NCG551255_Complete File_20220812

Weaver, Charles
From:
Weaver, Charles
Sent:
Friday, August 12, 2022 8:01 AM
To:
Boone, Ron; Graznak, Jenny
Cc:
Homer, Seren M
Subject:
RE: NCG551255
If the pipeline people call you back, explain that they need to submit a change of ownership form if they want the CoC
renewed.
If they intend to demolish the home to make way for the pipeline, we'll make the CoC Inactive.
If you don't hear from MVP by the end of the month, we'll make it Inactive.
CHW
From: Boone, Ron <[e-mail]>
Sent: Thursday, August 11, 2022 2:41 PM
To: Weaver, Charles <[e-mail]>; Graznak, Jenny <[e-mail]>
Cc: Homer, Seren M <[e-mail]>
Subject: NCG551255
All, see screenshot below. This property sold in 5/20 to Mountain Valley Pipeline. I've called and left a message on the
number on their website inquiring about the status of the property/permit. The property and all buildings on it appear
very abandoned. No one there.
What do you want to do with this permit? I'll let you know what they say if they call me back.
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Best Regards,
Ronald C. Boone, Environmental Program Consultant
NC Department of Environmental Quality, Division of Water Resources, Water Quality Regional Operations Section,
Winston-Salem Regional Office
450 West Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
Main: 336-776-9800
Direct: 336-776-9690
Mobile: [phone]
Fax [phone]
[e-mail]
http://deg.nc.gov/about/­­divisions/water-resources
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
z

LOWER YADKIN RIVER
DRAINAGE AREA

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Director
NORTH CAROLINA
Em *vnmental Quality
February 5, 2019
Karen Harris
1601 Shamrock Drive
Burlington, NC 27215
Subject: General Permit NCG550000
Certificate of Coverage (CoC) NCG551255
1620 NC Hwy 54
Alamance County
Dear Permittee:
The Division has renewed General Permit NCG550000. The Division hereby issues you a revised
version of NCG551255, along with a copy of the renewed General Permit. 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].
If you have an email address, please send it to Charles H. Weaver of the NPDES program
[[e-mail]]. Future renewals can be sent to you electronically.
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 CoC is not transferable excerpt after notice to the Division. The Division
- -ma`y 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-'alocumentina the transfer of this CoC. - - -AN -
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 Derek Denard of the NPDES staff [919 707-3618 or via email at
derek.denard@ncdenr. gov] .
cc: NPDES file
Sincerely, for 'nda Culpepper�/
Director, Division of Water Resources
North Carolina Department of Environmental Quality I Division of Water Resources
1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919-707-3616

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG551255
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,
Karen Harris
is hereby authorized to discharge <1000 gallons per day of domestic wastewater from a
facility located at
1620 NC Hwy 54
Graham
Alamance County
to receiving waters designated as the Haw River, a class WS-V NSW stream in subbasin 03-06-01
of the Cape Fear River Basin in accordance with the effluent limitationsr onitoring requirements,
and other conditioi set forth in Parts I, II, and III hereof. -= `m
This certificate of— overage takes effect February 5, 2019.
This Certificate--oM,overage shall remain valid for the duratiori of tte General Permit
Signed this day February 5, 2019
,/"a /)" e.,
for da Culpepper
Director, Division of Water Resources
By Authority of the Environmental Management Commission

ROY COOPER
Gonemsrr
MICHAEL S. REGAN
Cf.
secretary
WaterResvurces S. JAY ZIMMERMAN
FxvIar»tMEWAL 4uaEsrr vow"r
May 30, 2017 RE 5I V©
Karen Harris JUN 0 5 2017
1601 Shamrock Dr
CENTRAL FILES
Burlington, NC 27215
DWR SECTION
SUBJECT: Compliance Evaluation Inspection Report
Certificate of Coverage NCG551255 under NPDES General Permit NCG550000
Facility Located at 1620 NC Hwy 54, Graham, Alamance County
Dear Ms. Harris:
On May 25, 2017, Paul DiMatteo and George Smith of the Division of Water Resources ("Division"),
Winston-Salem Regional Office conducted a Compliance Evaluation Inspection of the above referenced
wastewater treatment system. The Division is required to inspect these types of systems at least every 5
years. An inspection summary follows and an inspection report is attached for your records.
Site Review
1. The system consists of a septic tank, subsurface sand filter, and chlorination, with final disposal in
the Haw River. Chlorine tablets were observed in the chlorinator.
The discharge pipe was not located at the time of inspection due to high water level of the Haw
River.
3. No sewage malfunction was observed at the sand filter.
Documentation & Monitoring Review
A review of documentation was not conducted at the time of inspection. We would like to remind you
to conduct and document the following:
- Effluent monitoring must be performed as required in the permit.
- Inspect the septic tank and secondary tanks at least yearly to determine if solids must be removed.
- Pump the septic tank every 5 years, or when the solids level is found to be more than 1/3 of the
liquid depth in any compartment, whichever is greater. All tanks should be emptied of their
contents whenever any of the tanks meet this requirement.
- Contents removed from septic tanks shall be disposed of at a location and in a manner compliant
with all local and state regulations.
- Inspect the outfall location at least twice per year to ensure that no visible solids or other obvious
evidence of system malfunctioning is observed.
- Inspect the tablet chlorinator (if applicable) at least weekly to ensure there is an adequate supply
of tablets for continuous & proper operation. Tablets used for chlorination must be labeled for
wastewater use.
State of North Carolina I Environmental Quality I Water Resources
450 West Hanes Mill Road, Suite 300, Winston-Salem, NC 27105
336-776-9800

- Any monitoring data obtained shall be retained onsite for a minimum of 5 years.
- Additional requirements as stated in NCG550000.
There were no significant issues noted during the inspection; therefore, a response to this report is not
required.
If you should have any questions, please do not hesitate to contact our office at 336-776-9800.
Sincerely,
G` i Sherri V. Knight, P.E., Regional Supervisor
Water Quality Regional Operations Section
Winston-Salem Regional Office
Division of Water Resources, NCDEQ
ATTACHMENTS — Inspection Report and Summary
Cc: WQS Winston-Salem Regional Office - Enforcement File
NPDES Compliance/Enforcement Unit - Enforcement File
Central Files
State of North Carolina I Environmental Quality I Water Resources
450 West Hanes Mill Road, Suite 300, Winston-Salem, NC 27105
336-776-9800

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 IN I 2 15 1 3 I NCG551255 I11 121 17/05/25 I17
18 L C J 19 L e i 20I
21111111 11111111111 1111111 1 1 11111
111111111 1J�J6
Inspection
Work Days Facility Self -Monitoring Evaluation Rating B1 CIA
Reserved-
67
70 u 71 u 72 L N
I-J
73 � 74 75
80
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES Dermit Number)
11:55AM 17/05/25
13/08/01
1620 NC Hwy 54
1620 NC Hwy 54
Exit Time/Date
Permit Expiration Date
Graham NC 27253
12:15PM 17/05/25
18/07/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Karen Harris,1601 Shamrock Dr Burlington NC 27215//336-229-1856/
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit 0 Other
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers
Date
Paul DiMatteo � -,�) „/44D WSRO WQ//336-776-9691/
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers
Date
o1
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page#

NPDES yr/mo/day Inspection Type (Cont.)
31 NCG551255 I11 12' 17/05/25 117 18 I ( I
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Site Review
1. The system consists of a septic tank, subsurface sand filter, and chlorination, with final disposal in
the Haw River. Chlorine tablets were observed in the chlorinator.
2. The discharge pipe was not located at the time of inspection due to the high water level of the Haw
River.
3. No sewage malfunction was observed at the sand filter.
Documentation and Monitoring Review
A review of documentation was not conducted at the time of inspection. We would like to remind you to
conduct and document the following:
- Effluent monitoring must be performed as required in the permit.
- Inspect the septic tank and secondary tanks at least yearly to determine if solids must be removed.
- Pump the septic tank every 5 years, or when the solids level is found to be more than 1/3 of the
liquid depth in any compartment, whichever is greater. All tanks should be emptied of their contents
whenever any of the tanks meet this requirement.
- Contents removed from septic tanks shall be disposed of at a location and in a manner compliant
with all local and state regulations.
- Inspect the outfall location at least twice per year to ensure that no visible solids or other obvious
evidence of system malfunctioning is observed.
- Inspect the tablet chlorinator (if applicable) at least weekly to ensure there is an adequate supply of
tablets for continuous & proper operation. Tablets used for chlorination must be labeled for wastewater
use.
- Any monitoring data obtained shall be retained onsite for a minimum of 5 years.
- Additional requirements as stated in NCG550000.
Page#

Permit: NCG551255 Owner - Facility: 1620 NC Hwy 54
Inspection Date: 05/25/2017 Inspection Type: Compliance Evaluation
Permit
(If the present permit expires in 6 months or less). Has the permittee submitted a new
application?
Is the facility as described in the permit?
# Are there any special conditions for the permit?
Is access to the plant site restricted to the general public?
Is the inspector granted access to all areas for inspection?
Comment:
Other
Comment:
Yes No NA NE
❑ ❑ ■ ❑
Yes No NA NE
Page# 3

ALT,
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Chuck Wakild, P.E. Dee Freeman
Governor Director Secretary
January 10, 2012
Mr. & Mrs. Jon & Karen Harris
Felta Whitlow Property
1601 Shamrock Drive
Burlington, NC 27215
Subject: Compliance Evaluation Inspection — General Wastewater Permit No. NCG551255
Fleta Whitlow Property —1620 NC Highway 54, Graham
Alamance County
Dear Mr. & Mrs. Harris:
On January 6, 2012, Jenny Graznak of this office performed a General Permit Inspection on the
wastewater treatment system at the abovementioned address in Alamance County, North Carolina. This
inspection consisted of two basic parts: a review of self -monitoring data, and an on -site inspection of the
facility and its effluent.
You hold a General Permit to discharge domestic wastewater from a single family residence under
the National Pollutant Discharge Elimination System (NPDES). The effluent discharges to Haw River
(Class C; NSW) in the Cape Fear River Basin. All system components appeared to be well maintained
and functioning properly. Chlorine tablets were observed in the chlorination tubes on the day of the
inspection. R & A Labs samples and performs the annual effluent testing for this facility. The latest
sampling event took place on December 9, 2011, and the results were under compliance limits.
According to your files, the septic tank was last pumped out on April 22, 2010. The following is a
reminder list of required maintenance activities:
✓ Septic tanks shall be maintained at all times to prevent seepage of sewage
✓ Septic tanks will be checked at least yearly to determine if solids must be removed
✓ Septic tanks shall be pumped out within 3-5 years of issuance date of the Permit
✓ Contents removed from septic tanks shall be disposed of at a location and in a manner
compliant with all local and state regulations
✓ Surface sand filters, disinfection apparatus shall be inspected weekly
If you have any questions concerning this report, please contact Ms. Graznak at [phone].
Sincerely,
W. Corey Basinger
Surface Water Protection Supervisor
cc: SW P — GeA496 41W _4'1-LLS toeAR-)
SWP — WSRO
North Carolina Division of Water Quality, Winston-Salem Regional Office
Location: 585 Waughtown St. Winston-Salem, North Carolina 27107
Phone: [phone] FAX: [phone] Customer Service:1-877-623-6748
Internet: www.ncwaterquality.org
NorthCarolina
Naturally
An Equal Opportunity 1 Affirmative Action Employer

United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 INI 2 15 I 11 NCG551255 111 121 12/01 /06 117 181 C I 19 I S I 20
!-
Remarks
21111111111111111111111111111111111111111111111_6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA--_-----------_—Reserved---- -
67 I 169 70131 71 U 721 N I 73 L U 74 751 I I I I I I 180
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
09:00 AM 12/01 /06
09/07/27
1620 NC Hwy 54
1620 NC Hwy 54
Exit Time/Date
Permit Expiration Date
Graham NC 27253
10:00 AM 12/01/06
12/07/31
Name(s) of Onsite Representative(syTitles(syPhone and Fax Number(s)
Other Facility Data
Karen Harris//336-229-1856 ext 213/
Name, Address of Responsible OfficiaUTitle/Phone and Fax Number
Contacted
Karen Harris,1601 Shamrock Dr Burlington NC 27215//336-229-1856/ No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit 0 Self -Monitoring Program N Facility Site Review N Effluent/Receiving Waters
Section D: Summary of Finding/Comments Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
WSRO WQ//336-771-5000/ I �' p f 2012
Jennifer F Graznak✓�
p�
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
+ �-J'- I J . 1)"j cj% G„'S 1Z� 10 .I.o Af 20 rZ
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page # 1

NPDES yr/mo/day Inspection Type
3I NCG551255 I11 12, 12/01/06 17 181
C1
(cont.) 1
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
On January 6, 2012, Jenny Graznak of this office performed a General Permit Inspection on the wastewater
treatment system at the abovementioned address in Alamance County, North Carolina. This inspection
consisted of two basic parts: a review of self -monitoring data, and an on -site inspection of the facility and its
effluent.
You hold a General Permit to discharge domestic wastewater from a single family residence under the
National Pollutant Discharge Elimination System (NPDES). The effluent discharges to Haw River (Class C;
NSW) in the Cape Fear River Basin. All system components appeared to be well maintained and
functioning properly. Chlorine tablets were observed in the chlorination tubes on the day of the inspection.
R & A Labs samples and performs the annual effluent testing for this facility. The latest sampling event took
place on December 9, 2011, and the results were under compliance limits:
BOD 3.08 mg/I
TSS 6.16 mg/I
Fecal col <1 colonies/100 ml
pH 6.69
TRC 3.86 mg/I
Temperature 14.4 degrees C
According to your files, the septic tank was last pumped out on April 22, 2010.
Page # 2

l
Permit: NCG551255 Owner - Facility: 1620 NC Hwy 54
Inspection Date: 01/06/2012 Inspection Type: Compliance Evaluation
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
Is the facility as described in the permit?
# Are there any special conditions for the permit?
Is access to the plant site restricted to the general public?
Is the inspector granted access to all areas for inspection?
Comment:
Effluent Pipe
Is right of way to the outfall properly maintained?
Are the receiving water free of foam other than trace amounts and other debris?
If effluent (diffuser pipes are required) are they operating properly?
Comment:
Effluent Sampling
Is composite sampling flow proportional?
Is sample collected below all treatment units?
Is proper volume collected?
Is the tubing clean?
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type representative)?
Comment:
Yes No NA NE
❑n■❑
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Page # 3

NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue, Governor
Karen Harris
1601 Shamrock Dr
Burlington, NC 27215
Dear Permittee:
Division of Water Quality
Coleen H. Sullins, Director
July 27, 2009
Dee Freeman, Secretary
Subject: Renewal of coverage / General Permit NCG550000
1620 NC Highway 54
Certificate of Coverage NCG551255
Alamance County
In accordance with your renewal application [received on July 22, 2009], the Division is renewing
Certificate of Coverage (CoC) NCG551255 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 Winston-Salem Regional Officeprior 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,
1
f)rC�ol!TnH. 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 NorthCarollna
Phone: [phone] / FAX [phone] / Internet: www.ncwaterquality.org ;Vatmrally
An Equal Opportunity/Affirmative Action Employer - 500/o Recycled/10% Post Consumer Paper

10
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG551255
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,
Karen Harris
is hereby authorized to discharge domestic wastewater [<1000 GPD] from a facility located
at
1620 NC Highway 54
Graham
Alamance County
to receiving waters designated as the Haw River, a class C-NSW stream in subbasin 03-06-01 of
the Cape Fear 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 July 27, 2009.
This Certificate of Coverage shall expire on July 31, 2012.
Signed this day July 27, 2009
for een H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

4 : ;A Division of Water Quality / Water Quality Section
National Pollutant Discharge Elimination System
NCDENR
NORTH CARO- DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES NCG550000
RENEWAL FORM FOR EXISTING PERMITTED FACILITIES
NPDES renewal application for continued coverage under General Permit NCG550000:
Certificate of Coverage NCG55 / ZS
(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 K* (Z C� I'fAAZ, f
Street Address ` S M 6 CK or
City B "
Telephone (Home),S 3 k L L? nl ` Z' (Mobile) -ram Q-011
(e-mail address) ) a n h t ('P kit . da%-61 /'1
* Address to which all permit correspondence will be mailed
2) Location of facility producing discharge*:
Street Address / � NL
City: GP /\A 14`�
County
/I //j
C
Telephone
(Home)-7
� 1-2 f�
2-3(Mobile) J J /' SAP J"2 �
* 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 RECEIVED
Vacation/second home
❑ Undeveloped property
JUL 2 2 2009
❑ Other [describe]: DENR _ UTATER 10
POINT SOURCE BRANCH
Page 1 of 2

NCG550000 renewal form
VQ
4) Please check the components that comprise the wastewater treatment system:
t4e_ptic tank Dosing tank A'fr—imary sand filter /Secondary sand filter
❑ Recirculating sand filter(s) Chlorination ❑ Dechlorination
❑ Other form of disinfection: ❑ Post Aeration (describe)
5) Other Information: l
a) When was the septic tank last pumped out? ! `!
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? Y�� 2-0t-�
c) Approximately how many people use the facility when it is occupied?
d) When was the wastewater system installed?.
6) Certification:
/Ik _1z'
N
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�* /V/414�4_�E
(Signature of/pplican- 0
North Carolina General Statute 143-215.6 b (i) provides that:
? , f-/af
(Date Signed)
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
:71/�`aiiagement' Cominissiorpimplenjenting 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.
Ctitti 101+ provides a bnVnt 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 seltic service to:
Mr. Charles H. Weaver, Jr.
2KM NC DENR / DWQ / NPDES
f 4 e j (��,' 1617 Mail Service Center
Raleigh, NC 27699-1617
Page 2 of 2

2224 Long Dairy Road - L r" ��V
Graham. NC 27253-9598 �-�-lJ
A rye Nr�
In Account With
.A. EDWA"S & SONS
p
GRAVEL - CUSTOM DITCHING
(0 b SINCE 1941
SEPTIC TANKSREPAIR
CLEANING f Phones: [phone] or [phone]
TERMS: -'t,,9-f i C A -.At k- 2'C d (4�-) w 'I'd e r
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Customer agrees to pay a finance charge on any unpaid balance of 11/2 % per month commencing 30 days from
the date of this invoice, and all costs of collection including reasonable attorney fees.
6

Weaver, Charles
From: Graznak, Jenny
Sent: Monday, July 20, 2009 1:31 PM
To: Weaver, Charles
Subject: Whitlow Property NCG551255
Charles,
I visited Karen Harris Single Family Residence NCG551255 in Alamance County last week. Although they are compliant with
the permit, I noticed in BIMS that they did not renew their permit - it shows a status of "expired." But they are paid up on
fees. I gave them a copy of renewal application at inspection and told them to send it in. They thought they had already done
it back in 2007 but could not find a copy of it in their files, so I told him to do it again. Keep an eye out for it. Thanks.
Please note new E-mail address: [e-mail]
Jenny Graznak
NC DENR Winston-Salem Regional Office
Division of Water Quality
585 Woughtown Street
Winston-Salem, NC 27107
Voice: [phone]
FAX: [phone]
E-moil correspondence to and from this address may be subject to the North
Carolina Public Records law and may be disclosed to third parties.

Duke Power, Allen Steam Station
004979A-02•.... ,..v...�.......... :..�.�.. ...._... a..... ...:.'_:.... ,� ...... ,.
Issued December 15, 2006
Engineer's Certification - continued "
I certify that the construction of the above referenced project was observed to be built within
substantial compliance and intent of the approved p144� and,,specifications.
We understand that the monitoring requirements• associated with NPDI S P,armit.NC000497.9
IrYterrial Oulfa11.005 now apply..
Signature
Date
Registration No._
Send to: Construction Grants & Loans
Attn: Cecil G. Madden, Jr., P.E.
DENR/DWQ
1633 Mail Service Center ,
Raleigh, NC 27699-1633

OF W ATFq
� r
o �
Mrs. Karen Harris
1601 Shamrock Drive
Burlington, NC 27215
Subject: Compliance Evaluation Inspection
Single Family Residence
General Wastewater Permit No. NCG551255
Alamance County
Dear Mrs. Harris:
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
August 2, 2006
On July 27, 2006, Jenny Freeman of this office performed a General Permit Inspection on
the wastewater treatment system at the abovementioned address in Alamance County, North
Carolina. This type of inspection consists of two basic parts: a review of self -monitoring data,
and an on -site inspection of the facility and its discharge.
You hold a General Permit to discharge domestic wastewater from a single family
residence under the National Pollutant Discharge Elimination System (NPDES). You were
found to be in compliance with General Permit No. NCG551255. R & A Labs staff performs
the annual effluent testing per the requirements of the permit. Records and documents are
maintained according to permit. The effluent discharges to Haw River (Class C; NSW) in the
Cape Fear River Basin. All system components appeared to be well maintained and functioning
properly. This office appreciates your efforts to maintain compliance with the General Permit.
The following is a reminder list of required maintenance activities:
- Septic tanks shall be maintained at all times to prevent seepage of sewage
- Septic tanks will be checked at least yearly to determine if solids must be removed
- Septic tanks shall be pumped out within 3-5 years of issuance date of the Permit
- Contents removed from septic tanks shall be disposed of at a location and in a manner
compliant with all local and state regulations
- Surface sand filters, disinfection apparatus shall be inspected weekly
If you have any questions concerning this report, please contact Ms. Freeman or me at
[phone].
Sincerely,
Steve W. Tedder
i Regional Supervisor
Surface Water Protection Section
cc: Charles Weaver, NPDES Unit
Surface Water Central Files
WSRO
N` Carolina
oNaturally
North Carolina Division of Water Quality 585 Waughtown Street Winston Salem, NC 27107 Phone [phone] Customer Service
Internet: http://h2o.enr.state.nc.us FAX [phone]
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper

t
United States Environmental Protection Agency
Form Approved.
EPA Washington, D.C. 20460
OMB No. 2040-0057
Water Compliance Inspection Report
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type
1 I NI 2 15I 3I NCG551255 Ill 121 06/07/27 117 18I CI 19I SI 20I I
Remarks
21111111IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII1116
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA ----------Reserved----------
67I 169 70I 31 71 I( 721 N I 73 W 74 75I I I I I I I 180
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
Entry Time/Date
Permit Effective Date
POTW name and NPDES permit Number)
12:30 PM 06/07/27
04/04/30
Karen Harris - SFR
Exit Time/Date
Permit Expiration Date
1620 NC Hwy 54
Graham NC 27253
01:00 PM 06/07/27
07/07/31
Name(s) of Onsite Representative(s)/ritles(s)/Phone and Fax Number(s)
Other Facility Data
Karen Harris//336-229-1856 ext 213/
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Karen Harris,1601 Shamrock Dr Burlington NC 27215//336-229-1856/ No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit 0 Records/Reports Self -Monitoring Program N Facility Site Review
Effluent/Receiving Waters
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date
Jennifer M. Freeman WSRO WQ//336-771-5000/ p
/C�)
C� ^ '.
t/
Signature of ManagementQ A Reviewer Agency/Office/Phone and Fax Numbers Date
EPA Form 3560- (Rev 9-94) Previous a itions are obsolete.
Page # 1

le
NPDES yr/mo/day Inspection Type
3I NCG551255 I11 12I 06/07/27 I17 18IcI
(cont.) 1
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
On July 27, 2006, Jenny Freeman of this office performed a General Permit Inspection on the wastewater
treatment system at the abovementioned address in Alamance County, North Carolina. This type of
inspection consists of two basic parts: a review of self -monitoring data, and an on -site inspection of the
facility and its discharge.
You hold a General Permit to discharge domestic wastewater from a single family residence under the
National Pollutant Discharge Elimination System (NPDES). You were found to be in compliance with
General Permit No. NCG551255. R & A Labs staff performs the annual effluent testing per the
requirements of the permit. Records and documents are maintained according to permit. The effluent
discharges to Haw River (Class C; NSW) in the Cape Fear River Basin. All system components appeared
to be well maintained and functioning properly. This office appreciates your efforts to maintain compliance
with the General Permit. The following is a reminder list of required maintenance activities:
- Septic tanks shall be maintained at all times to prevent seepage of sewage
- Septic tanks will be checked at least yearly to determine if solids must be removed
- Septic tanks shall be pumped out within 3-5 years of issuance date of the Permit
- Contents removed from septic tanks shall be disposed of at a location and in a manner compliant with all
local and state regulations
- Surface sand filters, disinfection apparatus shall be inspected weekly
Page # 2

Permit: NCG551255
Inspection Date: 07/27/2006
Owner - Facility: Karen Hams - SFR
Inspection Type: Compliance Evaluation
Permit
(If the present permit expires in 6 months or less). Has the permittee submitted a new application?
Is the facility as described in the permit?
# Are there any special conditions for the permit?
Is access to the plant site restricted to the general public?
Is the inspector granted access to all areas for inspection?
Comment:
Effluent Pipe
Is right of way to the outfall properly maintained?
Are the receiving water free of foam other than trace amounts and other debris?
If effluent (diffuser pipes are required) are they operating properly?
Comment:
Effluent Sampling
Is composite sampling flow proportional?
Is sample collected below all treatment units?
Is proper volume collected?
Is the tubing clean?
Is proper temperature set for sample storage (kept at 1.0 to 4.4 degrees Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type representative)?
Comment:
Page # 3

Permittee
Permit
Location Address 6y6 t>r40
i("-40 NC +-►Ij
Contact Person
Phone
Inspectors esnnsl'
County - oxyY as\&CU
Date Inspected 10- - /(3
Self-m.onitorina Records— -8 ---
No
Chlorinator Present-- Ye ---No
Chlorine Tablets-- es --No
Did Home Owner know of System- Ye --No Cascade Aeration --- Yes-- Imo
Aae of System
Last Repaired ,, �D4
Discharge Pipe Found- <YeD-No
Sample Taken --- Yes-- (�D
General observations/Stream Conditions/Inspection Summary:
lc
January 28,2000

el f / 17/ G!J!JO 11+• JO f[CJGr'1ftVn Q "14"LL I I I "" L.ML)J
RESEARCh & ANA1 TiCA1 ♦ ���~•���'
I-Ab4RATWES, INC. z: +
13
NC#34
Analytical/Process Consultations p f
too 8111b
Jon Harris Date Sample Collected o6/22/06
1602 Shamrock Drive Date Sample Received 06/22/06
Burlington, NC 27215 Date Sample Analyzed 06/22/06
Attn: Mr. Harris Date of Report 06/28/06
Analyses Performed by 67K -YJ -LP
Lab Sample -Number
--------------------
563648
Parameter Storet # Results
BOD-5 (00110) 10.4 mg/l
TSS (00530) <5.0 mg/l
Fec Coli-MF (31616) 41 col/100 ml
Clients Sample Source EFFLUENT DISCHARGE
Number
Time collected (Hro) 1105
P.p. Box 473 • 106 Short Street • Kerner5ville, North Carolina 27284. 335-996.2841 • Fox 336-996.0326
www.researchandanalytioal.com

oGMichael F. Easley
� Governor
wa�
7 William G. Ross Jr., Secretary
Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
Division of Water Quality
April 30, 2004
Ms. Karen Harris, Power of Attorney for Fleta Whitlow
1601 Sham Rock Drive
Burlington, NC 27215
Subject: General Permit No. NCG550000
Cert. of Coverage NCG551255
Fleta Whitlow Property, Karen Harris, Power of Attorney
1620 NC Highway 54
Alamance County
Dear Ms. Harris:
In accordance with your application for discharge, the Division is forwarding herewith the subject Certificate of
Coverage to discharge under the subject state-NPDES general permit. This permit 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 May 9, 1994.
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 of Water
Quality. The Division of Water Quality may require modification or revocation and reissuance of the certificate of
coverage.
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 this permit, p*ase contact Mack Wiggins at telephone number 919/733-
5083, extension 542.
I
Sincerely,
cc: Central Files
Winston-Salem Regional Office, Water Quality
Stormwater and General Permits Unit
Alamance County Health Department
/a'-_n'W. Klimek, P.E.
srA
`J_CDENA
Customer Service
1 800 623-7748
Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 [phone]

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
CERTIFICATE OF COVERAGE
GENERAL PERMIT NO. NCG551255
TO DISCHARGE DOMESTIC WASTEWATERS FROM SINGLE FAMILY RESIDENCES AND OTHER
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,
Karen Harris, Power of Attorney for Fleta Whitlow
is hereby authorized to operate a wastewater treatment facility that consists of, septic tank, dosing tank, sandfilter,
chlorination chamber, discharge pipe and associated appurtenances with the discharge of treated wastewater from a
facility located at the
Fleta Whitlow Property, Karen Harris Power of Attorney
1620 NC Highway 54
southeast of Graham
Alamance County
to receiving waters designated as Haw River in the Cape Fear 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 30, 2004
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day April 30, 2004
Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

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