NCG550130_Permit (Issuance)_20100604

e
TicirA
Ai;
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue, Governor Coleen H. Sullins, Director Dee Freeman, Secretary
June 4, 2010
Mary E. Mazzagatti
52 Bald Creek School Road
Burnsville, NC 28714-5739
Subject: Renewal of coverage/General Permit NCG550000
52 Bald Creek School Road
Certificate of Coverage NCG550130
Yancey County
Dear Permittee:
In accordance with your renewal application [received on June 4, 2010], the Division is renewing
Certificate of Coverage (CoC) NCG550130 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
permit application. Unless such demand is made, the certificate of coverage shall be final and binding.
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 Asheville 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
Asheville 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 North Carolina
Phone: [phone]/FAX [phone] I 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 NCG550130
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,
Mary E. Mazzagatti
is hereby authorized to discharge domestic wastewater [300 GPD] from a facility located at
52 Bald Creek School Road
Burnsville
Yancey County
to receiving waters designated as Bald Creek, a class C stream in subbasin 04-03-07 of the French
Broad 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 June 4, 2010.
This Certificate of Coverage shall expire on July 31, 2012.
Signed this day June 4, 2010
for'"6oleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

•
•
A77ADivision of Water Quality/Water Quality Section
National Pollutant Discharge Elimination System
NCDENR
NORTH GROLINA DEPARTMENT OF
ENVIRONMENT AN°N.vURAL RE�°R°ES NCG550000
RENEWAL FORM FOR EXISTING PERMITTED FACILITIES
NPDES renewal application for continued coverage under General Permit NCG550000:
Certificate of Coverage NCG55
(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 tAA.4- t L 141- -h
ttoo
Street Address SZ 3r�,.t cl C eek-/'�
City ‘3-t p..In.S t)11 t o 414- 0
Telephone (Home) (C (Mobile)
(e-mail address) Cati-SS Lim r4 L L #3-14,13 Address to which all permit correspondence will be mailed
2) Location of facility producing discharge*:
ou
Street Address SL ICI Sr i! 2 6
City: -j .%(Vs-s i). r'I L N .*U-e64tt.s1 .M4—
County Li Pr -1
Telephone (Home) Leri`k L-S E
* If the facility is not yet constructed,give the street address or lot number where the structure will be
built.
3) Description of Discharge: • E �
a) '°6"
Type of facilityproducingwaste(please check one): ���
YP/ P ��N - 4 2
E Primary residence Oq QUN Cµ N
vEts
❑ Vacation/second home %tg S ouRce9ca
❑ Undeveloped property
❑ Other [describe]:
Page 1 of 2

a
NCG550000 renewal form ;
4) Please check the components that comprise the wastewater treatment system:
Erb tic tank ❑ Dosing tank ❑ Primary sand filter ❑ Secondary sand filter
❑ Recirculating sand filter(s) 0 Chlorination 0 Dechlorination
0 Other form of disinfection: 0 Post Aeration(describe)
5) Other Information:
a) When was the septic tank last pumped o t %/ 3 e31n-7f.
/ Lt
NOTE: the septic tank must be pumped out at lea t once every 3-5 years
b) Is the facility [home] occupied year-round,or only seasonally?✓ - 11-svt..,4
c) Approximately how many people use the facility when it is occupied?/ l
d) When was the wastewater system installed?Tr '4 .c 1' .-e-- L-04-0--,-� ..2" -7" e
.i-1la-a5-ems 1 D 4 e.Pit 0
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: VA-*}In g • 2-4••-01 1
3 1/6c4.- --- (0 - I - i0
(Signature ofApplica (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
A

June_2, 2010
Mr. Weaver,
I didn't have a copy of the receipt from having the septic tank pumped out in 2008.
My brother that lives in Florida paid for this for me. I live alone, and he helped me out
with my expenses. He said he thought this was paid by a check, but he will have to ask
his bank for research in a copy, I will forward this on to you once he mails the copy to
me. Sorry for the inconvenience.
egar ,
�� -
Mary Mazza

Tax Card Page 1 of 1.
Tax Report
r :
Account Information 2008 Tax Evaluation Info
PIN: 988000647735.000 RESIDENTIAL
Deed: 495-509 Land Value: $25,500.00
Deed Date:07/14/2005 Building Value:$69,850.00 ;,
Total Acreage: 0.25 ` M`
5 Property Location
52 BALD CREEK SCHOOL RD Total Value: $95,350.00 =
- _ ':1
Owner Information Sale information
MAZZAGATTI,MARY I _ a
Date: 07/14/2005 • �"
ELAINE
Price:$0.00 • _ ,,� , . ,
52 BALD CREEK SCHOOL RID . „, , 7_ NI :
Type:LAND +BLDG4 ._____... .._
BURNSVILLE„NC 28714 i i s
eta •;
- ,' IL . :,4. ,
Additional Information
Structure Description Addition SqFt
Year Built: 1948 Style: OLD STYLE Garage,Detached-Frame 2Fr 1008
Story
Num Buildings: 1 Height: 2 Canopy EP 224
123013 288
Total Living Ground 1Fr 160
Area: 2176 Floor 2176 OP 96
Sq Footage: OP 48
Rooms: 5 heat/ac: BASIC EP 176
Bedrooms: 2 Heati FLOOR
' FURNCE
Full Baths: 2 Fuel: OIL
Half Baths: 0 Ext_walls: FRAME
Basement: NONE/SLAB Attic: NONE
Rec Room: 0 Zoning.
http://mapping.yanceycountync.gov/TaxForm2010.aspx?ID=5589 5/17/2010

Itasinwide Information Management System it:'. _Tit Si
t� AP
File Tasks Queries Administration Help
Find Pc-i wr. _....- .,. ___ _
f Affiliation Details t Affiliation Usage Y Affiliations Shared Address/Phone
Honorarium: .,- Home Phone: i
First Name: Stephanie Work Phone: [phone] EA.:L
Middle Name: Fax: , ,
Last Name: Christie J Cellular
J
' Suffix Prof.Title:[ Pager: Ext.: I -
Organization Name: - Email:
Comment. -----------'. 'A
Find Per —"---------_ - -
0
-- "--- Mailing Address: • Physical Address: _ I
Address Line1 Rt 2 Box 170 1 AddressLinel:L
K.
f.,.„e e I Address Line2:I AddressLlne2: Di
City: Hendersonville I State: NC ( ] City:_- -7 •
State: 1-1
r ZIP:128792 ZIP:I J
,edd,... Country: United States j Country:
aro email 1
_,1- Qlose
r ..
Past Due Ae d*ra fora 676 SC;= ome share cantry Effects of
eshen/e wIP Reoort4-12-... new permit... re0ue_. 5--3-10.docr women.doa growth an...
iwoices