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Home My WebLink AboutWQ0000236_Application_20230927DWR State of North Carolina Department of Environmental Quality Division of Water Resources Division of Water Resources 15A NCAC 02T .0600 — SINGLE-FAMILY RESIDENCE WASTEWATER IRRIGATION SYSTEM — RENEWAL FORM: SFRWWIS-R 02-21 Pursuant to 15A NCAC 02T .0107(b), if the application does not include all required information and the necessary supporting documentation, the application shall be returned. The application and attachments shall be prepared in accordance with 15A NCAC 02T .0100, 15A NCAC 02T .0600, and Division Policies. For more information, visit the Water Quality Permitting Section's Non -Discharge Branch website. The Applicant shall submit an electronic copy of the application and attachments uploaded as a single Portable Document Format (PDF) file to httos://edocs.deo.nc.gov/Forms/NonDischarae-Branch-Submittal- Form-Ver2, or emailed to Non-Discharge.Renorts(&ncdenr. ov if less than 20 megabytes (MB). SECTION I — APPLICANT INFORMATION 1. Applicant: Anthony S. Dearing 2. Permit No.: WQ0000236 3. Signature authority: Anthony S. Dearing Title: Owner 4. Mailing address: 416 Sherron Rd. City: Durham State: NC Zip: 27703- 5. Contact person: Anthony S. Dearing Primary phone number: (507) 202-9913 Home Email.- anthonydearing@yahoo.com Secondary phone number: ( ) - Select 6. Secondary Contact person: Primary phone number: ( ) - Select Email: Secondary phone number: ( ) - Select SECTION IL— FACILITY INFORMATION 1. Physical address: 416 Sherron Rd. County: Durham City: Durham State: NC Zip: 27703- SECTION III — BILLING INFORMATION 1. Billing address: 416 Sherron Rd. City: Durham State: NC Zip: 27703- 2. Verify the Applicant does not have any overdue annual fees: https://deq.nc.�ov/about/divisions/water-resources/water-resources-permits/wq-enayments Pursuant to 15A NCAC 02T .0120(c], permits for renewing facilities shall ndt be granted if the Applicant or any affiliation has an unpaid annual fee. 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These requirements are: ❑ A scaled map of the site with topographic contour intervals not exceeding 10 feet or 25 percent of total site relief and showing all facility -related structures and fences within the wastewater treatment, storage, and irrigation areas. ❑ Soil mapping units shown on all irrigation sites. ❑ The location of all wells (including usage and construction details if available), streams (ephemeral, intermittent, and perennial), springs, lakes, ponds, and other surface drainage features within 500 feet of all wastewater treatment, storage, and irrigation sites. ❑ Delineation of the compliance and review boundaries per 15A NCAC 02L .0107 and .0108, and 15A NCAC 02T .0601. ❑ Setbacks as required by 15A NCAC 02T .0606. ❑ Site property boundaries within 500 feet of all wastewater treatment, storage, and irrigation sites. ❑ All habitable residences or places of public assembly within 500 feet of all treatment, storage, and irrigation sites. No — Skip Attachment A. ATTACHMENT B SIGNATURE AUTHORITY DELEGATION Does the signature authority in Section I, Item 3 meet the requirements pursuant to 15A NCAC 02T .0106N? Yes — Skip Attachment B. ❑ No — Submit a delegation letter pursuant to 15A NCAC 02T .0106(c) authorizing the signature authority to sign. ATTACHMENT C — FLOW REDUCTION Does the existing permit include an approved flow reduction? ❑ Yes — Submit a copy of the flow reduction approval letter, as well as the measured monthly average amount of wastewater flow contributed per unit for the 12 months prior to permit renewal. If any of these monthly averages are within 20% of the approved flow reduction value, the Permittee shall provide a reevaluation of the reduced flow value pursuant to the requirements in 15A NCAC 02T.0114ff1. No — Skip Attachment C. ATTACHMENT D — EASEMENT, ENCROACHMENT, AND LEASE AGREEMENTS Does the Permittee own all of the land associated with the wastewater collection, treatment, conveyance, and irrigation system? 5' Yes — Skip Attachment D. ❑ No — Pursuant to 15A NCAC 02T .0116(c), provide a copy of all easements, lease agreements, and encroachment agreements allowing the Permittee to operate and maintain the wastewater collection, treatment, conveyance, and irrigation system on property not owned by the Permittee. ATTACHMENT E — AFFILIATIONS Are the Permittee's affiliations of record correct? Check affiliations. Yes — Skip Attachment E. ❑ No Provide the corrected affiliations and their contact information. ATTACHMENT F — COMPLIANCE SCHEDULES Does the existing permit include any Compliance Schedules? (See Section I of the most recently issued permit) ❑ Yes — Submit documentation that t compliance schedules have been met. No — Skip Attachment F. 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