characteristics (structure or clay mineralogy) (Rule .1941)
X Unsuitable soil wetness condition (Rule .1942)
Unsuitable soil depth (Rule .1943)
Presence of restrictive horizon (Rule .1944)
Insufficient space for septic system and repair area (Rule .1945)
Unsuitable for meeting required setbacks (Rule .1950)
Other (Rule .1946)
These severe soil or site limitations could cause premature system failure, leading to the discharge of untreated
sewage on the ground surface, into surface waters, directly to ground water or inside your structure.
The site evaluation included consideration of possible site modifications, as well as use of modified, innovative, or
alternative systems. However, the Division of Environmental Health has determined that none of the above options
will overcome the severe conditions on this site. A possible option might be a system designed to dispose of sewage
to another area of suitable soil or off -site to additional property.
For the reasons set out above, the property is currently classified UNSUITABLE, and no improvement permit shall
be issued for this site in accordance with Rule .1948(c).
Note that a site classified as UNSUITABLE may be classified as PROVISIONALLY SUITABLE if written
documentation is provided that meets the requirements of Rule .1948(d). A copy of this rule is enclosed. You may
P.O. Box 7408, Asheville, NC 28802 buncombecounty.org
[phone]
In accordance with Federal law and U.S. Department of Agriculture (USDA) and U.S. Department of Health & Human Services (HHS) policy, this institution is prohibited
from discriminating on the basis of race, color, national origin, sex, age, or disability. Under the Food Stamp Act and USDA policy, discrimination is prohibited also on
the basis of religion or political beliefs.

hire a consultant to assist you if you wish to try to develop a plan under which your site could be reclassified as
PROVISIONALLY SUITABLE.
You have a right to an informal review of this decision. You may request an informal review by the soil scientist or
environmental health supervisor at the Buncombe County Health Center. You may also request an informal review by
the N.C. Department of Environment and Natural Resources regional soil specialist. A request for informal review by
the regional soil specialist must be made in writing to the Buncombe County Health Center.
You also have a right to a formal appeal of this decision. To pursue a formal appeal, you must file a petition for a
contested case hearing with the Office of Administrative Hearings, 6714 Mail Center, Raleigh, N.C. 27699-6714. To get
a copy of a petition form, you may write the Office of Administrative Hearings or call the office at (919) 733 -0926 or
from the OAH web site at www.oah.state.nc.us/form.htm. The petition for a contested case hearing must be filed in
accordance with the provision of North Carolina General Statutes 130A-24 and 150B-23 and all other applicable
provisions of Chapter 150B. N.C. General Statute 130A-335 (g) provides that your hearing would be held in the county
where your property is located.
Please note: If you wish to pursue a formal appeal, you must file the petition form with the Office of Administrative
Hearings WITHIN 30 DAYS OF THE DATE OF THIS LETTER The date of this letter is October 4, 2022. Meeting
the 30-day deadline is critical to your right to a formal appeal.
If you file a petition for a contested case hearing with the Office of Administrative Hearings, you are required by
law (NC General Statute 150B-23) to serve a copy of your petition on the Office of General Counsel, NC
Department of Health and Human Services, 2001 Mail Service Center, Raleigh, N.C. 27699-2001.
Do NOT serve the petition to the Buncombe County Department of Health and Human Services. Sending a copy of
your petition to the Buncombe County Department of Health and Human Services will NOT satisfy the legal
requirement in NC General Statute 150B-23 that you send a copy to the Office of General Counsel, NC Department
of Health and Human Services.
You may call or write Buncombe County Department of Health and Human Services, Environmental Health Division, if
you need any additional information or assistance.
Sincerely,
Environmental Health Specialist
P.O. Box 7408, Asheville, NC 28802 buncombecounty.org
[phone]
In accordance with Federal law and U.S. Department of Agriculture (USDA) and U.S. Department of Health & Human Services (HHS) policy, this institution is prohibited
from discriminating on the basis of race, color, national origin, sex, age, or disability. Under the Food Stamp Act and USDA policy, discrimination is prohibited also on
the basis of religion or political beliefs.

ATTACHMENT B
Letter from NC Licensed Soil Scientist

r.
LAND RESOURCE MANAGEMENT
Land Evaluation by Land Experts
Pa 19 A! - Fe iI 6F, v"u's... _A'10 F kI C010
SCOTT AND CARLI B ROW N
70 TEAGUE ROAD
PIN# 8793-88-7122
BUNCOMBE COUNTY, NC
LRM PROJECT #269422
Client: Scott Brown
Contact: Scott Brown
Email: [e-mail]

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This report Is nut a septic system permit. All design specifications are subject to review
by the Buncombe County Health Department (RCM). REPAIR:
System design is for a 240 GPD residence. System Kind: Pump and Haul
Based upon five days or normal flow and two days emergency storage per 2003 NE'DI'H
EHS MO,A, the minimum tank size fur the property would be 1680 gallons. Attached is LTAR: NIA 2-Bedroom Design (240 GPD)
the cut sheet for a 2250 gallon tank that is being requested for use to meet the required Trench Depth (in.): N/A Trench Width (in.): NIA
volume. .- -- __. — -- - ___ - ----
Tank access lids will require. access for pumping without soil removal. Risers may be NOTES:
required to allow necessary access. i 1) Current septic system is a straight pipe to the road ditch as noted by
High water alarm float with auto dial telemetry Is required per MOA. LRbf recommends, Buncombe County, NCDEH, and LRM.
use of an SJE Rhombus tank Alert 4x Alarm box paired with an SJE Rhombus i 2) All guidelines of the NCDPH EHS Memorandum of Agreement
Autudialer or equivalent. j (MOA) regarding pump and hauls must be met.
i
Elston Scott Brown
70 Teague Road
8793-88-7122
DRAWN BY:
JSE
SCALE:
V-30-
CHECKED BY:
WBF
DATE:
11/112022
PROJECT NO:
269422
REVISION:
NONE
LRM��
LAND RESOURCE MANAGEMENT, PLLC
P.O. BOX 9251
ASHEVILLE, N.C. 28815
Phone: [phone]
www.landrm.com

ATTACHMENT C
7Q10 Report

mbrooks
From: Weaver, John C <[e-mail]>
Sent: Thursday, February 16, 2023 12:13 PM
To: mbrooks
Cc: [e-mail]; Montebello, Michael J; Dowden, Doug; Litzenberger,
Kristin S; Denard, Derek; Albertin, Klaus P; Weaver, John C
Subject: USGS response to DWR USGS Low Flows request # 2023-258 (dated 2023/02/14) for
Sandymush Creek Madison Buncombe Counties ... RE: [EXTERNAL] Low -flow request
approval
Mr. Brooks,
In response to your inquiry about the low -flow characteristics for Sandymush Creek between the "V-shaped" alignment
of Teague Road along the boundary between southwestern Madison County and northwestern Buncombe County
boundary, the following information is provided:
A check of the low -flow files here at the USGS South Atlantic Water Science Center (SAWSC, Raleigh office) does not
indicate a previous low -flow determination for the point of interest, identified by the lat/long coordinates (35.72231, -
82.71159) provided via email dated 02/14/2023 from the DWR USGS Low Flows portal following your request
submission.
No USGS discharge records are known to exist for the point of interest.
In the absence of site -specific discharge records sufficient for a low -flow analysis, estimates of low -flow characteristics at
ungaged locations are determined by assessing a range in the low -flow yields (expressed as flow per square
mile drainage area, or cfsm) at nearby sites where estimates have previously been determined.
A basin delineation completed using the online USGS StreamStats application for North Carolina
(https•//streamstats.usgs.gov/ss/) indicates the drainage area for the point of interest (StreamStats adjusted
coordinates 35.72231,-82.71159 NAD83) is 41.4 sgmi.
For streams in southwestern Madison County and northwestern Buncombe County, low -flow characteristics
published by the USGS are provided in the following reports:
(1) The first is a statewide report completed in the early 1990's. It is USGS Water -Supply Paper 2403, "Low -flow
characteristics of streams in North Carolina (Giese and Mason, 1993). An online version of the report is available
at http://Pubs..usgs.gov/wsp/­2403/report.pd . The report provides the low -flow characteristics (based on data through
1988) via regional relations and at -site values for sites with drainage basins between 1 and 400 sgmi and not considered
or known to be affected by regulation and/or diversions.
(2) The second is a statewide report published in March 2015. It is USGS Scientific Investigations Report 2015-5001,
"Low -flow characteristics and flow -duration statistics for selected USGS continuous -record streamgaging stations in
North Carolina through 2012" (Weaver, 2015). The report is available online
at http•/Zpubs.usgs.govZsir/2015/5001/. The report provides updated low -flow characteristics and flow -duration
statistics for 266 active (as of 2012 water year) and discontinued streamgages across the state where a minimum of 10
climatic years discharge records were available for flow analyses.
Low -flow characteristics estimated for point of interest:

Inspection of the above two reports indicates the presence of fourteen (14) nearby selected USGS partial -record sites
(12) and continuous -record streamgages (2) across western Madison County, northwestern Buncombe County, and
northeastern Haywood County in the general vicinity of the point of interest where low -flow characteristics were
published. Among these 14 index sites, the low -flow discharge yields for the indicated flow statistics are as follows:
Annual 7Q10 low -flow yields ==> from 0.065 to 0.22 cfsm (average about 0.14 cfsm, median about 0.13 cfsm)
Annual 30Q2 low -flow yields ==> from 0.18 to 0.39 cfsm (average about 0.28 cfsm, median about 0.29 cfsm)
Winter 7Q10 low -flow yields ==> from 0.13 to 0.29 cfsm (both average and median about 0.2 cfsm)
Annual 7Q2 low -flow yields ==> from 0.15 to 0.33 cfsm (both average and median about 0.23 cfsm)
Average annual discharge yields ==> from 0.73 to 1.4 cfsm (average about 1 cfsm, median about 0.92 cfsm)
Application of the above range in yields to the drainage area (41.4 sgmi) for the point of interest results in the following
estimated low -flow discharges:
Annual 7Q10 low -flow discharges =_> from 2.7 to 9.1 cfs (average about 5.8 cfs, median about 5.4 cfs)
Annual 30Q2 low -flow discharges =_> from 7.5 to 16.1 cfs (average about 11.6 cfs, median about 12 cfs)
Winter 7Q10 low -flow discharges =_> from 5.4 to 12 cfs (both average and median about 8.3 cfs)
Annual 7Q2 low -flow discharges ==> from 6.2 to 13.7 cfs (both average and median about 9.5 cfs)
Average annual discharge discharges ==> from 30.2 to 58 cfs (average about 41.4 cfs, median about 38.1 cfs)
Please note:
(1) The estimated flows are provided in units of cubic feet per second (cfs).
(2) The low -flow yields provided above are rounded to 2 significant figures. Estimated low -flow discharges less than 1
cfs are rounded to 2 significant figures. If between 1 and 100 cfs, then rounded to 1 decimal place; if greater than 100,
then rounded to the nearest whole number (zero decimal places).
(3) The information provided in this message is based on a preliminary assessment and considered provisional, sub'ect
to revision pending collection of future data and further analyses.
These provisional streamflow statistics are provided via the DWR USGS Low Flows cooperative agreement between
the USGS and the N.C. Department of Environmental Quality, Division of Water Resources.
Hope this information is helpful.
Thank you.
Curtis Weaver
J. Curtis Weaver, Hydrologist, PE Email: icweaver usos.00v
USGS South Atlantic Water Science Center Online: httas://www.usus.gov/centers/sa-water
North Carolina - South Carolina - Georgia
3916 Sunset Ridge Road
Raleigh, NC 27607
Phone: [phone] // Fax: [phone]

From: Albertin, Klaus P <[e-mail]>
Sent: Tuesday, February 14, 2023 10:33 AM
To: [e-mail]
Cc: Albertin, Klaus P <[e-mail]>; [e-mail]; Weaver, John C <[e-mail]>;
Montebello, Michael J <[e-mail]>; Dowden, Doug <[e-mail]>; Litzenberger,
Kristin S <[e-mail]>; Denard, Derek <[e-mail]>
Subject: [EXTERNAL] Low -flow request approval
This email has been received from outside of DO[ - Use caution before clicking on links, opening attachments, or responding.
Your request has been approved and will be forwarded to USGS. A response from USGS usually takes 7 - 10 business
days.
Request Flow Statistic Approval
Request ID: 258
Requestor: Mark Brooks
Requestor e-mail: mbrooks 2brooksea.com
Requestor Phone: [phone]
Local Government:
Public Water Supply:
Consultant:
Contact:
Reason: Permit
River/Stream: Sandy Mush Creek
Drainage Area (sq. mi.): 43.8
Latitude: 37.721924
Longitude:-82.711853
Other Information: Off of Teague RoadCoordinates in request are incorrect. Correct coordinates are Lat: 35.72231 Lon: -
82.71159
Statististics: ["7Q10","30Q2"]
3

Approved by: Albertin, Klaus P

r
National Pollutant Discharge Elimination System
(NPDES)
Division of Water Resources
Application for SURFACE DISCHARGE
Environmental Certificate of Coverage (COC) Under
Quality General Permit NCG550000
For Single -Family Residences and Similar Discharges
100%-domestic wastewater - <_ 1,000 gallons per day
FOR AGENCY USE ONLY
Date Received
Year
Month
Day
06
lb
Certificate of Coverage (COC)
N
C
1G
5
5
O
Check #
Amount
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Uyr
Assigned to:
The Division of Water Resources will not accept an application package unless all instructions are followed.
Failure to submit all required items may result in the application being returned. For more information, visit
the Water Quality Permitting Section's NPDES Permitting Unit website. (Press TAB to navigate form)
1. Regional Office Contact: Please contact your DWR Regional Office before submitting this
application. If you have not met with your appropriate DWR Regional Office Representative, the
application will be returned.
Please list the DWR Regional Office representative(s) with whom you have discussed this project:
Name(s): Tim Heim Date: 10/24/22
2. Owner's Contact Information:
Applicant Type: [3 Individual ❑ Corporation ❑ Partnership
Owner Name and Title: Elston Scott & Carli Louise Brown
Street Address: 547 Elk Park Drive Unit 611
City: Asheville State: NC Zip:28804-
Telephone #(IT): Telephone # (W):
Cell/Mobile #: [phone] Email: @ [e-mail]
3. Location of Facility Producing the Discharge: Please list the address of the facility. If facility is not yet
constructed, give street address or lot number.
Street Address: 70 Teague Road
City: Leicester
County: Buncombe
Telephone #:
Website:
4. Site -Location Narrative:
State: NC Zip:28748 -
Celt/Mobile #: [phone]
Please describe how to get to the facility from the nearest town, major highway or identifiable roadway
intersection (use street names, state road numbers, and/or distances and directions).
From New Leicest Hwy, turn off of Alexander Rd, to Bear Creek Rd 1.7 miles, to Piney Knob 3.7 miles, to
Teague Rd.
Page 1 of 6 Revised: A. Orlando NPDES 21 Sept2017

J Application for Certificate of Coverage (COC) and/or Authorization to Construct (ATC)
under General -Permit NCG550000
5. Describe the nature of the project. ["New" means has not yet been physically constructed, "existing"
means system already physically exists. Please see 15A NCAC 02H .0103(11) for further clarification].
® Installation of a New Wastewater Treatment System (If yes, skip to Number 9.)
❑ Expansion of an Existing Wastewater Treatment System (for example, adding bedrooms) (If yes,
skip to Number 9.)
❑ Replacement of an Existing Wastewater Treatment System (If yes, go to Number 6.)
6. Describe the Existing Wastewater Treatment System:
® Conventional Sgptic Tank/Leach-field — Discharge to Sub -Surface Soils. If previously permitted,
please attach a copy of the permit or enter the permit number
If you are not aware of an existing permit, check here. ❑
❑ Sandfilter — Discharge to Surface Waters [or other, as defined 15A NCAC 02H.0103(11)]. If
previously permitted, please attach a copy of the permit or enter the permit number
If you are not aware of an existing permit, check here. ❑
❑ Filter Media System (Pod System)— Discharge to Surface Waters [or other, as defined 15A NCAC
02H.0103(11)J. If previously permitted, please attach a copy of the permit or the permit number.
If you are not aware of an existing permit, check here. ❑
❑ Other
❑ Check here if submitting proposal for a new system or if no treatment system exists.
7. Check all EXISTING wastewater treatment components:
[ Septic tank ❑ Dosing tank ❑ UV disinfection
❑ Primary sand filter ❑ Secondary sand filter ❑ Recirculating sand filter(s)
❑ Chlorination ❑ Dechlorination ❑ Other components:
❑ Self -Contained POD system [describe]
❑ Leach Field
❑ Post Aeration (specify type)
8. Provide Details of Single -Family Residence (SFR) or Similar Facility:
a) Type of facility:
®Residential ❑ Commercial
❑ Other:
b) Amount of wastewater discharged:
Residential: Number of bedrooms 3 x 120 gallons per bedroom = 360
gallons per day (flow)
- Commercial: How many employees? (25 gpd/person)
Page 2 of 6 Revised: A. Orlando NPDES 21 Sept2017

9.
Application for Certificate of Coverage (COC) and/or Authorization to Construct (ATC)
under General -Permit NCG550000
c) Is your existing treatment system failing? Yes [X No ❑
d) Has the Health Department formally condemned your existing system
"unsuitable for repair?" Yes ® No ❑
X If yes, please name the Health Department [local, county, or state], and provide the site -
inspection date [attach Health Department's judgement letter, if available]: Buncombe
If previously permitted [local, county, or state], provide permit number and date issued [attach
copy, if available]: Click here to enter text.
Check all PROPOSED new system components
[3 Septic tank ❑ Dosing tank ❑ UV disinfection:
❑ Primary sand filter ❑ Secondary sand filter ❑ Recirculating sand filter(s)
❑ Chlorination ❑ Dechlorination ❑ Other components:
[3Self-Contained POD system [describe] EZ Treat Redicrculating Media Pod & Dose Tank
ER Post Aeration (specify type) Steps
❑ Proposed Modifications to Existing Treatment System - Explain in detail the nature of the
modification. Attach all site maps, plans and specifications, signed by an NC Certified Engineer.
If prepared by others, plans must conform to 15A NCAC 02H .0139.
Click here to enter text.
Proposed New Treatment System for Surface Discharge (not constructed) - Attach all site maps,
plans and specifications, to be signed by an NC Certified Engineer. If prepared by others, plans
must conform to 15A NCAC 02H .0139.
attached.
Expanding Flow? - Do you propose to increase permitted or existing flow? ® Yes ❑ No
Provide details of the Proposed NEW Discharge [Flow and Source Water]:
❑ Check if same as 6.
Existing: Amount of wastewater currently discharged: Number of bedrooms 2 x 120
gallons per bedroom = 240 gallons per day to be permitted (design flow)
Expanding: Amount of wastewater proposed to be discharged: Number of bedrooms 3
120 gallons per bedroom = 360 gallons per day to be permitted (design flow
10. Evaluate Alternatives to Discharge to Waters of the State. Please address the feasibility of
discharge alternatives as instructed in the NCDEQ Engineering Alternatives Analysis (EAA)
Guidance Document found here. (Note: Evaluation for endangered species is not required.)
8) Connection to an Existing Wastewater Treatment System - Provide the distanceto the
nearest connection, such as a regional or municipal sewer system, and theestimated cost per
foot to connect including fees.
The nearest public sewer connection is off of-Olivette Road which is over 6.9 miles away as the crow flies and over 10
miles away via paved roads. Cost/foot would be well over $60/ft for line with multiple pump stations.
Page 3 of 6 Revised: A. Orlando NPDES 21 Sept2017

Application for Certificate of Coverage (COC) and/or Authorization to Construct (ATC)
under General -Permit NCG550000
11
b) Land Application — Assess the land application disposal alternatives such as spray
irrigation, drip irrigation, individual/community onsite subsurface systems, and/or
innovative ground -absorption. Questions to consider:
(1) Are on -site soils suitable for land application? Yes ❑ No EN
(2) Is there sufficient area on -site? Yes ® No ❑
c) Wastewater Reuse — Evaluate reusing all or a portion of the wastewater
generated, such as for golf course irrigation, crop irrigation (e.g., hardwood or
pine plantation, grasses), athletic field irrigation, landscape uses, and/or
commercial/industrial uses. Insufficient Room.
d) On -Site Soil Evaluation — Submit an evaluation of the soils on-site,documented by a
certified report from a NC Professional Soil Scientist, or byyour local or county health
department report (if available). See attached.
e) Cost of Alternatives — Provide an estimation of the cost of each discharge alternative or
combination of alternatives.
The only alternative is a sewer line which is shown to be complete cost prohibitive.
Provide Regional Information: Please provide the following information. If you need
assistance in obtaining this information, please contact your local DEQ regional office.
a) Stream Classification -Verify the stream classification for the nearest downgradient named
waterbody. The NC Surface Water Classification map can be found by clicking Class C
b) Is it a High -Quality Water? If so, check if it is by definition or by designation? Ui order to
check this, ask the Planning Unit. NO
c) Map - Provide a map locating the nearest downstream waters -of -the -State (i.e. where the effluent
reaches an unnamed tributary, creek, stream, river, or lake via any surface -water conveyance).
See enclosed Engineering Plans.
d) Site Evaluation - Contact DE 's local Regional Office for a site evaluation to confirm the
proposed discharge flow path to the nearest waters -of -the -State. The wastewater/stream
confluence and stream class must be verified in the field by DEQ's Regional Staff. Please list the
Regional Office staff member you contacted for the inspection. Done.
e) Flow Path - Display graphically the flow path of the discharge to the nearest surface Waters of
the State. Document any potential hydrologic trespass or right-of-way infringement on any
neighboring property (i.e. note all properties encountered prior to reaching waters -of -the -State).
Flow path shown on accompanying plans.Flow enters an NCDOT culvert, crosses Teague Rd and
discharges in to Sandy Mush Creek.
fl s ima e- Contact USGS J. Curtis Weaver (919-571-4043) to provide the estimated
7Q10 and 30Q2 stream -flow estimates for the first downstream point -of -contact with waters -of -
the -State. Enclosed
Page 4 of 6 Revised: A. Orlando NPDES 21Sept2017

I
Application for Certificate of Coverage (COC) and/or Authorization to Construct (ATC)
under General -Permit NCG550000
il. Certificates of Coverage/Notices of Intent to Discharge/Authorizations to Construct -Check ALL of
the following information has been provided. Incomplete Applications will be returned.
® An original letter [two (2) copies] requesting coverage under NCC550000.
® This application [two (2) copies]. Your signature on this application, certifies that you are le all
responsible for the proposed treatment system (see page 6 of 6) for the COC/NOI/ ATC.
® A check or money order for $60.00 permit fee made payable to NCDEQ.
12. Additional Application Requirements
a) Narrative Description of the treatment system. This narrative should present treatment components
in order of flow — influent to outfall, including anti -erosion structures and sample -port location(s).
b) Final Plans and Specifications for a wastewater treatment system shall be signed by a North
Carolina -registered Professional Engineer, or if prepared by others, must conform to 15A NCAC
02H .0134. All documents are to be stamped "Final Design - Not Released for Construction."
Submittal shall include a site map showing the proposed outfall and the effluent proposed path to
surface waters -of -the -State. (see Item I for location verification by DWR Regional [wee staff.)
c) Submittals by a Consulting Engineer or Engineering Firm shall include:
1. A copy of your written authorization to represent, signed by the legal
permit Applicant; and
2. Upon completion of proposed work, a signed copy ofDWRs Engineer's
Certification form attesting that the project was completed in accord
with the DWR approved COC/ATC, as issued.
CERTIFICATION
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing:
Title: 0 wv1_4�-
(Please revieynl SA NCAC 02jtI.011
(Signature of Applicant)
for definition of authorized signing officials)
11's
(Date Signed)
Page 5 of 6 Revised, A. Orlando NPDES 21 Sept2017

Application for Certificate of Coverage (COC) and/or Authorization to Construct (ATC)
under General -Permit NCG550000
NOTE: Treatment System Maintenance is Required - Upon receiving a Certificate of
Coverage/Authorization to Construct (COC/ATC), the Division recommends that the Permittee solicit
manufacturer -certified training, or solicit a qualified contractor or service to regularly inspect and
maintain this treatment system. The Permittee is responsible under this COC/ATC to maintain all
components of the approved treatment system, designed to meet Surface Water Quality Standards [see
attached Operation and Maintenance Agreement].
Compliance duties include:
• paying your annual fee [due on the anniversary of COC/ATC effective date],
• following the manufacturer's guidelines,
• conducting and documenting inspections, in compliance with General Permit NCG550000,
• establishing sources for OEM spare parts and supplies,
• taking discharge samples for analysis, and logging the results,
• making necessary repairs, documenting said maintenance in logs, and
• keeping logs onsite for the life of the permit, available for DWR inspection.
North Carolina General Statute & 143-215.613 provides that:
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 this Article or a rule implementing this
Article; or who knowingly makes a false statement of a material fact in a rulemaking proceeding or contested
case under this Article; or who falsifies, tampers with, or knowingly renders inaccurate any recording or
monitoring device or method required to be operated or maintained under this Article or rules of the Commission
implementing this Article, shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten
thousand dollars ($10,000). 18 U.S.C. Section 1001 provides a punishment by a fine or imprisonment not more
than 5 years, or both, for a similar offense.
Application must be accompanied by a check or money order for $60.00
madepayable to:
NCDEQ
Mail this application and one copy of the entire package (with check) to:
NCDEQ / DWR / NPDES
Attention: John Hennessy, Supervisor
Compliance and Expedited Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Attn: John Hennessy
Note: Submission of this document insures DWR's consideration, but does not
guarantee issuance of a Certificate of Coverage/Authorization to Construct.
Page 6 of 6 Revised: A. Orlando NPDES 21 Sept2017