NCG550111_Permit (Issuance)_20100416

ATFA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue, Governor Coleen H.Sullins, Director Dee Freeman, Secretary
April 16, 2010
David L. Price
P.O. Box 893
Stoneville,NC 27048-0893
Subject: Renewal of coverage/General Permit NCG550000
167 Fieldale Drive
Certificate of Coverage NCG550111
Rockingham County
Dear Permittee:
In accordance with your renewal application [received on April 15, 2010],the Division is renewing
Certificate of Coverage (CoC)NCG550111 to discharge under NCG550000. 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].
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
is made,the certificate of coverage shall be final and binding.
permit application. Unless such demandg g
Please take notice that this Certificate of Coverage is not transferable except after notice to the
Division. The Division may require modification or revocation and reissuance of the certificate of coverage.
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 other permits which may be required by
the Division of Water Quality or permits required by the Division of Land Resources, Coastal Area
Management Act or any other Federal or Local governmental permit that may be required.
If you have any questions concerning the requirements of the General Permit,please contact Charles
Weaver of the NPDES staff[919 807-6391 or [e-mail]].
Sincerely,
for Coleen H. Sullins
cc: Central Files
Winston-Salem Regional Office/Surface Water Protection
NPDES file
1617 Mail Service Center,Raleigh,North Carolina 27699-1617 One
512 North Salisbury Street,Raleigh,North Carolina 27604 NorthCarolina
Phone: [phone]/FAX [phone]/Internet:www.ncwaterquality.org• Naturally
An Equal Opportunity/Affirmative Action Employer—50%Recycled/10%Post Consumer Paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG550111
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,
David L. Price
is hereby authorized to discharge domestic wastewater [450 GPD] from a facility located at
167 Fieldale Drive
Stoneville
Rockingham County
to receiving waters designated as an unnamed tributary to the Dan River, a class WS-IV CA
stream in subbasin 03-02-03 of the Roanoke River Basin in accordance with the effluent
limitations, monitoring requirements, and other conditions set forth in Parts I, II, III and IV
hereof.
This certificate of coverage shall become effective April 16, 2010.
This Certificate of Coverage shall expire on July 31, 2012.
Signed this day April 16, 2010
for een H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

Division of Water Quality/Water Quality Section
NCDENRNational Pollutant Discharge Elimination System
NORTM CAROUNA DEPARTMENT OF
ENVIRONMENT ANS NATURAL RESOURCE! NCG550000
RENEWAL FORM FOR EXISTING PERMITTED FACILITIES
NPDES renewal application for continued coverage under General Permit NCG550000:
Certificate of Coverage NCG55 YI(/
(Please verify the information in items 1 & 2 as correct, or note any corrections that should be made.)
(Please print or type)
1) Mailing address* of.property owner:
Owner Name II,v it4L
Pi Bg :Street Address I�p 1I`v✓�tjct�iv t�✓�% O
City 5+010 d;'I42/
Telephone (Home) /� 7.- 1 1,f7 (Mobile) 33k 3 1j
-81.3?'/-
(e-mail address)
*Address to which all permit correspondence will be mailed
2) Location of facility producing discharge*:Street Address �/O l rJd�C 0 l� (Ka:I A / c a
II re5 5)
City:Sfe&vl( 'J
County ►\od,k,,��hq Il•-• / /�
Telephone (Home) 1??7 " ��'?-cub/ (Mobile) ?3'6 ')?q L^ Y `
* 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):
Primary residence
❑ Vacation/second home
❑ Undeveloped property
❑ Other [describe]: D)
APR 15 2010
DEN A-WATER QUAL tY
POINT SOURCE BRANCH
Page 1 of 2

NCG550000'renewal form '
4) Please check the components that comprise the wastewater treatment system:
19 Septic tank 0 Dosing tank d Primary sand filter Secondary sand filter
0 Recirculating sand filter(s) chlorination 0 Dechlorination .
0 Other form of disinfection: E Post Aeration(describe)
5) Other Information: I
a) When was the septic tank last pumped out? NU-- Stirs
NOTE: the septic tank must be pumped out at least once every 3-5 years
b) Is the facility [home] occupied year-round, or only seasonally? , ay'_rtnArn
(94 c) Approximately how many people use the facility when it is occupied?_
d) When was the wastewater system installed? 11 u
6) 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: a t/d(61 A I / C1?_
044/1‘./
(Signature of Applicant) (Date Signed)
North Carolina General Statute 143-215.6 b (i) 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 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 $25,000, 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 $25,000 or imprisonment not more
than 5 years, or both,for a similar offense.)
Mail this completed form and a copy of the receipt for your last septic service to:
Mr. Charles H. Weaver, Jr.
NC DENR/DWQ/NPDES
1617 Mail Service Center
• Raleigh, NC 27699-1617
Page 2 of 2

Ar4 .7A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
4 January 2010
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
7008-3230-0003-2547-2200
David Price
P.O. Box 893
Stoneville, NC 27048
SUBJECT: Disposal of Domestic Wastewater at Single Family Residence Located at
167 Fieldale Drive, Stoneville, Rockingham County, NC, 27048
Notice of Violation with Notice of Intent to Enforce: NOV-2009-PC-0909
General Permit#: NCG550000
Certificate of Coverage #: NCG550111
Rockingham County
Dear Mr. Price:
1. We, the NC Division of Water Quality (DWQ or the Division), are sending you this
correspondence regarding the proper disposal of domestic wastewater from your single family
residence located at 167 Fieldale Drive, in Stoneville, Rockingham County, NC, 27048. We
have attempted numerous times over the past several years to contact you via mail regarding
this matter and have yet to receive any response from you. We therefore must now inform
you that your failure to respond to this correspondence will result in the assessment of
civil penalties (fines) against you.
2. Ron Boone, of the Division's Winston-Salem Regional Office (WSRO), conducted a
compliance evaluation inspection (CEI) of the wastewater treatment system (WWTS) located
at your residence on 28 October 2009. However, because you were not present for the
inspection Mr. Boone could not evaluate everything that he needed to. The Division sent you a
letter dated 12 November 2009, which summarized the results of that inspection. That letter
was sent to your residential address via certified mail on 12 November. It was sent to your
residential address because you have so far failed to respond to any correspondence
previously sent to your post office box address. The Division also sent another letter to your
post office box address (amongst many others) which was dated 19 March 2009, and again
received no response from you. The letter dated 12 November, and its attachments, are
attached to this letter. Please refer to them to find exactly what you must do.
3. In summary, the WWTS at your residence discharges to surface waters of the State, which
requires a discharge permit issued by the Division, pursuant to the requirements of NC
North Carolina Division of Water Quality,Winston-Salem Regional Office
Location:585 Waughtown St.Winston-Salem,North Carolina 27107 One
Phone:[phone] FAX:[phone]\Customer Service:1-877-623-6748 NorthCarolina
Internet:www.ncwaterquality.org Naturally
fAr lly
An Equal Opportunity 1 Affirmative Action Employer `K tL �/

Mr. David Price,Owner
SFR 167 Fieldale Drive,Stoneville,NC,27048
NPDES Wastewater General Permit NCG550000
Certifcate of Coverage#: NCG550111
4 January 2010
Page 2 of 2
General Statute (NCGS) 143-215.1. However, your permit was last issued in September 1993
and expired in July 1997. Your discharge permit/certificate of coverage ICOC) is expired
and you are therefore discharging wastewater illegally into waters of the State. Pursuant
to NCGS 143-215.6A, in such cases the Division is authorized to assess civil penalties (fines)
of not more than $25,000 per day against any person who is required but fails to apply for or
to secure a permit required by NCGS 143-215.1, or who violates or fails to act in accordance
with the terms, conditions, or requirements of such permit.
4. If we do not receive a satisfactory response from you within 10 days, of your receipt of
this letter, we will initiate the above referenced enforcement procedures against you.
Thank you for your cooperation in this matter. Should you have any questions please feel free
to contact Mr. Boone or me at [phone].
Sincerely,
67, Steve W. Tedder
Water Quality Regional Supervisor
Winston-Salem Region
Division of Water Quality
Attachments:
1 . WSRO Letter Dated 12 November 2009, With Attachments
cc: SWP —WSRO
Central Files
NPDES West Unit, Attn: Charles Weaver
Rockingham County Department of Environmental Health
Attn: Mr. Bob Jones
P.O. Box 204
Wentworth, NC 27375

rr �
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
CERTIFIED MAIL ITEM 7002 0860 0006 5836 1974 - RETURN RECEIPT REQUESTED
March 19, 2009
Mr. David L. Price
P.O. Box 893
Stoneville,NC 27048-0893
Subject: Wastewater disposal at 167 Fieldale Drive
Certificate of Coverage NCG550111
Rockingham County
Dear Mr. Price:
We are contacting you to determine the status of a wastewater disposal system on your property.
That system was previously covered under a state NPDES discharge permit.
An audit of expired/unresolved files noted that coverage for your system expired in July 1997. The
Division needs information from you to determine if coverage under NCG550000 [the General Permit for
domestic wastewater] is still necessary.
➢ If your property still has a wastewater system like the ones described in the enclosed Technical
Bulletin,you must renew the subject CoC. Complete the enclosed form and submit it to me at the
address on the form.
➢ If you have questions regarding the application or your system's components, contact Ron Boone in
the NC DENR Winston-Salem Regional Office at 336 771-5000. He [or other staff members] can
help you.
➢ If your property no longer discharges wastewater,contact me at the address or phone number
listed below to request rescission of the CoC.
If you have any questions, please contact me at the telephone number or e-mail address listed below.
Thanks for your attention to this matter.
Sincerely,
Charles H. Weaver,Jr.
NPDES Unit
cc: Central Files
Winston-Salem Regional Office/Ron Boone
NPDES file
1617 Mail Service Center,Winston-Salem,North Carolina 27699-1617 One
512 North Salisbury Street,Winston-Salem,North Carolina 27604 NorthCarolina
Phone: [phone]/FAX [phone]/[e-mail] Naturally
An Equal Opportunity/Affirmative Action Employer—50%Recycled/10%a Post Consumer Paper

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Rockingham County NC - Parcel No: 132698 Page 1 of 3
•
DATE 8/18/08 ROCKINGHAM COUNTY PAGE 1
TIME 16:45:09 PROPERTY CARD PROG# AS2006
USER RONNIE FOR YEAR 2008
PRICE DAVID L PARCEL ID.. 132698 PIN... 7968 01 19 7573 00
LOCATION... 167 FIELDALE DR
DEED YEAR/BOOK/PAGE..
PO BOX 893 PLAT BOOK/PAGE.. OWNER ID.. 21373
LEGAL DESC:LOT 80 RIVERDALE DB 716-5 DISTRICT.. 117 SHILOH FD
30
TOWNSHIP... 4 MAYO
STONEVILLE NC 27048--0893 79680119741600 NBRHOOD... R101L RIVERBEND/HOMESTEAD
DESCRIPTION SINGLE FAMILY RES NH CLASS..
DESCRIPTION RESIDENTIAL RES PROTECTED COUNTY
MAINTAINED 5/31/2007 BY KCARTER VALUED.. 6/02/2008 BY KCARTER
VISITED 6/14/2000 BY HT ROUTING#.. 8100
PARCEL STATUS... ACTIVE CATEGORY.. REAL & PERSONAL
SALES HISTORY
DEED BK/PAGE SALE DATE SALES INSTRUMENT DISQUALIFIED SALE AMOUNT STAMP AMOUNT DEED NAME
1 1 7/01/1986 DEED CONVERTED PRICE DAVID L
LAND SEGMENTS
LND STRAT LAND TOT CURRENT
# ZONE CODE TYPE/CODE LAND QTY LAND RATE DPT% SHP% LOC% SIZ% OTH% TOP% ADJ FMV
1 100 FF FF 155.000 65.00 110.00 .00 .00 .00 100.00 100.00 110.00 11,082
DPTH.. 193 OTHER ADJ... .00 .00 .00 .00
2 100 UB RH 1.000 5,000.00 .00 .00 .00 .00 .00 .00 .00 5,000
TOTAL ACRES.. .000 TOTAL LAND FMV.. 16,082
IMPROVEMENT # 1 MAJOR IMPR-M
MAIN FIN AREA.. 912.00 ACT/EFF YR/AGE.. 1977 1977 26 VISITED.. 6/14/2000 BY HT
STRAT 100 DESCRIPT... . SINGLE FAMILY DWELLING MAINTAINED.. 5/31/2007 BY KCARTER
MAIN GROUND SF.... 912.000
BUILT USE 01 SINGLE FAMILY DWELLING CURRENT USE.... CR CURRENT USE RESIDENTIAL
LOCATION # 167 FIELDALE DR
COMPONENT TYPE/CODE/DESC PCT UNITS RATE STR# STR% SIZ% HGT% PER% CDS% COST %CMPL
AC B BASEMENT UNFINISHED 100 912.00 10.70 1.00 9,758 *
AC LA LIVING AREA 100 76.00 32.09 1.00 2,438 *
AC LA LIVING AREA 100 24.00 32.09 1.00 770 *
AC LA LIVING AREA 100 40.00 32.09 1.00 1,283 *
AC OPG OPEN PORCH GRADE 100 30.00 8.02 1.00 240 *
AC WD WOOD DECK 100 144.00 8.02 1.00 1,154 *
MA RO1 SFR MAIN AREA FRAME 100 912.00 53.49 1.00 122.00 59,514 *
EW N/A N/A 100 1.00 .00 0 *
- AR 005 ELECTRIC 100 912.00 2.04 1,860 *
- FP 010 1 ST FIREPLACE 1 OPE100 1.00 2100.00 2,100 *
- PD CCD D CONS CLASS 100 1.00 .00 0 * I
- PD EL03 AVG ELECTRIC 100 1.00 .00 0 *
- PD EX05 HARDBOARD LAP SIDING100 1.00 .00 0 *
- PD FL71 CARPET& VINYL 100 1.00 .00 0 *
http://arcims2.webgis.net/linkedfiles/nc/Rockingham/cards/13/132698.htm 9/12/2008

Rockingham County NC -Parcel No: 132698 Page 2 of 3
DATE 8/18/08 ROCKINGHAM COUNTY PAGE 2
TIME 16:45:09 PROPERTY CARD PROG# AS2006
USER RONNIE FOR YEAR 2008
PRICE DAVID L PARCEL ID.. 132698 PIN... 7968 01 19 7573 00
IMPROVEMENT # 1 MAJOR IMPR-M
COMPONENT TYPE/CODE/DESC PCT UNITS RATE STR# STR% SIZ% HGT% PER% CDS% COST %CMPL
- PD FN34 CONTINUOUS WALL BRIC100 1.00 .00 0 *
- PD IF01 INT FINISH DRYWALL 100 1.00 .00 0 *
- PD PL03 PLUMBING AVERAGE 100 1.00 .00 0 *
- PD RFO1 GABLE ROOF 100 1.00 .00 0 *
- PD RM01 ROOF MATERIAL ASPHAL100 1.00 .00 0 *
- PL 001 2 FIXTURE BATH 100 1.00 1600.00 1,600 *
NOTE: REFLECTS LAST REVAL SCHEDULES
RCN... PCT COMPLETE 100 x 80,717
RCN... COUNTY RCN ADJ 100.00 x 80,717
QUAL.. QG D CONSTRUCTION GRADE D 100.00 x 80,717
DEPR.. DA 26 YEARS .00 - 0
ADDL.. PHYSICAL DEPR 20.00 - 16,143 16,143 T
••• 64,574
http://arcims2.webgis.net/linkedfiles/nc/Rockingham/cards/13/132698.htm 9/12/2008

Rockingham County NC - Parcel No: 132698 Page 3 of 3
•
DATE 8/18/08 ROCKINGHAM COUNTY PAGE 3
TIME 16:45:09 PROPERTY CARD PROG# AS2006
USER RONNIE FOR YEAR 2008
PRICE DAVID L PARCEL ID.. 132698 PIN... 7968 01 19 7573 00
IMPROVEMENT # 1 MAJOR IMPR-M
+--12---+
1 1
2 2
+---+ 38 8
2
4
+--12----6-+----20 +
+--12-- 5 20----+
5-6-+
AC LA LIVING AREA TRAVERSE
AC LA LIVING AREA TRAVERSE
AC LA LIVING AREA TRAVERSE
AC OPG OPEN PORCH GRADE TRAVERSE
AC WD WOOD DECK TRAVERSE
MA R01 SFR MAIN AREA FRAME FLOOR: 1.00 TRAVERSE
TOTAL PARCEL VALUES---- LAND / OVR IMPROVEMENTS / OVR TOTAL LAND/IMPROVE 2007 VALUE
FMV 16,082 64,574 80,656 80,656
APV 16,082 64,574 80,656 80,656
http://arcims2.webgis.net/linkedfiles/nc/Rockingham/cards/13/132698.htm 9/12/2008

i • �OF W A T F90 Michael F.Easley,Governor
0 G William G.Ross Jr.,Secretary
Vj r North Carolina Department of Environment and Natural Resources
> _ - —{
5 Alan W.Klimek,P.E.Director
Division of Water Quality
August 17, 2006
Mr. David Price
PO Box 893
Stoneville, NC 27048
SUBJECT: General Permit No. NCG550000
Certficate of Coverage NCG550111
Rockingham County
Dear Mr. Price:
Your are receiving this notice because you currently own a home/property covered under
the subject General Permit for the discharge of domestic wastetwater. The Certificate of Coverage
specific to your property expired in 2002.
The Division needs information from you to determine if coverage under NCG550000 is still
necessary.
✓ If your property still has a wastewater system like the ones described in the enclosed
Technical Bulletin, you should renew the subject permit. Completed the enclosed form and
submit it to the address on the form.
✓ If you are not sure what type of system your property has, contact David Russell in the
NCDENR Winston-Salem Regional Office at(336) 771-5000. He can help you determine if
you should renew coverage under the General Permit.
✓ If you know that your property no longer discharges wastewater to a waterbody, contact me
at the address of phone numbers below to request rescission of the Certificate of Coverage.
If you have any questions please contact Mr. David Russell in our Winston-Salem Regional
Office at(336) 771-4967.
Sincerely,
al:4y / 4„..4„.i.zR
arles H. Weaver
NPDES Unit
cc: Charles Weaver, NPDES Fite
Central Files
WSRO
Nose Carolina
�tura!!y
North Carolina Division of Water Quality 585 Waughtown Street Winston-Salem,NC 27107 Phone[phone] Fax[phone]
Internet: h2o.enr.state.nc.us
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UNITED STATES POSTAL SERVICE First-Class Mail
I I Postage&Fees Paid
USPS
Permit No. G-10
• Sender:Please print your nam an + i t D
Charles H. Weaver APR - 3 2009
NC DENR / DWQ / NPDES Unit
1617Mail Ser4i .1Y'ATERnt
Raleigh, QUALITY
NC i
Pr tNT Sni IRCF BRANCH
IIiIII1il1I1IIftllliil}I}lili}II �III3S1}�ilfiil}3I}}ifff'Ilii!}}FI37I}l13lllill

SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. Agent
• Print your name and address on the reverse 'x ,4;, `.i A ssee
so that we can return the card to you. B. Received by(P' ed(Verne) C. Date of Delivery
• Attach this card to the back of the mailpiece, ff ��G( f�,c* -,
or on the front if space permits. T
D. Is delivery address different from item 1? ❑Yes
1. Article Addressed to: If YES,enter delivery address below: 0 No
DAVID L PRICE
PO BOX 893
STONEVILLE NC 27048-0893 3. Service Type
0 Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
El Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number 7002 0860 0006 5836 1974
(Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540