NCG551819_Certificate of Coverage (COC)_20240807

Docusign Envelope ID: C64834FD-A29A-4BEF-A162-2436B64019C1
ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
Douglas Jacobs
1401 W Academy St
Fuquay-Varina, NC 27526
Dear Mr. Jacobs
NORTH CAROLINA
Environmental Quality
8/7/2024
Subject: Issuance to Certificate of Coverage (COC) /
Authorization to Construct (ATC)
NPDES General Permit NCG551819
under General Permit NCG550000
Single Family Residence (SFR)
1401 W Academy St
Wake County
In accordance with your application for discharge under the subject NPDES General Permit, the Division
of Water Resources (DWR) herewith forwards a Certificate of Coverage (COC) and Authorization to
Construct (ATC) permit for new facilities. We issue this permit pursuant to the requirements of North
Carolina General Statue 143-215 .1, the Memorandum of Agreement between North Carolina and the US
Environmental Protection Agency (EPA) dated October 15, 2007 (or as subsequently amended).
Your permit package includes:
13 Certificate of Coverage (COC) /Authorization to Construct (ATC)
13 Operation and Maintenance Instructions
o Engineer's Certification form (to be returned to DWR upon project completion).
13 A copy of Wastewater Discharge General Permit NCG550000 can be found here
https://www.deq.nc. gov/water-quality/aquifer-protection/afo/permits/ncg550000-renewal-
2020/download
To maintain your Certificate of Coverage (COC), you must remit an annual fee of $60, due each year on
the date of this letter, to the Division of Water Resources. Please include the COC number NCG551819
on your check. Mail your Annual Fee to:
NCDEQ / DWR / NPDES / SFR Permitting
Attn. Wren Thedford
1617 Mail Service Center
Raleigh, NC 27699-1617
DWR understands that the subject property has been judged "unsuitable" for a ground -absorption sewer
system by the Wake County Health Department. Therefore, your authorized consultant, Agri -Waste
Technology, Inc. intends to upgrade/install a wastewater treatment system designed to discharge to
Surface Waters of the State in accord with plans and specifications signed by the engineer on May 15,
2024. Compliance under General Permit NCG550000 restricts discharge flow, not to exceed 1,000
gallons per day. This ATC covers treatment facilities for a four (4)-bedroom single-family residence
estimated to discharge 480 gpd (120 gallons per bedroom).
North Carolina Department of Environmental Quality I Division of Water Resources
R E Q i 512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
NORTH CAROLINA
o.P.w�n m eaai�.nantii oaarty 919.707.9000

Docusign Envelope ID: C64834FD-A29A-4BEF-A162-2436B64019C1
....I- - .._ .
NPDES General Permit NC551819
Please note that you must provide regular treatment -system operation, maintenance and inspections in
accord with manufacturer's recommendations and this ATC; all records, water analyses, and logs to be
kept onsite available for DWR inspection [NCG550000, Section A. (2.)].
Operation and Maintenance. The Permittee is responsible to maintain all components of the
approved treatment system, designed to meet Surface Water -Quality Standards. Compliance includes
following the manufacturer's guidelines, conducting and documenting inspections, establishing sources
for OEM spare parts and supplies, taking samples for analyses, making necessary repairs, and
documenting said maintenance for the duration of the permit. Please note that the receiving stream is
currently classified and governed as C (Secondary contact recreation, aquatic life).
If DWR determines that your discharge contributes to future degradation or impairment of this
waterbody, an individual NPDES permit may be mandatory. Upon DWR's request, the Permittee must
provide records and demonstrate regular efforts to maintain the approved treatment system. The
Division recommends that the Permittee solicit manufacture -certified training, or a qualified contractor
or service to regularly inspect and maintain this treatment system.
Authorization to Construct (ATC) Permit. This ATC details the conditions of installation and
operation. Before startup, activation requires notice to the Raleigh Regional Office (919-791-4252),
attention Michael Hall, a minimum of three (3) days in advance of discharge. Such notification shall be
made during normal office hours from 8:00 a.m. until 5:00 p.m. Monday through Friday, excluding State
holidays. The attached Engineer's Certification form, must be returned to DWR by the Engineer,
documenting compliance "as built" in accord with this ATC and approved plans and specifications
submitted to DWR on May 15, 2024. No changes may be made without prior approval.
Therefore, in accord with the application and the attached approved plans and specifications, DWR
hereby authorizes the installation of upgrades to the existing surface -water discharge treatment system
described as:
• Septic tank with Effluent Filter
• AdvanTex AX-20 RT Pod
• UV Disinfection
• Discharge point with Rip -Rap
Compliance with the above shall include a leakage test performed on reused tanks and proposed new
tanks, or leak -certified new by the manufacture not to exceed an exfiltration rate of twenty (20) gallons
per twenty-four (24) hours per 1,000 gallons of tank capacity. The Engineer's Certification shall serve as
proof of compliance with this condition. Mail the completed Engineer's Certification to:
DEQ / DWR/ NPDES Program
1617 Mail Service Center
Raleigh, NC 27699-1617
❖ The Permittee shall, for the life of the treatment facility, maintain on site a copy
of the approved plans and specifications available for DWR inspection.
All elbow piping must conform to the long -sweeping type. All cleanouts must be housed in meter boxes
below grade. This treatment system shall be located at least 15 feet away from a dwelling, at least 100
feet from any water -supply well either on- or off -site. The system shall also be located and constructed
above any applicable 100-year flood line; 50-ft setback from property lines.

Docusign Envelope ID: C64834FD-A29A-4BEF-A162-2436B64019C1
....I- - .._ .
NPDES General Permit NC551819
Upon completing construction and prior to operating this permitted facility, a North Carolina -
registered engineer shall sign and submit to DWR the attached Engineer's Certification form, thereby
certifying that the permitted facility has been installed in accordance with the NPDES Permit, this
Certificate of Coverage, this Authorization to Construct, and the approved plans and specifications.
This ATC permit is issued in accordance with Part III, Paragraph 2 of NPDES General Permit
NCG550000, and is subject to revocation unless wastewater treatment facilities are constructed in
accordance with the conditions and limitations specified in this General Permit. In the event that the
facilities fail to perform satisfactorily, including creating nuisance conditions, the Permittee shall take
immediate corrective action as may be required by this Division, such as the construction of additional or
replacement wastewater treatment(s) or disposal facilities. Failure to abide by the requirements of this
ATC permit may subject the Permittee to an enforcement action by the Division of Water Resources in
accordance with North Carolina General Statute 143-215.6A to 143-215.6C.
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.
This COC is not transferable except after notice to the Division of Water Resources. The Division may
modify or revoke and reissue this COC. This COC does not affect your legal obligation to obtain other
permits that may be required by the Division of Water Resources, the Division of Energy, Mineral and
Land Resources, the Coastal Area Management Act, or any other Federal or Local government.
NPDES Contact. If you have any questions concerning the requirements of this Certificate of Coverage
or Authorization to Construct (ATC) permit, please email Kate Shadwell [[e-mail]] or
call her direct line [919-707-3613].
Sincerely,
DocuSigned by:
8328B44CE9EB4A1...
John E. Hennessy
Section Chief Regional Operations
Division of Water Resources
Attachments: COC; Engineer's Certification form (to be signed and returned to DWR), Outfall Map
cc: Raleigh Regional Office — Laserfiche
NPDES General Permit Files — Laserfiche
Kevin Davidson, P.E. — Agri -Waste Technology, Inc.

Docusign Envelope ID: C64834FD-A29A-4BEF-A162-2436B64019C1
....I- . .._ .
NPDES General Permit NC551819
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
CERTIFICATE OF COVERAGE - NCG551819
Under GENERAL PERMIT NCG550000
TO DISCHARGE 100%-DOMESTIC AND SIMILAR WASTEWATERS
UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
(NEDES)
In compliance with the provisions 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,
Douglas Jacobs
is hereby authorized to operate a wastewater treatment facility consisting of a septic tank with effluent
filter, AdvanTex AX-20 RT Pod, UV disinfection, effluent discharge pump; outfall with erosion
protection/aeration (rip -rap); discharging from facilities located at the
Single -Family Residence (SFR)
1401 W Academy St, Fuquay-Varina
Wake County
to receiving waters designated as Unnamed Tributary to Kenneth Creek [Stream Index: 18-16-1-(1)] a
waterbody currently classified C located within sub -basin 03-06-07 [HUC: 030300040501 ] 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 of General Permit NCG550000 as attached.
This Authorization to Construct (ATC) shall become effective 10/01/2024
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signedthis day August 7, 2024 DocuS,^i/gned by:
C�
E�83281344CE9E!34M ...
John E. Hennessy, Section Chief Regional Operations
Division of Water Resources
By Authority of the Environmental Management Commission

nnrncinn Fnvalnna in. ('RAR3AFf1_A9QA_dRFF_A1R9_9d3RRFAl11Q(:1

Docusign Envelope ID: C64834FD-A29A-4BEF-A162-2436B64019C1
ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
Permittee-
NPDES COC/ATC Number:
Coun
Engineer's Certification:
NORTH CAROLINA
Environmental Quality
1401 W Academy St. Fuquay-Varina, NC 27526
NCG551819
Wake County
I, , a duly registered Professional Engineer
in the State of North Carolina, as authorized by the Permittee to observe [ daily, part time, full time ]
the construction of the project, ,
Project Name
Location
do hereby state that to the best of my abilities, I practiced due care and diligence to observe the construction of
said project such that it was advanced and completed in accordance and in compliance with the NPDES Permit,
approved plans and specifications, Authorization to Construct Permit, and General Permit Certificate of Coverage
issued by the Division of Water Resources.
Signature
Registration No.
Date
[Stamp]
[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
$10,000, 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 $10,000 or imprisonment not more than 5 years, or both, for a similar offense.]
D � ��� North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
�w 919.707.9000