NCG550216_Permit (Issuance)_19970806

State of North Carolina
Department of Environment,
Health and Natural Resources 46111117A
Division of Water Quality
James B. Hunt, Jr., Governor p E H N
Jonathan Howes, Secretary
A. Preston Howard, Jr., P.E., Director August 6, 1997
Gregory & Carol Smith
556 Beaver Lodge Circle
Reidsville, NC 27320
Subject: Certificate of Coverage No. NCG550216
Renewal of General Permit
Smith, Gregory & Carol- Residence
Rockingham County
Dear Permittee:
In accordance with your application for renewal of the subject Certificate of Coverage, the Division is forwarding
the enclosed General Permit. This renewal is valid from the effective date on the permit until July 31, 2002. This
permit is issuedpursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of
q
Agreement between North Carolina and the U.S. Environmental Protection Agency dated December 6, 1983. If any
parts,measurement frequencies or sampling requirements contained in this 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, this certificate of coverage shall be final and binding.
The Certificate of Coverage for your facility is not transferable except after notice to the Division. Use the enclosed
Permit Name/Ownership Change form to notify the Division if you sell or otherwise transfer ownership of the
subject facility. The Division may require modification or revocation and reissuance of the Certificate of Coverage.
If your facility ceases discharge of wastewater before the expiration date of this permit, contact the Regional
Office listed below at [phone]. Once discharge from your facility has ceased, this permit may be rescinded.
This permit does not affect the legal requirements to obtain other permits which may be required by the Division of
Water Quality, 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,please contact the NPDES Group at the address below.
Sincerely,
1),trik--- 4. grrote,cii
fiel/r A. Preston Howard,Jr.,P.E.
cc: Central Files
Winston-Salem Regional Office
NPDES File
Facility Assessment Unit
P.O. Box 29535, Raleigh, North Carolina 27626-0535 [phone] FAX[phone] p&[e-mail]
An Equal Opportunity Affirmative Action Employer 50% recycled /10%post-consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG550000
CERTIFICATE OF COVERAGE NO. NCG550216
TO DISCHARGE DOMESTIC WASTEWATERFROM 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,
Gregory & Carol Smith
is hereby authorized to operate a wastewater treatment facility which includes a septic tank, sand filter
and associated appurtenances with the discharge of treated wastewater from a facility
located at
Smith, Gregory & Carol - Residence
556 Beaver Lodge Circle
Reidsville
Rockingham County
to receiving waters designated as subbasin 30203 in the Roanoke 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 No. NCG550000 as attached.
This certificate of coverage shall become effective August 6, 1997.
This certificate of coverage shall remain in effect for the duration of the General Permit.
Signed this day August 6, 1997.
•
ye-11)#A,E.,( 4. 97i-doft,c,-
/A. Preston Howard, Jr., P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission

•
Letter to Gregory & Carol Smith August 1,1997
NCG550216
INVOICE FOR RENEWAL OF
NPDES PERMIT
k.
Check here if you do NOT wish to renew this permit.
Cif �`rn
Cif 7,
Please return this page along with a letter documenting your reasons I
11
for not requesting renewal to: rn p
Mr. Charles H. Weaver, Jr. _ 3 m
Division of Water Quality/WQ Section CO
NPDES Group S.
x
Post Office Box 29535 --
Raleigh, North Carolina 27626-0535
Check here if you wish to renew this permit.
Please verify that the following information is documented accurately:
Mailing Address
Gregory & Carol Smith ❑ No revision required.
Smith, Gregory & Carol- Residence
556 Beaver Lodge Circle Revision required. (Please specify below.)
Reidsville , NC 27320
Phone number: [phone] NON. „t Um� /�I Dl
42,
Fax number: r 1 `v t / J
e-mail address: e-Nncu I .CMA
Facility Location
Gregory & Carol Smith 'No revision required.
Smith, Gregory & Carol- Residence
556 BEAVER LODGE CIRCLE El Revision required. (Please specify below.)
REIDSVILLE ,NC 27320
Please return this page with your letter requesting renewal, and $240 fee (payable to NCDEHNR) to:
Mr. Charles H. Weaver, Jr.
Division of Water Quality/WQ Section
NPDES Group
Post Office Box 29535
Raleigh, North Carolina 27626-0535
Signature of applicant or authorized representative care_ Krev►
Date

i.14•
P03 ati.4 cP

d
August 2,1997
Mr.Charles H.Weaver,Jr.
Division of Water Quality/WQ Section
NPDES Group
Post Office Box 29535
Raleigh,NC 27626-0535 tb
=
Dear Mr.Weaver, C r rt
G7 z
:rjrn
SUBJECT:RENEWAL OF NPDES PERMIT NO.NCG550216 C,I `° ��c")
rrt
We, Greg and Carol Smith, are requesting renewal of our NPDES Permit No. NCG550216. A completed Y c)3 Crt
invoice form and a check for$240.00 to cover the processing fee are enclosed.
O
C
gMBI
Sincerely,
(titte,H.Lri4
Greg and Carol Smith
556 BEAVER LODGE CIRCLE
REIDSVILLE, NC 27320