NCG550280_Application (ATC)_19890927

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State of North Carolina
Department of Environment, Health, and Natural Resources
Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27611
James G. Martin,Governor R. Paul Wilms
William W. Cobey,Jr., Secretary Director
September 27, 1989
Mr. Paul H. Latham
c/o Forsyth Builders, Inc.
P. O. Box 1563
King, N. C. 27021
Subject: Permit No. NC0059170
Authorization to Construct
Mr. Paul H. Latham
Single Family Discharge
Forsyth County
Dear Mr.Latham:
A letter of request for an Authorization to Construct was received on September 12, 1989,
by the Division and final plans and specifications for the subject project have been reviewed and
found to be satisfactory. Authorization is hereby granted for the construction of a 450 GPD single
family wastewater treatment and disposal facility which consists of a 1,000 gallon baffled septic
tank, a distribution box, a 450 square foot primary subsurface sand filter, a distribution box, a
450 square foot secondary subsurface sand filter, a tablet chlorinator, a chlorine contact chamber
with thirty minutes detention, a step aerator, and all appurtenances to serve the Paul H. Latham
residence in Forsyth County with the discharge of treated wastewater into an unnamed tributary to
Johnson Creek.
This Authorization to Construct is issued in accordance with Part III paragraph B of
NPDES Permit No. NC0059170, which was issued on August 29, 1989, and which is scheduled
to be reissued on or about November 16, 1989, and shall be subject to revocation unless the
wastewater treatment facilities are constructed in accordance with the conditions and limitations
specified in Permit No. NC0059170.
The sludge generated from these treatment facilities must be disposed of in accordance with
G.S. 143-215.1 and in a manner which is approved by the North Carolina Division of
Environmental Management.
In the event that the facilities fail to perform satisfactorily, including the creation of
nuisance conditions,the Permittee shall take immediate corrective action, including those as may be
required by this Division, such as the construction of additional or replacement wastewater
treatment or disposal facilities.
Pollution Prevention Pays
P.O.Box 27687,Raleigh,North Carolina 27611-7687 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

The Winston-Salem Regional Office, phone no. 919/761-2351, shall be notified at least
forty-eight (48) hours in advance of operation of the installed facilities so that an in-place
inspection can be made. Such notification to the regional supervisor shall be made during the
normal office hours from 8:00 a.m. until 5:00 p.m. on Monday through Friday, excluding State
Holidays.
The septic tank must be checked annually and pumped as needed. The Permittee shall
maintain records of all inspections and maintenance performed on the system for at least five years.
The septic tank and sand filter shall be located at least 100 feet away from any drinking
water well.
The sand media of the subsurface sand filters must comply with the Division's sand
specifications.
If excavation into bedrock for the septic tank or sand filter installation is required, the pit
shall be lined with a 10 mil synthetic liner.
A set of the approved plans and specifications for the subject project must be retained by
the Permittee for the life of the project.
A leakage test shall be performed on the septic tank to insure that any exfiltration occurs at a
rate which does not exceed twenty (20) gallons per twenty-four (24) hours per 1,000 gallons of
tank capacity.
Failure to abide by the conditions contained in this Authorization to Construct may subject
the Permittee to an enforcement action by the Division of Environmental Management in
accordance with North Carolina General Statute 143-215.6.
The issuance of this Authorization to Construct does not preclude the Permittee from
complying with any and all statutes, rules, regulations, or ordinances which may be imposed by
other government agencies (local, state, and, federal) which have jurisdiction.
One (1) set of approved plans and specifications is being forwarded to you. If you have
any questions or need additional information, please contact Mr. Randy Jones, telephone number
919/733-5083.
Sincerely,
/(/p C
R. Paul Wilms
cc: Forsyth County Health Departmen,l
Winston-Salem Regional Office U
Beeson Engineering (PO Box 5685, Winston-Salem, NC 27113-5685)

• AC0059170
September 27, 1989
Engineer's Certification
I, , as a duly registered Professional Engineer in the State of
North Carolina, having been authorized to observe (periodically, weekly, full time) the construction
of the project, , for the
Project Name Location
Permittee hereby state that, to the best of my abilities, due care and diligence was used in the
observation of the construction such that the construction was observed to be built within substantial
compliance and intent of the approved plans and specifications.
Signature Registration No.
Date