HomeMy WebLinkAboutNCG550166_Permit (Issuance)_20161107 PAT MCCRORY
Governor
f:,a
DONALD R. VAN DER VAART
Secretan
Water Resources S. JAY ZIMMERMAN
ENVIRONMENTAL QUALITY
Director
November 7, 2016
Ms. Kimberly A. Woods
1080 Baker Crossroads Rd
Reidsville, NC 27320
Subject: General Permit NCG550000
1080 Baker Crossroads Rd
Certificate of Coverage NCG550166
Rockingham County
Dear Permittee:
The Division has received and approved your request to transfer ownership of the subject Certificate
of Coverage (CoC) under General Permit NCG550000. As a result, the Division hereby reissues NCG550166.
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 provide a copy of the deed as soon as possible for our
records.
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 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 Local
governmental permit that may be required. If you have any questions concerning the requirements of the
General Permit, please contact Brianna Young of the NPDES staff[919-807-6388 or
brianna.young@ncde nr.gov].
Si erely,
for S.Jay Zimmerman, P .
Director, Division of Water Resources
cc: Winston-Salem Regional Office
NPDES File
State of North Carolina Environmental ali W R r� Qu ty� ater esou ces
1617 Mail Service Center I Raleigh,NC 27699-1617
919 807 6300 919-807-6389 FAX
hugs://deq.nc.gov/about/di vi sion s/water-resources/water-resources-permits/wastewater-branch/npdes-wastewater-permits
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG550166
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,
Kimberly A. Woods
is hereby authorized to discharge <1000 gallons per day of domestic wastewater from a
facility located at
1080 Baker Crossroads Rd
Reidsville
Rockingham County
to receiving waters designated as Rock House Creek, a class C stream in subbasin 03-20-03 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 takes effect November 7, 2016.
This Certificate of Coverage shall remain valid for the duration of the General Permit.
Signed this day November 7, 2016.
for .ay Zimmerman, P.G.
I irector, Division of Water Resources
By Authority of the Environmental Management Commission
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
Secretary
Water Resources S. JAY ZIMMERMAN
ENVIRONMENTAL 01.1AL:"Y
l nreclor
°441'A-3NPDES Certificate of Coverage (CoC)
OWNERSHIP CHANGE FORM
I. Please enter the CoC number for which the change is requested.
Certificate of Coverage
N CGS 5 U \ tQ to
II. Please provide the following for the requested change(revised permit).
a. Request for change is a result of: EKChange in ownership of the residence/property
❑ Name change of the facility or owner
If other please explain:
b. Permit will be issued to(company
name, if applicable):
c. Person legally responsible for permit: v rnbU‘ f A \N coed
First MI Last
Vomepwref
Title
\Ok O 9>C.\C cf Cx oss C o e c.
Permit Holder Mailing Address
ee‘6 \1\\\� c 21320
City State Zip
(3Zlo )(01.2"Cl LP
Phone E-mail Address
d. Facility name(discharge):
e. Facility address:
Address
City State Zip
f. Facility contact person:
First MI Last
( )
Phone E-mail Address
III. Permit contact information (if different from the person legally responsible for the permit)
Permit contact:
First MI Last
Title
Mailing Address
City State Zip
( )
Phone E-mail Address
IV. Will this permitted facility continue to discharge the same volume and type of wastewater as
pri to this ownership or name change?
LDS Yes
❑ No(please explain)
Revised 9/2016
NCG550000 OWNERSHIP CHANGE FORM
• • • Page 2 of 2
VI. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING:
This completed application is required for both name change and/or ownership change
requests.
El Legal documentation of the transfer of ownership(such as a property deed,relevant pages of a
contract,or a bill of sale)is required for an ownership change request.
The certifications below must be completed and signed by the new applicant in the case of an ownership
change request.
APPLICANT CERTIFICATION
I, ,attest that this application for a name/ownership change has been reviewed and is accurate and
complete to the best of my knowledge. I understand that if all required parts of this application are not
completed and that if all required supporting information is not included,this application package will be
returned as incomplete.
(A6;"‘„) 10 /ai j ) V
Signature Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
NC DEQ/DWR/NPDES
1617 Mail Service Center
Raleigh,North Carolina 27699-1617
Revised 9/2016
I
PAT MCCRORY
6
Governor
DONALD R.VAN DER VAART
Secretary
Water Resources S.JAY ZIMMERMAN
ENVIRONMENTAL QUALITY
Director
September 9, 2016
CHRISTOPHER ROSS&KIMBE WOODS
2144 RIVERSIDE CIR
EDEN,NC 27320
Subject: Wastewater Disposal at
1080 Baker Cross Rd,Reidsville,NC 27320
Certificate of Coverage(CoC)NCG550166
Rockingham County
Dear Owners:
County tax records list CHRISTOPHER ROSS&KIMBE WOODS as the current owners of the subject
property.We are contacting you to determine the status of a wastewater disposal system on your property that was
covered by General Permit NCG550000 [the General Permit for single family residence domestic wastewater].An
audit for expired unresolved files noted that the Certificate of Coverage(CoC)for your property's wastewater
disposal system expired on 7/31/2012 and has overdue annual fees.The last CoC was issued to Charles&Kristy
Benton on 6/15/2009.The Division needs information from you to renew coverage under NCG550000.Please
respond by October 21,2016 with one the following:
> If your property still has a wastewater system like the ones described in the enclosed Technical Bulletin,you
must renew the subject CoC.Please complete the enclosed form and submit it to Charles Weaver at the
address on the form.In addition,a$60 in overdue annual fees is required to renew and maintain this permit.
Please send payment for the enclosed invoice(s):
2011PR007265,2012PR008263,2013PR007115,2014PR007342.
(Payment instructions are provided on the invoice.)
> If you are not sure what type of system your property has,contact George Smith in the NC DEQ Winston-
Salem Regional Office at 336-776-9800.This contact[or other staff members] can help you determine if you
should renew your CoC.
> If you know that your property no longer discharges wastewater and the treatment system has been replaced
with a different treatment system or connected to a city sewer,please contact me at the address or phone
number listed below to request rescission of the CoC.
If you have questions concerning this matter,please do not hesitate to contact Derek Denard at 919-807-6307 or -
derek.denard@ncdenr.gov.
ly,
John E.Hennessy
Division of Water Resources,DEQ
cc: Winston-Salem Regional Office,DWR WQRO
NPDES General Permit Files NOD-2016-RV-0017
Teresa Revis,DWR Budget Office
State of North Carolina I Environmental Quality I Water Resources
1611 Mail service Center I Raleigh,North Carolina 27699-1611
919 707 9000
Rockingham County NC Property Card Page 1 of 4
•
1 DATE 7/14/16 ROCKINGHAM COUNTY PAGE 1
TIME 22:35:50 PROPERTY CARD PROG# AS2006
USER RONNIE FOR YEAR 2016 ��i
WOODS CHRISTOPHER ROSS P TD 1_66257 L/ PIN... 7965 00 12 7949 00
WOODS KIMBERLY ALLISON OCATION... 1080 BAKER CROSSROAD
DEED YEAKTIKJUN PAL,r... [DID 1496 31 ASSESSMENT NONE
2144 RIVERSIDE CIR PLAT BOOK/PAGE.. 702 467 OWNER ID.. 1313480
( - LEGAL DESC:2.18 AC DISTRICT.. 124 JACOBS CREEK FD
// Area/Fire: 924 JACOBS CREEK
,''��' Ai,- TOWNSHIP... 10 WENTWORTH
EDEN NC 27288-8210 NBRHOOD... R110 JACOBS CREEK
DESCRIPTION SINGLE FAMILY RES NH CLASS..
DESCRIPTION RESIDENTIAL RES AG COUNTY
MAINTAINED 2/17/2016 BY LSTANLEY VALUED.. 2/17/2016 BY LSTANLEY
VISITED 2/11/2016 BY HT ROUTING#.. 3400
PARCEL STATUS... ACTIVE CATEGORY.. REAL & PERSONAL
SALES HISTORY
DEED BK/PAGE SALE DATE SALES INSTRUMENT DISQUALIFIED SALE AMOUNT STAMP AMOUNT DEED NAME
1496 2531 10/09/2015 DEED GOVT/PUB UT/LEN 76,000 WOODS CHRISTOPHER ROSS & KIMBE ye
1470 2378 3/03/2014 DEED FORCED SALE / P 99,000 LOCAL iTUva"RNMLN'r'-Ea'rFLUYEhb CkE
1166 2115 8/22/2003 DEED QUALIFIED 143,000 BENTON CHARLES R II & KRISTY A mph(
1112 1308 8/02/2002 DEED STAMPS BELOW MI TIN LINDA K '
994 2127 7/09/2002 SPLIT FAST TRACK SPLI MARTIN DONNIE GALE & LINDA
LAND SEGMENTS
LND STRAT LAND TOT CURRENT
# ZONE CODE TYPE/CODE LAND QTY LAND RATE DPT% SHP% LOC% SIZ% OTH% TOP% ADJ FMV
1 RA 100 UB RH 1.000 10,000.00 .00 .00 .00 .00 100.00 .00 .00 10,000
2 RA 100 AC RA 2.180 4,200.00 .00 .00 .00 217.00 90.00 100.00 195.30 17,881
TOTAL ACRES.. 2.180 TOTAL LAND FMV.. 27,881
IMPROVEMENT # 1 MAJOR IMPR-M
MAIN FIN AREA.. 2,181.00 ACT/EFF YR/AGE.. 1976 1976 35 VISITED.. 2/11/2016 BY HT
W
STRAT 100 DESCRIPT.... SINGLE FAMILY DWELLING MAINTAINED.. 2/17/2016 BY LSTANLEY
MAIN GROUND SF.... 2,181.000
BUILT USE 01 SINGLE FAMILY DWELLING CURRENT USE.... CR CURRENT USE RESIDENTIAL
LOCATION # 1080 BAKER CROSSROAD RD
COMPONENT TYPE/CODE/DESC PCT UNITS RATE STR# STR% SIZ% HGT% PER% CDS% COST %CMPL
AC AGFD GAR/FIN/WITH DOOR 100 696.00 18.00 1.00 12,528
AC OPR OPEN PORCH RAISED 100 96.00 12.00 1.00 1,152
AC WD WOOD DECK • 100 156.00 9.00 1.00 1,404
• MA RO1 SFR MAIN AREA FRAME 100 2181.00 60.00 1.00 90.00 117,774
EW 04 VINYL SIDING 100 196.00 .00 0
- AR 004 FORCED HOT AIR & CEN100 2181.00 4.50 9,814
- PD EL03 AVERAGE ELECTRIC 100 1.00 .00 0
- PD EX04 VINYL SIDING 100 1.00 .00 0
- PD FL71 CARPET& VINYL 100 1.00 .00 0
- PD FN35 CONTINUOUS WALL BLOC100 1.00 .00 0
- PD •IF03 INT FINISH AVG PLYWD100 1.00 .00 0
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Rockingham County NC Property Card Page 2 of 4
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DATE 7/14/16 ROCKINGHAM COUNTY PAGE 2
TIME 22:35:50 PROPERTY CARD PROG# AS2006
USER RONNIE FOR YEAR 2016
WOODS CHRISTOPHER ROSS PARCEL ID.. 166257 PIN... 7965 00 12 7949 00
IMPROVEMENT # 1 MAJOR IMPR-M
COMPONENT TYPE/CODE/DESC PCT UNITS RATE STR# STR% SIZ% HGT% PER% CDS% COST %CMPL
- PD PL03 PLUMBING AVERAGE 100 1.00 .00 0
- PD RFO1 GABLE ROOF 100 1.00 .00 0
- PD RMO1 RF MATERIAL ASPHALT 100 1.00 .00 0
RCN... PCT COMPLETE 100 x 142,672
RCN... COUNTY RCN ADJ 100.00 x 142,672
QUAL.. QG D+ CONSTRUCTION GRADE D 110.00 x 156,939
DEPR.. DA 35 YEARS .00 - 0
ADDL.. PHYSICAL DEPR 40.00 - 62,775 62,775 T
94,164
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Rockingham County NC Property Card Page 4 of 4
DATE 7/14/16 ROCKINGHAM COUNTY PAGE 4
TIME 22:35:50 PROPERTY CARD PROG# AS2006
USER RONNIE FOR YEAR 2016
WOODS CHRISTOPHER ROSS PARCEL ID.. 166257 PIN... 7965 00 12 7949 00
IMPROVEMENT # 3 MISC IMPR-X
COMPONENT TYPE/CODE/DESC PCT UNITS RATE STR# STR% SIZ% HGT% PER% CDS% COST %CMPL
MS SP2 SWIMMING POOL VINYL 100 512.00 33.20 110.00 18,698
RCN... PCT COMPLETE 100 x 18,698
QUAL.. QG 000 000 100.00 x 18,698
DEPR.. DA 31 YEARS .00 - 0
ADDL.. PHYSICAL DEPR 80.00 - 14,958 14,958 T
FMV... 3,740
TOTAL PARCEL VALUES---- LAND / OVR IMPROVEMENTS / OVR TOTAL LAND/IMPROVE 2015 VALUE
FMV 27,881 98,004 125,885 125,885
APV 27,881 98,004 125,885 125,885
•
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Rockingham County NC Property Card Page 3 of 4
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DATE 7/14/16 ROCKINGHAM COUNTY PAGE 3
TIME 22:35:50 PROPERTY CARD PROG# AS2006 4
USER RONNIE FOR YEAR 2016
WOODS CHRISTOPHER ROSS PARCEL ID.. 166257 PIN... 7965 00 12 7949 00
IMPROVEMENT # 1 MAJOR IMPR-M
+---13--+ 44 +
1 1
2 2 •
+ 24 +--13---+ •
•
•
• 2 1
2 9
9 •
+ 24---- + + 57 + +
4
4 24 +
AC AGFD GAR/FIN/WITH DOOR TRAVERSE
AC OPR OPEN PORCH RAISED TRAVERSE
AC WD WOOD DECK TRAVERSE
MA RO1 SFR MAIN AREA FRAME FLOOR: 1.00 TRAVERSE
IMPROVEMENT # 2 MISC IMPR-Y
MAIN FIN AREA.. ACT/EFF YR/AGE.. 1981 1981 30 VISITED.. 2/11/2016 BY HT
STRAT 100 DESCRIPT.... SHED OPEN SIDES MAINTAINED.. 2/17/2016 BY LSTANLEY
BUILT USE 20 SHED OPEN SIDES CURRENT USE.... CA CURRENT USE AGRICULTURAL
LOCATION # 1080 BAKER CROSSROAD RD
COMPONENT TYPE/CODE/DESC PCT UNITS RATE STR# STR% SIZ% HGT% PER% CDS% COST %CMPL
MS NA NA 1.00 1.00
QUAL.. QG 000 000 100.00 x 0
DEPR.. DA 30 YEARS .00 - 0 0 T
PCT COMPLETE 100
100
IMPROVEMENT # 3 MISC IMPR-X
MAIN FIN AREA.. ACT/EFF YR/AGE.. 1980 1980 31 VISITED.. 2/11/2016 BY HT
STRAT 100 DESCRIPT.... SWIMMING POOL MAINTAINED.. 2/17/2016 BY LSTANLEY
BUILT USE 13 SWIMMING POOL CURRENT USE.... CR CURRENT USE RESIDENTIAL
LOCATION # 1080 BAKER CROSSROAD RD
•
http://www.webgis.net/nc/Rockingham/PropertyCard.php?pid=166257 7/29/2016