WQ0002128_Renewal (Application)_20240624

Initial Review
Reviewer nathaniel.thornburg
Is this submittal an application? (Excluding additional information.) *
Yes No
Permit Number (IR) * WO0002128
Applicant/Permittee Pebble Beach Homeowners' Association, Inc.
Applicant/Permittee Address 9201 Coast Guard Rd
Is the owner in BIMS? Yes No Is the facility in BIMS? Yes No
Owner Type
Facility Name
County
Fee Category Major
Is this a complete application?*
Yes No
Signature Authority
Signature Authority Title
Signature Authority Email
Document Type (if non -application)
Email Notifications
Organization
Pebble Beach Condos WWTP
Carteret
Does this need review by the hydrogeologist? * Yes No
Regional Office
CO Reviewer
Admin Reviewer
Fee Amount
Complete App Date
06/24/2024
$0
Below list any additional email address that need notification about a new project.
Email Address
Comments to be added to email notfication
Comments for Admin
Comments for RO

Comments for Reviewer
Comments for Applicant

Submittal Form
Project Contact Information
Please provide information on the person to be contacted by NDB Staff regarding electronic submittal, confirmation of receipt, and other correspondence.
...................................................................................................................................................................................................................................................................................... ... ... ... ... ... .. ... ... ... ... ..
Name* Pebble Beach Homeowners Association, Inc.
Email Address*
[e-mail]
Project Information
Application/Document Type*
New (Fee Required)
Modification - Major (Fee Required)
Renewal with Major Modification (Fee
Required)
Annual Report
Additional Information
Other
Phone Number*
2523546333
Modification - Minor
Renewal
GW-59, NDMR, NDMLR, NDAR-1,
N DAR-2
Residual Annual Report
Change of Ownership
We no longer accept these monitoring reports through this portal. Please click on the link below and it will take you to the correct form.
https://edoes.deq.nc.gov/Forms/NonDischarge_Monitoring_Report
Permit Type:*
Wastewater Irrigation
High -Rate Infiltration
Other Wastewater
Reclaimed Water
Closed -Loop Recycle
Residuals
Single -Family Residence Wastewater
Other
Irrigation
Permit Number:*
WQ0002128
Has Current Existing permit number
Applicant/Permittee *
Pebble Beach Homeowners' Association, Inc.
Applicant/Permittee Address*
9201 Coast Guard Rd
Facility Name*
Pebble Beach Condos WWTP
Please provide comments/notes on your current submittal below.
At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg
at [e-mail].
Please attach all information required or requested for this submittal to be reviewed here.
(Application Form, Engineering Plans, Specifications, Calculations, Etc.)
20240624104153856.pdf 3.18MB
Upload only 1 PDF document (less than 250 MB). Multiple documents must be combined into one PDF file unless file is larger
than upload limit.
* By checking this box, I acknowledge that I understand the application will not be accepted for pre -review until the fee (if required) has
been received by the Non -Discharge Branch. Application fees must be submitted by check or money order and made payable to the
North Carolina Department of Environmental Quality (NCDEQ). I also confirm that the uploaded document is a single PDF with all parts
of the application in correct order (as specified by the application).
Mail payment to:
NCDEQ — Division of Water Resources
Attn: Non -Discharge Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Signature
Submission Date 6/24/2024

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Divlslon of Water Resources 15A NCAC 02T .0700 — HIGH -RATE INFILTRATION SYSTEM — RENEWAL
FORM: HRIS-R 02-21
Pursuant to 15A NCAC 02T .0107{bj, 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 .0700, 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) rile to https:I/edacs.dea.nc.uov/Forms/NonDischarffe-Branch-Submittal-
Form-Vert, or emailed to Non-Discharp-e.Renorts{&,nedenr.sov if less than 20 megabytes (MB).
SECTION I — APPLICANT INFORMATION
1. Applicant: Pebble Beach Homeowners Association
2. Permit No.: WQ002128
3. Signature authority: Crystal Coast Management Consultants Title: Association Manager
Phone number: [phone] Office Email: [e-mail]
4. Mailing address: PO Box 5359
City: Emerald Isle State: NC Zip: 28594-
5. Contact person: dames Bunger Email: [e-mail]
Primary phone number: [phone] Office Secondary phone number: ( } - Select
SECTION II -- FACILITY INFORMATION
1. Physical address: 9201 Coast Guard Rd County: Carteret Parcel No.: 5383103 601250 00
City: Emerald Isle State: NC Zip: 28594-
2. Treatment facility coordinates to the sixth decimal degree:
Latitude: 34.658274' Longitude:-77.060871 ° Method: Map interpretation by extraction
SECTION III —FLOW INFORMATION�T
1. Permitted flow: 70000 GPD (The mayinaum allowable flow based on what has been permitted)
2. As -built flow: GPD (The nuainrzun allowable flow based on what has been constructed)
3. Average flow: GPD (The average of all reported flows on the previous calendar ),ear's NDMRs)
4. Hydraulic capacity: % (Divide the m,e)-age flow in Item 3 by the As -built flow in Item 2)
5. Wastewater composition: Domestic : % Industrial: % Stormwater: %
1. Billing address: PO Box 5359
City: Emerald Isle
SECTION IV -- BILLING INFORMATION
State: NC
2. Verify the Applicant does not have any overdue annual fees:
httt)s://deu.nc. eov/about/divisions/water-resources/water-resources-i)ennitS/wa-eDavments
Zip: 28594-
Pursuant to 15A NCAC 02T .0I20(c), permits for renewing facilities shall not be granted if the Applicant or any affiliation has
an unpaid annual fee.
FORM: HRIS-R 02-21 Page 1 of 6

1. ORC: Don Omara
Grade: 3
Certification No.: 7904
Mailing address: PO Box 4602
City: Emerald Isle
State: NC
Zip: 28594-
Phone number: [phone] Select
Email:
2. Back -Up ORC:
Grade:
Certification No.:
Mailing address: PO Box 4602
City: Emerald Isle
State: NC
Zip: 28594-
Phone number: ( } - Select
Email:
L List all open -atmosphere treatment and storage structures associated with the renewing permit. Attach additional sheets if
necessary.
Type Parcel No. Volume (gal) Liner Type Freeboard (ft) Latitude Longitude
-
Select Select
Select Select
Select Select -
Select Select
'' `SECTION%VIII 'MONITORING-WkLLS
1. List all groundwater monitoring wells associated with the renewing permit. Attach additional sheets if necessary.
Well Name Parcel No.
Status
Gradient
Location Latitude
Longitude
1 538310360125
Select
Select
Select
°
2 538310361574
Select
Select
Select
° - °
3
Select
Select
Select
° - °
Select
Select
Select
° - °
Select
Select
Select
° - °
Select
Select
Select
° - °
Select
Select
Select
° - °
Select
Select
Select
° - °
Select
Select
Select
° - °
Select
Select
Select
° - °
Select
Select
Select
° - °
FORM: HRIS-R 02-21 Page 2 of 6

1. List all infiltration sites associated with the renewing permit. Attach additional sheets if necessary. rl
Site County Parcel No. Deeded Owner Area Cover Crop Latitude Longitude
0
0 0
0
0
0
0 C;
0 0
0
0 a
0 0
0
0
0
0
0
0
0
0 0
0
0
0 0
0 0
0 a
0
Total Acreage:
FORM: HRIS-R 02-21 Page 3 of 6

ATTACHMENT A — SITE MAP
Was the facility originally permitted or had a major modification issued after September 1, 2006?
® Yes — Pursuant to 15A NCAC 02T .0105(d), submit a site map pursuant to the requirements in 15A NCAC 02T .0704(d).. 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 infiltration areas.
® Soil mapping units shown on all infiltration 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 infiltration sites.
® Delineation of the compliance and review boundaries per 15A NCAC 02L .0107 and .0108.
® Setbacks as required by 15A NCAC 02T .0706.
® Site property boundaries within 500 feet of all wastewater treatment, storage, and infiltration sites.
® All habitable residences or places of public assembly within 500 feet of all treatment, storage, and infiltration 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 .0106(h)?
® Yes — Skip Attachment B.
❑ No — Submit a delesation letter pursuant to 15A NCAC 02T .0 106(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 .0I 14(f).
® No — Skip Attachment C.
ATTACHMENT D — CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY
Is the Applicant a Privately -Owned Public Utility?
❑ Yes — Pursuant to 15A NCAC 02T .01 I5(a)(1), submit the Certificate of Public Convenience and Necessity from the North
Carolina Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise.
® No — Skip Attachment D.
ATTACHMENT E — OPERATIONAL AGREEMENT
Is the Applicant a Home/Property Owners' Association or Developer of Lots to be Sold?
❑ Yes (Home/Property Owners' Association)— Pursuant to 15A NCAC 02T .0I 15(a)(2), submitan executed Operational Agreement
(FORM: HOA). Pursuant to 15A NCAC 02T .0115(c), if the applicant is a legally formed Homeowners' or Property Owner's
Association, submit a copy of the Articles of Incorporation, Declarations, and By-laws.
❑ Yes (Developer of Lots to be Sold) — Pursuant to 15A NCAC 02T .01 15(a)(2), submit an executed Onerational Aereement
(FORM: DEV). Pursuant to 15A NCAC 02T .01 I5(b), if the applicant is a developer of lots to be sold, submit a copy of the
Articles of Incorporation, Declarations, and By-laws.
® No — Skip Attachment E.
FORM: HRIS-R 02-21 Page 4 of 6

ATTACHMENT F — DEMONSTRATION OF FUTURE WASTEWATER TREATMENT CAPACITIES
Is the applicant a municipality, county, sanitary district, or public utility?
❑ Yes — Proceed to the next question.
® No — Skip Attachment F.
Does the hydraulic capacity in Section III, Item 4 exceed 70%?
❑ Yes (the hydraulic capacity is greater than 70%, but less than 80%) — Pursuant to 15A NCAC 02T .0118(I ), prior to exceeding
80 percent of the system's permitted hydraulic capacity (based on the average flow during the last calendar year), the pennittee
shall submit an engineering evaluation of their future wastewater treatment, utilization, and disposal needs. This evaluation shall
outline plans for meeting future wastewater treatment, utilization, or disposal needs by either expansion of the existing system,
elimination or reduction of extraneous flows, or water conservation and shall include the source of funding for the improvements.
If expansion is not proposed or is proposed for a later date, a justification shall be made that wastewater treatment needs will be
met based on past growth records and future growth projections, and as appropriate, shall include conservation plans or other
measures to achieve waste flow reductions.
❑ Yes (the hydraulic capacity greater than 80%) — Proceed to the next question.
® No — Skip Attachment F.
If answered Yes above, does the hydraulic capacity in Section III, Item 4 exceed 80%?
❑ Yes (the hydraulic capacity is greater than 80%) Pursuant to 15A NCAC 02T .0118(2), prior to exceeding 90 percent of the
system's permitted hydraulic capacity (based on the average flow during the Iast calendar year), the permittee shall obtain all
permits needed for the expansion of the wastewater treatment, utilization, or disposal system and, if construction is needed,
submit final plans and specifications for expansion, including a construction schedule. If expansion is not proposed or is proposed
for a later date, a justification shall be made that wastewater treatment needs will be met based on past growth records and future
growth projections, and as appropriate, shall include conservation plans or other specific measures to achieve waste flow
reductions.
❑ No — Skip Attachment F.
ATTACHMENT G — EASEMENT, ENCROACHMENT, AND LEASE AGREEMENTS
Does the Permittee own all of the land associated with the wastewater collection, treatment, conveyance, infiltration, and groundwater
lowering (if applicable) system?
® Yes — Skip Attachment G.
❑ 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, infiltration, and groundwater
lowering (if applicable) system on property not owned by the Permittee.
ATTACHMENT H — AFFILIATIONS
Are the Permittee's affiliations of record correct? Check affiliations.
® Yes — Skip Attachment H.
❑ No — Provide the corrected affiliations and their contact information.
ATTACHMENT I — COMPLIANCE SCHEDULES
Does the existing permit include any Compliance Schedules? (See Section I of the most recently issued permit)
❑ Yes — Submit documentation that the compliance schedules have been met.
® No -- Skip Attachment I.
ATTACHMENT J — CIVIL PENALTIES AND OUTSTANDING VIOLATIONS
Does the Permittee have any existing civil penalties or outstanding violations?
❑ Yes (civil penalties) — Submit payment for the civil penalty, or proof of remission request.
❑ Yes (violations) -- Submit a copy of your response to the Notice of Violation.
® No — Skip Attachment J.
NORM: HR1S-R 02-21 - Page 5 of 6

ATTACHMENT K — INDUSTRIAL WASTEWATER
Does the wastewater composition in Section III, Item 5 include any industrial wastewater?
❑ Yes — Proceed to the next question.
® No — Skip Attachment K.
Has the nature of the industrial wastewater changed since the last permit issuance (i.e., changes in industrial process, introduction of
new materials or chemicals, etc.)?
❑ Yes — Provide a chemical analysis of the wastewater pursuant to the requirements in 15A NCAC 02T .0704(h). Provide an
overview of the manufacturing process; an inventory of all chemical and biological materials used in the manufacturing process;
and an overview of the cleaning and treatment methodology.
❑ No -- Provide an overview of the manufacturing process; an inventory of all chemical and biological materials used in the
manufacturing process; and an overview of the cleaning and treatment methodology.
ATTACHMENT L -- SETBACK WAIVERS
Does the existing permit include setback waivers?
❑ Yes — Pursuant to 15A NCAC 02T .0706(d), provide setbacks waivers that have been written, notarized, signed by all parties
involved, and recorded with the county Register of Deeds. Waivers involving the compliance boundary shall be in accordance
with 15A NCAC 02L .0107.
® No — Skip Attachment L.
APPLICANT'S CERTIFICATION
_attest that this application
(Signature authority's name as noted in Section 1, Item 3)
has been reviewed by me and is accurate and complete to the best of my knowledge. 1 understand that if all required parts of this
application package are not completed, and that if all required supporting information and attachments are not included, this
application package will be returned as incomplete. I further certify pursuant to 15A NCAC 02T .0120(b), that the applicant, or any
parent, subsidiary, or other affiliate of the applicant has: not been convicted of environmental crimes under; not previously abandoned
a wastewater treatment facility without properly closing the facility; not paid a civil penalty; not been compliant with any compliance
schedule in a permit, settlement agreement, or order; not paid an annual fee.
Note: The Applicant's Certification shall be signed pursuant to 15A NCAC 02T .0106(b). An alternate person may be delegated as
the signing official if a letter is provided pursuant to 15A NCAC 02T .0106(c). Pursuant to § 143-215.6A and § 143-215.613, any
person who knowingly makes any false statement, representation, or certification in any application package shall be guilty of Class
2 misdemeanor, which may include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: Date: 6,17#17Dr,y
THE COMPLETED APPLICATION AND ATTACHMENTS SHALL BE SUBMITTED AS A SINGLE PDF FILE VIA:
Email:
Non-Discharee.Renorts(a ncdenr.eov
Laseriiche Upload:
httns:Hedoes.deo.ne.eov/Forms/NonDischaree-Branch-
Submittal-Form-Vert
FORM: HRIS-R 02-21 Page 6 of 6

A •,
NON -DISCHARGE APPLICATION REPORT (NDAR-2)
Permit No.:
W00002128
Facility Name:
Pebble Beach
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County: Carteret
� Month
March
Year: 2024
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