NCG550097_Permit (Issuance)_20220209

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ROY COOPER
Governor
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ELIZABETH S.BISER u ;
Secretary `4kpyw n�►"-
S.DANIEL SMITH NORTH CAROLINA
Director Environmental Quality
February 9, 2022
Jahn Mastromonica&Kaylee Mastromonica
1149 Pine Knolls Rd
Kernersville, NC 27284
Subject: General Permit NCG550000
Certificate of Coverage (CoC) NCG550097
1149 Pine Knolls Rd
Forsyth County
Dear Permittee:
The Division has approved your request to transfer coverage under the subject General Permit.
Accordingly, the Division hereby issues you a revised version of NCG550097, along with a copy of
NCG550000. Discard any earlier versions of the permit and use this version until further notice. This CoC
is issued pursuant to the requirements of North Carolina General Statue 143-215.1 and the Memorandum of
Agreement between North Carolina and the US Environmental Protection agency dated October 15, 2007 [or
as subsequently amended].
PLEASE NOTE:Your facility discharges to a class C waterbody. Therefore,you will use the limits
and monitoring frequencies found in Part I,section C. (1.)of NCG550000.
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 CoC is not transferable except after notice to the Division. The Division may require
modification or revocation and reissuance of the CoC. Contact the Winston-Salem Regional Office
Prior to any sale or transfer of the permitted facility. Regional Office staff will assist you in
documenting the transfer of this CoC.
This permit does not affect the legal requirements to obtain any other State, Federal,or Tonal
governmental permit that may be required. If you have any questions concerning the requirements of the
General Permit, please contact Derek Denard of the NPDES staff[[e-mail]].
Sincerely,
l )7-
for S. Daniel Smith
Director, Division of Water Resources
cc: NPDES file
��_ North Carolina Department of Environmental Qualky I Division of Water Resources
'��/� S12 North Salisbury Street 1617 Mail Service Center I Raleigh North Carolina 27699 1617
NC I}CHY"BJUNA
Impartment r!r.romr arldy 919.707.9000
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STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG550097
DISCHARGE OF DOMESTIC WASTEWATER FROM SINGLE FAMILY RESIDENCES AND
OTHER 100% DOMESTIC DISCHARGES WITH SIMILAR CHARACTERISTICS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision 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,
John Mastromonica & Kaylee Mastromonica
is herebyauthorized to discharge <1000 gallons per day of domestic wastewater from a
g
facility located at
1149 Pine Knolls Rd
Kernersville
Forsyth County
to receiving waters designated as an unnamed tributary to Belews Creek, currently a class C
stream in subbasin 03-02-01 of the Roanoke River Basin in accordance with the effluent
limitations, monitoring requirements,and other conditions set forth in Parts I, II, and III hereof.
This certificate of coverage takes effect 2/9/2022.
This Certificate of Coverage shall remain valid for the duration of the General Permit.
Signed this day 2/9/2022
for S. Daniel Smith
Director, Division of Water Resources
By Authority of the Environmental Management Commission

,
Ms. Susan Wilson
January 11, 2005
Page 2
Please call if you have any questions or require any additional information.
Sincerely,
Harmon Environmental, PA
lef--4-e o
Richard L. Harmon, P.G.
President
cc: Mr. Glenn Hudson,Equipment& Supply,Inc.
Mr. Greg Hilderbran,Adams,Hendon, Carson, Crow and Saenger
Mr. Joe Nestor,NESCO,Environmental, PLLC

PAT MCCRORY
Got('itor
�.a
DONALD R. VAN DER VAART
Set reran
Water Resources S. JAY ZIMMERMAN
ENVIRONMENTAL QUALITY
DI,,rto,
RENEWAL FORM FOR EXISTING PERMITTED FACILITIES
NPDES renewal application for continued coverage under General Permit NCG550000:
Certificate of Coverage NCG55 O©9 7
(Please verify the information in items 1 &2 as correct, or note any corrections that should be made.)
(Please print or type) serfiehe
1) Mailing address*of property owner:
Owner Name Z1O-\\I 'MOtS•tV3 ry-10 Yl Cep Ora �ee"Cf1C 5.3•CO - etA
Street Address 1\40q \\S d
City r Zvi NC --1aL�
Telephone (Home) (Mobile) Lt J-1
(e-mail address) j-k'YYokwa YY13\@\icI.Yloo
*Address to which all permit correspondence will be mailed •
2) Location of facility producing discharge*: RECEIVED
Street Address F€$ 0 9 2022
City: ,
NCDEQIE WRINPDES
County
Telephone (Home)_ (Mobile)
* If the facility is not yet constructed, give the street address or lot number where the structure will be
built.
3) Description of Discharge:
a) Type of facility producing waste (please check one):
Ot Primary residence
❑ Vacation/second home
❑ Undeveloped property
❑ Other [describe]:
Page 1 of 2

2/9/22,2:10 PM Print Property Info
Property Summary
Tax Year:2022
REID 6888471158000 PIN 6888-47-1158 Property Owner Mastromonica,John T
1149 Pine Knolls RD L0036C BL5245A 1149 Pine Knolls Rd
Location Address Property Description Owners Mailing Address Kernersville NC 27284
Administrative Data Transfer Information Property Value
Plat Book&Page Deed Date 2/25/2016 Total Appraised Land Value $40,000
Old Map# 684886 Deed Book 003273 Total Appraised Building Value $171.000
Market Area 685888 Deed Page 00906 Total Appraised Misc
Improvements Value
Township BELEWS CREEK Revenue Stamps $385
Total Cost Value $211.000
Planning COUNTY WIDE Package Sale Date 2/25/2016
Jurisdiction Total Appraised Value-Valued $211,000
Package Sale Price $192,500
By Cost
City
Land Sale Date Other Exemptions
Fire District PINEY GROVE
Land Sale Price Exemption Desc
COUNTYWIDE
Spec District FIRE
Use Value Deferred
Improvement Summary
Land Class 1.01-SFD Dwelling Historic Value Deferred
Total Buildings 1
History REID 1 Total Deferred Value
Total Units 0
History REID 2 Total Taxable Value $211,000
Total Living Area 2,610
Acreage 0.48
Total Gross Leasable Area 0
Permit Date
Permit#
Building Summary
Card 1 1149 Pine Knolls RD
Building Details Building Description Building Total&Improvement Details
Bldg Type RESIDENTIAL Year Built 1979 Effective Year 1990 C+5 Grade
105%
Units 0 Additions 6 Remodeled 1986
Percent Complete 100
Living Area(SQFT) 2610 ADD FIREPLACE LC
(1.00)EXTRA STACK Total Adjusted Replacement $274,215
Number of Stories 2.00 Interior Adj LEVEL LC(1.00) Cost New
Style CONVENTIONAL FIREPLACE LC(1.00)
Physical Depreciation(% AVER
Foundation MASONRY Bad) 38%
Basement Car Storage
Frame FRAME Other Features 1100.00 Garage Doors Depreciated Value $171,005
Electric 500.00
Exterior ALUMINUM Economic Depreciation(% 0
Bad)
Const Type
Functional Depreciation(% 0
Heating Heat Pump Bad)
Air Cond HEAT PUMP Total epreciated Value $171,005
Baths(Full) 2 • Market Area Factor 1
Baths(Half) 1 Building Value $171,000
• Extra Fixtures 0 Misc Improvements Value
teilus.cd.forsyth.nc.us/ircpwa/PrintPRC.aspx?PARCELPK=113768 1/3

Page Four
Environmental, to assess the contamination and propose a clean up plan for the site.
Cadmium concentrations in the discharge will be evaluated after the facility is operational
and additional treatment equipment will be added if necessary to reduce cadmium
concentrations.
Signature of Report Preparer a ate
Water Qua egional Supervisor Date
hider\ds199\.dsr

2/9/22,2:10 PM Print Property Info
Total Plumbing 8 Total Improvement Value $171,000'
Fixtures
Assessed Land Value ,
Bedrooms 4
Assessed Total Value
CARPET-
Floor
CONCRETE
Roof Cover Asphalt Shingle
Roof Type
ype GABLE
Main Body(SQFT) 1305
Addition Summary
Story Type Code Area
1.00 OPEN FRAME PORCH OPEN 205
1.00 OPEN FRAME PORCH OPEN 180
1.00 FRAME DECK AVERAGE FRAM 304
1.00 UPPER STORY FINISHED UPPE 1305
1.00 BASEMENT-UNFIN-CF BASE 758
1.00 BASEMENT-FIN-AVG-R BASE 547
Building Sketch Photograph
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180sr ' ' ;ar .).)
E?5
' IH III I HMI
1`.
F
S4«,.ov Apex wan•a'
6888-47-1158.00 01 6/17/2016
Misc Improvements Summary
Card Unit Base Eff Phys Depr(% Econ Depr(% Funct Depr(% Common Interest(%
# Quantity Measure Type Value
Price Year Bad) Bad) Bad) Good)
No Data
Total Misc Improvements Value Assessed:
Land Summary
Land Class: 1.01-SFD Dwelling Deeded Acres:0.48 Calculated Acres:0.48
Zoning Soil Class Description Size Rate Size Adj.Factor Land Adjustment Land Value
RS30 RES-LOT 1.00 BY THE UNIT PRICE $40,000 $40,000
Total Land Value Assessed:$40,000
tellus.co.forsyth.nc.us!trcpwa'PrintPRC.aspx?PARCELPK=113768 2!3

Equipment&Supply
• EEI Project No. 790C-NC
However, if costs are the same in every time period from year one through year n (i.e., Ct = C, a
constant for t= 1,2,..., n), then the formula reduces to:
PV =C +C (1+r)" _l
r(l+r)"
Co = 53,307
C = 30,045
r =5.0 % (assumed)
n =10
PV= $285,307(assuming equal yearly costs)
4

2/9/22.2:10 PM Print Property Info
Ownership History
Owner Name Deed Type %Ownership Stamps Sale Price Book Page Deed Date
Current Mastromonica,John T DEED 100 385 $192,500 003273 00906 2/25/2016
1 Back Rammel,Marcia Lynn DEED 100 0 003111 02890 3/14/2013
2 Back Spillane,Mark S/Rammel,Marcia L DEED 100 317 $158,500 001974 03177 11/25/1997
Notes Summary
Building Card Date Line Notes
No Data
tellus.cn.forsyth.nc.us/Ircpwa/PrintPRC.aspx?PARCELPK=113768 3/3

Equipment&Supply
• EEI Project No. 790C-NC
However, if costs are the same in every time period from year one through year n (i.e., Ct = C, a
constant for t= 1,2,..., n), then the formula reduces to:
PV =C +C (1+
r(1+r)"
C° = 18,720
C = 16,000
r =5.0 % (assumed)
n =10
PV= $142,268 (assuming equal yearly costs)
6