HomeMy WebLinkAboutWQ0005015_Final Permit_20160330Water Resources
ENVIRONMENTAL QUALITY
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
Secretary
S. JAY ZIMMERMAN
Director
March 30, 2016
MARC E. AND LAUREN E. HABERKORN
8437 AZTEC DAWN COURT
RALEICrH, NORTH CAROLINA 27613
Dear Mr. and Mrs. Haberkorn:
Subject: Permit No. WQ0005015
5121 Swisswood Dr. SFR
Single -Family Residence
Wastewater Irrigation System
Wake County
In accordance with your permit change of ownership and major modification request received
October 29, 2015, and subsequent additional information received February 5, 2016, we are forwarding
herewith Permit No. WQ0005015 dated March 30, 2016, to Marc E. and Lauren E. Haberkorn for the
construction and operation of the subject single-family residence wastewater treatment and irrigation
facilities.
The subject permit has been modified by changing from a 4 -bedroom (480 GPD) to a 5 -bedroom
(600 GPD) capacity, removing the sand filter and adding an aerobic treatment unit, and changing from a
surface spray to a surface drip system.
Please note the Permittee has been changed from Stephen and Debra Smith to Marc E. and Lauren.
E. Haberkorn.
This permit shall be effective from the date of issuance until February 28, 2021, shall void Permit
No. WQ0005015 issued August 29, 2014, and shall be subject to the conditions and limitations as specified
therein. An extensionshall be requested at least six months prior to the expiration of this permit.
Upon receipt of the request, the Commission will review the adequacy of the facility described therein and,
if warranted, will extend the permit for such period of time and under such conditions and limitations as it
may deem appropriate.
Please pay particular attention to the operation and maintenance requirements listed in Section III
for they may differ from the previous permit issuance. Failure to establish an adequate system for collecting
and maintaining the required operational information shall result in future compliance problems. Also note
that Condition VI.6. requires the Permittee to retain a set of Division approved plans and specifications for
the life of the facilities permitted herein.
Please note the following permit condition is specific to your permit and requires your
attention:
➢ Condition 1.2. — This condition requires the Permittee to submit a follow-up soil scientist
evaluation conducted on the proposed drip irrigation area. This evaluation shall certify that
installation of the fill has not affected the drip irrigation area's ability to operate at the permitted
loading rate.
State of North Carolina I Environmental Quality I Water Resources I Water Quality Permitting I lion -Discharge Permitting
1617 Me Service Center I Raleigh, North Carolina 27699-1617
919 807 6464
Mr. Marc E. and Mrs. Lauren E. Haberkorn
March 30, 2016
Page 2 of 2
If any parts, requirements or limitations contained in this permit are unacceptable, the Permittee
has the right to request an adjudicatory hearing upon written request within 30 days following receipt of
this permit. This request shall be in the form of a written petition, conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings at 6714 Mail Service
Center, Raleigh, NC 27699-6714. Unless such demands are made, this permit shall be final and binding.
One set of approved plans and specifications is being forwarded to you. If you need additional
information concerning this permit, please contact Alice M. Wessner at (919) 807-6425 or
alice.wessnergncdenr. og_v.
Sincerely,
S. Jay Zimmerman, P.G., Direc
Division of Water Resources
cc: Wake County Health Department, Water Quality Division Director, Britt Stoddard,
bstoddard@wakegov.com (Electronic Copy)
Raleigh Regional Office, Water Quality Regional Operations Section (Electronic Copy)
John R. Harman, PE, jackharman53(cpmail.com (Electronic Copy)
Beth Buffington — Protection and Enforcement Branch (Electronic Copy)
Digital Permit Archive (Electronic Copy)
Central Files
NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
RALEIGH
SINGLE-FAMILY RESIDENCE WASTEWATER IRRIGATION SYSTEM PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules and Regulations
PERMISSION IS HEREBY GRANTED TO
Marc E. and Lauren E. Haberkorn
Wake County
FOR THE
construction and operation of a 600 gallon per day (GPD) single-family residence wastewater treatment
and irrigation facility consisting of:
a trash tank to assist with separating settleable and floatable solids; a `Clearstream 600' aerobic treatment
unit (ATU) with a 2.5 cubic foot per minute (CFM) aeration blower, clarifier and high water and blower
fail alarm; an ultraviolet (UV) disinfection system with one lamp with current sensor and audible alarm on
failure; a 5,400 gallon storage tank with an 18 gallon per minute (GPM) irrigation pump and audible/visual
high-water alarms; a rain moisture sensor; a 0.77 acre drip irrigation area comprised of three zones with
native soil amended with fill and all associated piping, valves, controls and appurtenances
to serve the single-family residence at 5121 Swisswood Dr., Raleigh, NC 27163 with no discharge of wastes
to surface waters, pursuant to the application received October 29, 2015, and subsequent additional
information received by the Division of Water Resources, and in conformity with the project plans,
specifications, and other supporting data subsequently filed and approved by the Department of
Environmental Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until February 28, 2021, shall void Permit No.
WQ0005015 issued August 29, 2014, and shall be subject to the following specified conditions and
Iimitations:
I. SCHEDULES
Upon completion of construction and prior to operation of this permitted facility, a certification
(attached) shall be submitted from a licensed North Carolina Professional Engineer certifying that the
permitted facility has been installed in accordance with this permit, Division approved plans and
specifications, and other supporting documentation, including the location of all monitoring wells as
applicable. If this project is to be completed in phases and partially certified the Permittee shall retain
the responsibility to track further construction approved under the same hermit and shall, provide a
final certificate of completion once the entire project has been completed. Mail the Certification to the
Division of Water Resources, Water Quality Permitting Section, 1617 Mail Service Center, Raleigh,
NC 27699-1617. [15A NCAC 02T .0116]
WQ0005015 Version 4.0 Shell Version 151201 Page 1 of 8
2. Upon completion of final site grading activities and prior to installation of the drip irrigation system, a
licensed soil scientist shall conduct a post -construction soil evaluation of proposed irrigation areas, and
submit a signed and sealed amended soils evaluation report to the Division of Water Resources Central
Office and Raleigh Regional Office. The Raleigh Regional Office shall be notified at this time and
given the opportunity to evaluate post -construction soil conditions prior to irrigation system
installation. In the event the post -construction soil conditions can no longer support the design flows
of the wastewater treatment system, the Permittee shall recondition the soil or take additional measures
to ensure that there is adequate disposal to meet the design flow of the treatment system and are
identified and incorporated into the permit. [15A NCAC 02T .0108(b)(2)]
3. The Raleigh Regional Office, telephone number (919) 791-4200, shall be notified at least 48 hours in
advance (excluding weekends and holidays) of operation of the installed facilities such that an in-place
inspection can be made. Notification to the regional supervisor shall be made from 8:00 a.m. until 5:00
p.m. on Monday through Friday, excluding State Holidays. [15A NCAC 02T .0108 (b)(2)]
4. No later than six months prior to the expiration of this permit, the Permittee shall request renewal of
this permit on official Division forms. Upon receipt of the request, the Division will review the
adequacy of the facilities described therein, and if warranted, will renew the permit for such period of
time and udder such conditions and limitations as it may deem appropriate. Please note Rule 15A
NCAC 02T .0105(d) requires an updated site map to be submitted with the permit renewal application.
[15A NCAC 02T.01 05, 02T.0109. 02T .0115(c)]
5. If a public or community sewage system is or becomes available, the subject single-family residence
wastewater treatment and irrigation facilities shall be closed and all wastewater shall be discharged into
the public or community sewage system within 180 days of its availability. Prior to the initiation of
these connection activities, appropriate Division approval shall be received. [15A NCAC 02T .0607]
II. PERFORMANCE STANDARDS
The subject non -discharge facilities shall be effectively maintained and operated at all times so there is
no discharge to surface waters, nor any contravention of groundwater or surface water standards. In
the event the facilities fail to perform satisfactorily, including the creation of nuisance conditions due
to improper operation and maintenance, or failure of the irrigation areas to adequately assimilate the
effluent, the Permittee shall take immediate corrective actions including Division required actions, such
as the construction of additional or replacement wastewater treatment or disposal facilities. [I 5A
NCAC 02T .0108(b)(1)]
2. This permit shall not relieve the Permittee of their responsibility for damages to groundwater or surface
water resulting from the operation of this facility. [ 15A NCAC 02B .0200, 02L .0100]
3. Application rates, whether hydraulic, nutrient or other pollutant, shall not exceed those specified in the
following table:
TABLE 1— APPLICATION LIMITATIONS
Field
Parameter
Hourly Rate
Yearly Max
Units
1
01284 —Non -Discharge Application Rate
0.1
13.52
inches
[15A NCAC 02T .06050)]
WQ0005015 Version 4.0 Shell Version 151201 Page 2 of 8
4. The subject facility has been approved to land apply wastewater effluent on the following fields:
TABLE 2 — IRRIGATION AREA INFORMATION
Field
Owner
County
Latitude
Longitude
Net
Dominant
Acreage
Soil Series
Marc E. and Lauren E.
I
Haberkorn
Wake
35.9525°
-78.72140
0.77
Creedmoor
[G.S. 143-215.1]
5. The Operation and Maintenance Agreement (attached) between the Permittee and the Division of Water
Resources is incorporated herein by reference and shall be a condition of this permit. Noncompliance
with the terms of the Operation and Maintenance Agreement shall subject the Permittee to all sanctions
provided by North Carolina General Statutes § 143-215.6A to § 143-215.6C for violation of or failure
to act in accordance with the terms and conditions of this permit. [15A NCAC 02T .0115 (2)]
6. The irrigation system shall be connected to a rain or moisture sensor, which shall indicate when effluent
application is not appropriate in accordance with Conditions 111.4. and 111. 5. of this permit. [ 15A NCAC
02T .0605(o)]
7. The compliance boundary is established at the property boundary. Any exceedance of standards at the
compliance boundary shall require action in accordance with 15A NCAC 02L.0106. [ 15A NCAC 02L
.0107(i)]
8. The review boundary is established midway between the compliance boundary and the effluent disposal
area. Any exceedance of groundwater standards at the review boundary shall require action in
accordance with 15A NCAC 02L.0106. [15A NCAC 02L .0108]
9. The Permittee shall apply for a permit modification to establish a new compliance boundary prior to
any sale or transfer of property affecting a compliance boundary. [15A NCAC 02L .0107(c)]
10. The facilities permitted herein shall be constructed according to the following setbacks:
a. The setbacks for irrigation sites permitted under 15A NCAC 02T .0600 shall be as follows (all
distances in feet):
L Any habitable residence or place of public assembly under separate ownership:
ii. Any habitable residence or place of public assembly owned by the Permittee:
iii. Any private or public water supply source:
iv. Surface waters:
v. Groundwater lowering ditches:
vi. Surface water diversions:
vii. Any well with exception of monitoring wells:
viii. Any property line:
ix. Top of slope of embankments or cuts of two feet or more in vertical height:
x. Any water line from a disposal system:
xi. Subsurface groundwater lowering drainage systems:
xii. Any swimming pool:
xiii. Public right of way:
xiv. Nitrification field:
xv. Any building foundation or basement:
[15A NCAC 02T .0606(a)]
100
15
100
100
100
25
100
50
15
10
100
100
50
20
15
WQ0005015 Version 4.0 Shell Version 151201 Page 3 of 8
b. The setbacks for storage and treatment units permitted under 15A NCAC 02T .0600 shall be as
follows (all distances in feet):
L Any habitable residence or place of public assembly under separate ownership: 100
ii. Any private or public water supply source: 100
iii. Surface waters: 50
iv. Any well with exception of monitoring wells: 100
v. Any property line: 50
[15A NCAC 02T .0606(b)]
III. OPERATION AND MAINTENANCE REOUIREMENTS
The facilities shall be properly maintained and operated at all times. The facilities shall be effectively
maintained and operated as a non -discharge system to prevent the discharge of any wastewater resulting
from the operation of this facility. The Permittee shall maintain an Operation and Maintenance Plan
pursuant to 15A NCAC 02T .0604(f). [15A NCAC 02T .0604(f)]
2. Upon the Water Pollution Control System Operators Certification Commission's (WPCSOCC)
classification of the subject non -discharge facilities, in accordance with 15A NCAC 08G .0200 the
Permittee shall designate and employ a certified operator in responsible charge (ORC) and one or more
certified operator(s) as back-up ORC(s). The ORC or their back-up shall visit the facilities in
accordance with 15A NCAC 08G .0200, but not less frequently than one time per month, and shall
comply with all other conditions specified in the previously cited rules. [ 15A NCAC 02T .0117]
3. A suitable year round vegetative cover (e.g. pine trees and rye grass) shall be maintained at all times,
such that crop health is optimized, allows for even distribution of effluent and allows inspection of the
irrigation system. [15A NCAC 02T .0108(b)(1)]
4. Adequate measures shall be taken to prevent effluent ponding in or runoff from the irrigation sites listed
in Condition 11.4. [15A NCAC 02T .0605(o)]
5. Irrigation shall not be performed during inclement weather or when the ground is in a condition that
will cause ponding or runoff. [15A NCAC 02T .0605(o)]
6. Only effluent from the single-family residence at 5121 Swisswood Dr., Raleigh, NC 27163 shall be
irrigated on the sites listed in Condition 1I.4. [G.S. 143-215.1 ]
7. No automobiles or machinery shall be allowed on the irrigation sites except during equipment
installation or while maintenance is being performed. [15A NCAC 02T .0108(b)(1)]
8. Public access to the irrigation sites and wastewater treatment facilities shall be prohibited. Fencing
shall be provided to prevent access to the irrigation site (minimum 2 -strand wire) and treatment units
shall be secured with locks on all tank accesses and control panels. [15A NCAC 02T .0605(i)]
9. The residuals generated from the wastewater treatment facilities shall be disposed or utilized in
accordance with 15A NCAC 02T .1100. [ I 5 NCAC 02T .1100].
10. Diversion or bypassing of untreated or partially treated wastewater from the treatment facilities is
prohibited. [15A NCAC 02T .0605(f)]
11. Pump/dosing tanks shall have audible and visual alarms external to any structure. [15A NCAC 02T
.0605(n)]
12. Any excavation into bedrock shall be lined with a 10 millimeter (mm) synthetic liner. [ 15A NCAC
02T .0605(d)]
WQ0005015 Version 4.0 Shell Version 151201 Page 4 of 8
13. The Permittee is responsible for the operation and maintenance of the entire treatment and disposal
system including, but not limited to, the following items:
a. The pretreatmentitrash and aeration tanks shall be checked annually and pumped out at a minimum
every two years. The septic tank effluent filter shall be checked and cleaned at the same frequency
as the septic tank. [ 15A NCAC 18A .1900, 02T .06051
b. The ultraviolet disinfection unit shall be checked weekly. The lamp(s) and quartz sleeve(s) shall be
cleaned or replaced as needed to ensure proper disinfection. [15A NCAC 02T .0605(1)]
c. The storage, pump, and alarm systems shall be inspected monthly. The scum layer shall be removed
at the same interval as the septic tank is cleaned out. [15A NCAC 02T .0108(b)(1)]
d. The system shall be inspected monthly to make certain of the proper operation of the drip lines,
that the system is free of leaks, that the vegetative growth allows a proper drip pattern, that the soil
is assimilating the disposed treated wastewater with no surface runoff,.and that no objectionable
odors are being generated. [15A NCAC 02T .0108(b)(1)]
IV. MONITORING AND REPORTING REQUIREMENTS
I. Any Division required monitoring (including groundwater, plant tissue, soil and surface water analyses)
necessary to ensure groundwater and surface water protection shall be established, and an acceptable
sampling reporting schedule shall be followed. [15A NCAC 02T .0108(c)]
2. Noncompliance Notification;
The Permittee shall report by telephone to the Raleigh Regional Office, telephone number (919) 791-
4200, as soon as..possible, but in no case more than 24 hours, or on the next working day following the
occurrence or first knowledge of the occurrence of any of the following:
a. Any process unit failure (e.g., mechanical, electrical, etc.), due to known or unknown reasons,
rendering the facility incapable of adequate wastewater treatment.
b. Any facility failure resulting in a by-pass directly to receiving surface waters.
c. Any time self-monitoring indicates the facility has gone out of compliance with its permit
limitations.
d. Ponding in or runoff from the irrigation sites.
Any emergency requiring immediate reporting (e.g., discharges to surface waters, imminent failure of
a storage structure, etc.) outside normal business hours shall be reported to the Division's Emergency
Response personnel at telephone number (800) 662-7956, (800) 858-0368, or (919) 733-3300. Persons
reporting such occurrences by telephone shall also file a written report in letter form within Eve days
following first knowledge of the occurrence. This report shall outline the actions taken or proposed to
be taken to ensure the problem does not recur. [15A NCAC 02T .0105(1)]
WQ0005015 Version 4.0 Shell Version 151201 Page 5 of 8
V. INSPECTIONS
1. The Permittee shall provide adequate inspection and maintenance to ensure proper operation of the
wastewater treatment and irrigation facilities. [15A NCAC 02T .0108(b)]
2. The Permittee or their designee shall inspect the wastewater treatment and irrigation facilities to prevent
malfunctions, facility deterioration and operator errors resulting in discharges, which may cause the
release of wastes to the environment, a threat to human health or a public nuisance. The Permittee shall
maintain an inspection log that includes, at a minimum, the date and time of inspection, observations
made, and any maintenance, repairs, or corrective actions taken. The Permittee shall maintain this
inspection Iog for a period of five years from the date of the inspection, and this log shall be made
available to the Division upon request. [15A NCAC 02T .0108(b)]
3. Any duly authorized Division representative may, upon presentation of credentials, enter and inspect
any property, premises or place on or related to the wastewater treatment and irrigation facilities
permitted herein at any reasonable time for the purpose of determining compliance with this permit;
may inspect or copy any records required to be maintained under the terms and conditions of this permit,
and may collect groundwater, surface water or leachate samples. [G.S. 143-215.3(a)(2)]
VI. GENERAL CONDITIONS
1. Failure to comply with the conditions and limitations contained herein may subject the Permittee to an
enforcement action by the Division in accordance with North Carolina General Statutes 143-215.6A to
143-215.6C. [G.S. 143-215.6A to 143-215.6C]
2. This permit shall become voidable if the permitted facilities are not constructed in accordance with the
conditions of this permit, the Division approved plans and specifications, and other supporting
documentation. [15A NCAC 02T .0110]
3. This permit is effective only with respect to the nature and volume of wastes described in the permit
application, Division approved plans and specifications, and other supporting documentation. No
variances to applicable rules governing the construction or operation of the permitted facilities are
granted, unless specifically requested and approved in this permit pursuant to 15ANCAC 02T.0 105(n),
[G.S. 14.-215.1]
4. The issuance of this permit does not exempt the Permittee from complying with any and all statutes,
rules, regulations, or ordinances, which may be imposed by other jurisdictional government agencies
(e.g., local, state, and federal). Of particular concern to the Division are applicable river buffer rules in
15A NCAC 02B .0200; erosion and sedimentation control requirements in 15A NCAC Chapter 4 and
under General Permit NCG010000; any requirements pertaining to wetlands under 15A NCAC 02B
.0200 and 02H .0500; and documentation of compliance with Article 21 Part 6 of Chapter 143 of the
General Statutes. [15A NCAC 02T .0105(c)(6)]
In the event the permitted facilities change ownership or the Permittee changes their name, a format
permit modification request shall be submitted to the Division. This request shall be trade on official
Division forms, and shall include appropriate property ownership documentation and other supporting
documentation as necessary. The Permittee of record shall remain fully responsible for maintaining
and operating the facilities permitted herein until a permit is issued to the new owner. [15A NCAC
02T .0104]
6. The Permittee shall retain a set of Division approved plans and specifications for the life of the facilities
permitted herein. [15A NCAC 02T .0108(b)(1)]
7. The Permittee shall maintain this permit until all permitted facilities herein are properly closed or
permitted under another permit issued by the appropriate permitting authority. [15A NCAC 02T
.01050)]
WQ0005015 Version 4.0 Shell Version 151201 Page 6 of 8
8. This permit is subject to revocation or unilateral modification upon 60 days notice from the Division
Director, in whole or part for the requirements listed in 15A NCAC 02T.01 10. [15A NCAC 02T .0110]
9. Unless the Division Director grants a variance, expansion of the permitted facilities contained herein
shall not be granted if the Permittee exemplifies any of the criteria in 15A NCAC 02T .0120(b). [15A
NCAC 02T.0120]
10. The Permittee shall pay the annual fee within 30 days after being billed by the Division. Failure to pay
the annual fee accordingly shall be cause for the Division to revoke this permit. [15A NCAC 02T
.0105(e)(3)]
Permit issued this the 30' day of March 2016
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
S. Jay Zimmerman, P.G., Direct r
Division of Water Resources
By Authority of the Environmental Management Commission
Permit Number WQ0005015
WQ0005015 Version 4.0 Shell Version 151201 Page 7 of 8
Permit No. WQ0005015 Single -Family Residence Wastewater Irrigation System
Marc E. and Lauren E. Haberkorn March 30, 2016
5121 Swisswood Dr. SFR Wake County
ENGINEERING CERTIFICATION
❑ Partial ❑ Final
In accordance with 15A NCAC 02T .0 116, I, , as
a duly registered Professional Engineer in the State of North Carolina, having the Permittee's authorization
to ❑ periodically ❑ weekly ❑ fully observe the construction of the permitted facility, hereby state to the
best of my abilities that due care and diligence was used in the observation of the construction, such that
the facility was built within substantial compliance and intent of this permit, the Division approved plans
and specifications, and other supporting documentation.
❑ Any variation to this permit, the Division approved plans and specifications, and other supporting
documentation has been documented in the attached as -built drawings, and shall serve as the
Permittee's minor modification request to amend the permit accordingly.
Provide a brief narrative description of any variations:
i
Professional Engineer's Name j
Engineering Firm
Mailing Address
City State Zip
Telephone E-mail NC PE Seal, Si nature & Date
THE COMPLETED ENGINEERING CERTIFICATION, INCLUDING ALL SUPPORTING
INFORMATION AND MATERIALS, SHALL BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
NON -DISCHARGE PERMITTING UNIT
B y U.S. Postal Service: By Courier/Special Delivm:
1617 MAIL SERVICE CENTER 512 N. SALISBURY ST.
RALEIGH, NORTH CAROLINA 27699-1617 RALEIGH, NORTH CAROLINA 27604
WQ0005015 Version 4.0 Sbell Version 151201
Page 8 of 8
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Wake County, City f R leigh
5121 Swisswood Drive
PIN:0880214768
Real Estate ID: 0139973
Map Name: 0880 03
Owner: HABERKORN, MARC EDWARD
HABERKORN, LAUREN ELIZABETH
Mailing Address 1: 8437 AZTEC DAWN CT
Mailing Address 2 RALEIGH NC 27613-7491
Deed Book: 015890
Deed Page: 00187
Deed Date: 0111.212015
Deeded Acreage: 8.21
Assessed Building Value: $0
Assessed Land Value: $150,000
Total Assessed Value: $150,000
Billing Class: Individual
Property Description: L066 HUNTER HILLS
SE3 BM1984 -01684
Heated Area: 0
Site Address: 5121 SWISSWOOD DR
Township: Leesville
Year Built: 0
Total Safe Price: $0
Land Class: VACANT
Old Parcel Number: 223-00000-0112
0 205 410 820 Feet
I 1 I I I I 1 I I
1 inch = 400 feet
Disclaimer
Maps makes every effort to produce and publish
the most current and accurate information possibie.
However, the maps are produced for information purposes,
and are NOTsurveys. No warranties, expressed or implied
,are provided for the data therein, its use,or its interpretation.
State of North Carolina
ry �D\NDepartment of Environmental Quality
cE���D�C�� Division of Water Resources
D-,OW,RI;A NCAC T .0600 — SINGL)��J►MILY RESIDENCE WASTEWATER IRRIGATION SYSTEMS
,,,r�" C_ toy OPERATION AND MAINTENANCE AGREEMENT
;M Division of Witter Resources FORM: SFRWWIS O&M 1L15
,yam,
f rO�Itng Un1
Permit No. V G, 0 b !�_O 15—
County: ti,J a, k,,E—
Property owner(s) as appearing on the recorded deed.
marc
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Mai I i ng ad dres s: _K.�- r�'JnC
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Facility address: 512 swisswVCJ 0L
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irrigation Method: TT SPRAY ❑ DRIP
I / We agree to operate and maintain the single-family residence wastewater treatment and irrigation system as follows:
1. The Permittee is responsible for the operation and maintenance of the entire wastewater treatment and irrigation
system including, but not limited to, the following items:
a. The septic tank shall be checked annually and pumped out as needed.
b. The septic tank effluent filter shall be checked and cleaned annually.
c. Accessible sand filter surfaces shall be raked and leveled every six months and any vegetative growth shall be
removed manually.
d. 4 The tablet chlorinator shall be checked weekly. Wastewater grade tablets (calcium hypochlorite) shall be
added as needed to provide proper chlorination (pool chlorine tablets shall not be used), OR
❑ The ultraviolet disinfection unit shall be checked weekly. The lamp(s) and quartz sleeve(s) shall be cleaned
or replaced as needed to ensure proper disinfection.
e. All pump and alarm systems shall be inspected monthly.
f. The irrigation system shall be inspected monthly to ensure that the system is free of leaks, that all irrigation
equipment is operating as designed, that vegetative growth does not interfere with the system inspection or
operation, that the soil is assimilating the disposed treated wastewater with no visible runoff or ponding, and
that no objectionable odors are being generated.
2. Failure to pay the annual fee shall be cause for the Division to revolve the permit pursuant to 15A NCAC 02T
.0105(ex3).
3. The Permittee's failure to properly operate this system is subject to a penalty up to $25,000 per day.
4. Failure to meet the permit conditions or violation of the State's surface water or groundwater regulations may void
the permit.
All ownen spMring go the WILy recorded propeEft deed shall Lia this O ration & Maintenance Amrmment
I / We understand the above re i ent an agree to these terms as part of the issued permit.
Owner Signature: .�/� Date: l fv
Owner Signature: Date: L!
FORM: SFitWWIS 0&M 11-15 Page l of I