WQ0023433_Final Permit_20090710

North Carolina
Beverly Eaves Perdue
Governor
DAVID MUSSARI, MANAGER
GARNER LANDMARK, LLC
11800 CONREY ROAD, SUITE 120
CrNcrNNATr, OH 45249
Dear Mr. Mussari:
M&71r,A-1
err DEN
Department of Environment and
Division of Water Quality
Coleen H. Sullins
Director
July 10, 2009
Natural Resources
Dee Freeman
Secretary
Subject: Permit No. WQ0023433
Cormi:n SFR
Surface Irrigation Facility
Chatham County
Per your request, please find attached the renewal application package for the surface irrigation system
located at 502 Royal Sunset Drive, Durham, NC 2771.3. Also, as :mentioned the annual monitoring fee of
$60 is due. Please complete and return the renewal package with attached check within 14 days to the
address below, or for your convenience, a self-addressed envelope is enclosed:
Aquifer Protection Section
Groundwater Protection Unit
1636 Mail Service Center
Raleigh, NC 27699-1636
Please contact Michael Rogers at [phone] if you need additional information concerning this
matter.
Sincerely,
l
Michael Rogers, Environmental
Specialist
cc: Raleigh Regional Office - Aquifer Protection Section w/out attachments
APS Central Files (WQ002-3433) - w/out attachments
Notebook Files
AQUIFER PROTECTI01'SECTION
163E Mail Service Center, Raleigh, North Carolina 27699-1636
Locatio- : 2728 Capital Boulevard. Raleigh, North Carolina 276Y o11e
Phone: [phone] FAX 1; 919.715-0588; FAX 2: 919-715.6048 \ Customer Service: 1-677-623-674. Internet www.ncvvaterguality.org 1� 7sTG tl a ©n(1
Psi Eq€ . 0p,_x1L,• l hffirmatwv Ac' jn Em�,in;:

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
INSTRUCTIONS FOR FORM: WWR 09-06
(RENEWAL WITHOUT MODIFICATION OF WASTEWATER NON -DISCHARGE SYSTEMS)
For more information or for an electronic version of this form, visit the Land Application Unit (LAU) web site at:
htt:I/h2o.errr.state.ne,.us/lau/main.htnzl
This form is for renewal without modification for all wastewater non -discharge systems. Wastewater non -discharge
systems include; High Rate Infiltration .Systems; Infiltration✓Evaporation Lagoons; Reclaimed Water Utilization
Systems; Wastewater Recycle Systems; Single Family Surface Irrigation Systems; and Surface Irrigation Systems.
This application may not be used for renewal of Lund Avylication. of Residuals Permits.
A. Application Form (All Application Packages):
✓ Submit one (1) original and two (2) copies of the completed and appropriately executed application form.
Any changes made to this form will result in the application package being returned.
✓ If the Applicant is a corporation or company, it must be registered for business with the NC Secretary of
State (h!tp://www.secretarv.state.nc.us/Corporations/CSearchesnx),
✓ If the Applicant is a partnership, sole proprietorship, trade name, or d/b/a enclose a copy of the certificate
filed with the register of deeds in the county of business.
✓ The application must be signed appropriately in accordance with 15A NCAC 2T .0106(b). An alternate
person may be designated as the signing official, provided that a delegation letter is provided from a person
who meets the referenced criteria. You may download an example delegation letter from the LAU web site.
✓ Submit three (3) copies of the most recently issued existing permit.
B. Additional Forms (Single Family Residence Surface Irrigation systems Only):
✓ Submit one (1) original and two (2) copies of a completed and properly executed FORM: SFR O&M. This
Form may be downloaded at: http_//h2o.enr..state.ne.us/lau/app,licadons.htmi#Single
C. Site Map
✓ Submit three (3) copies of an updated site map if required as part of the original submittal in accordance
with 15A NCAC 2T .0105(d).
1. GENERAL INFORMATION:
1. Permittee's name (Owner of the facility):
2. Complete mailing address of Permittee:
City:
Telephone number: ( )
Email Address:
State: Zip:
Facsimile number: ( )
3. Facility name (name of the subdivision, shopping center, etc.):
4. Complete address of the physical location of the facility (if different from above):
City:
5. County where project is located:
State: Zip:
6. Name and affiliation of contact person who can answer questions about project:
Email Address:
FORM: WWR 09-06 Page 1

II. PERMIT INFORMATION:
1. Existing permit number
2. Existing permit type:
and the issuance date
❑ High -Rate Infiltration ❑ Evaporation Lagoons ❑ Reclaimed Water Utilization
❑ Single Family Surface Irrigation ❑ Surface Irrigation ❑ Wastewater Recycle
3. Has the treatment and.disposal system been constructed? ❑ Yes ❑ No
4. If the system has not been constructed, would you like to rescind your permit (i.e. the permitted facilities
will not be needed)? ❑ Yes ❑ No
5. Has the wastewater system been connected to a municipal or community sewer system? ❑ Yes ❑ No
Applicant's Certification [signing authority must be in compliance with 15A NCAC 2T .0106(b)]:
I,
attest that this application for
(signing authority name and title)
(facility name)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that any discharge
of wastewater from this non -discharge system to surface waters or the land will result in an immediate enforcement
action that may include civil penalties, injunctive relief, and/or crirriinal prosecution. I will make no claim against
the Division of Water Quality should a condition of this permit be violated. I also understand that if all required
parts of this application package are not completed and that if all required supporting information and attachments
are not included, this application package will be returned to me as incomplete. I further certify that the applicant or
any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility without
proper closure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are
compliant with any active compliance schedule, and do not have any overdue annual fees under Rule 2T .0105.
Note: In accordance with NC General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any
false statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor,
which may include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature:
Date:
THE COMPLETED RENEWAL APPLICATION SHALL BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
AQUIFER PROTECTION SECTION
By U.S. Postal Service:
1636 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1636
TELEPHONE NUMBER: [phone]
FORM: WWR 09-06 Page 2
By CouriedSyecial Delivery:
2728 CAPITAL BOULEVARD
RALEIGH, NORTH CAROLINA 27604
FAX NUMBER: [phone]

OPERATION AND MAINTENANCE AGREEMENT
SINGLE FAMILY RESIDENCE SURFACE IRRIGATION SYSTEM
DIVISION OF WATER QUALITY
Property Owner(s) (as appearing on the property deed):
Mailing Address:
Facility Address (if different than above):
Disposal Method: ❑ SPRAY IRRIGATION a DRIP IRRIGATION (Check One)
County, Permit No.
I/We agree to operate and maintain the wastewater treatment system as follows:
1. 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 septic tank shall be checked annually and pumped out as needed. The effluent filter shall be
checked and cleaned at the same frequency of the septic tank.
b. The sand filter surface shall be raked and leveled every six (6) months and any vegetative growth
shall be removed by hand [accessible sand filters only].
c. Check one:
J The tablet chlorinator shall be checked every week. Tablets shall be added so as to provide
proper chlorination.
❑ The ultraviolet disinfection unit shall be checked every week. The lamp shall be cleaned
and/or replaced to ensure proper disinfection.
The storage, pump, and alarm systems shall be inspected monthly. The scum layer shall be
removed at the same time interval as the septic tank is pumped out.
e. The irrigation system shall be inspected monthly to make certain of proper operation, that
vegetative growth does not interfere with the system inspection or operation, that the soil is
assimilating the disposed treated wastewater with no surface runoff, and that no objectionable
odors are being generated.
2. Failure of the Permittee to properly operate this system is subject to a penalty up to $25,000 per day.
3. Failure to meet the permit conditions or violation of the State's surface or groundwater regulations
will require evacuating the dwelling and may void the permit.
NOTE: All persons (owners) appearing on the legally registered property deed must sign this O&M
Agreement
UWe understand the above requirements and agree to these terms as part of the issued permit.
Owner(s) Signature(s):
Owner(s) Signature(s):
SFR O&M (version 07/07)
Date:
Date:

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
PERMIT NAME/OWNERSHIP CHANGE FORM
Any changes made to this form will result in the application being returned.
(THIS FORM MAY RE PHOTOCOPIED FOR USE AS AN ORIGINAL)
For more information, visit our web site at, http://h2o.enr.state.nc.us/Iav-/main,html
I. REQ D rMM5
1, Submit one original of the completed and appropriately executed Permit Name/Ownership Change Form.
For a change of ownership, the certification must be signed by both the current permit holder and the new
applicant. For a name change only, the certification must be signed by the applicant,
2. Provide legal documentation of the transfer of ownership (such as a contract, d. -ed, article of incorporation,
etc,) for ownership changes.
3. Change of Ownership Applications for Homeowners Associations (HOAs) shall include the HOAs bylaws,
covenants, etc. [15A 2T .0115(c)]
4. Submit a properly executed Operation and Maintenance Agreement for all Single Family Residence Surface
Irrigation permits requesting a change of ownership.
n- CURRENT PERMIT INFORMATION
1. Permit number:
2. Permit holder's name:
3. Permit's signing official's name and title:
(Person legally responsible for permit)
(title)
4. Mailing address:
City,
Telephone number: ( )
State: Zip:
III, NEW OWNER/NAME INFORMATION
1. This request for a permit change is a result of:
a. Change in ownership of property/company
b. Name change only
c. Other (please explain):
2. New owner's name (name to be used in permit):
Facsimile number: (-)
FORM: PNOCF 09-06 Page 1 of 2

3. New owner's or signing official's name and title:
4, Mailing address:
City:
Telephone number: ( )
IV. CERTIFICATION
1. Current Pertnittee's Certification:
(Person legally responsible for permit)
(title)
S tate: Zip:
Facsimile number: ( )
1, , attest that this application for natnelownership change has been
reviewr:d and is accurate: and complete to the best of my knowledge. 1 understand that if all requirea parts, of
this application are not completcd and that if all required supporting information and attachments are not
included, this application package will be returned as incomplete. I understand I will continue to be
responsible for compliance with the current permit until a new permit is issued,
Signature: Date:
2, Applicant's Certification:
I, , attest that this application for name/ownership change has been
reviewed and is accurate and complete to the best of my knowledge, I understand that if all required parts of
this application are not completed and that if all required supporting information and attachments are not
included, this application package will be returned as incomplete. . I further certify that the applicant or any
affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility without
proper closure, does not have an outstanding civil penalty where all appeals have been exhausted or
abandoned, are compliant with any active oompliance. schedule, and do not have any overdue annual fees
under Rule 2T .0105.
Signature: Date:
THE COMPLETED APPLICATION PACKAGE.'INCLUDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTMENT OF EN WRONII.IENT AND NATURAL RESOURCES
DIVISION OIi' WATER QUALITY
AQUIFER PROTECTION SECTION
LAND APPLICATION UNIT
Via U.S. Postal Service
1636 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1636
Via Courier !_Special Delivery:
2728 CAPITAL BOULEVARD
RALEIGH, NORTH CAROLINA 27604
TELEPHONE NUMBER: [phone]
FORM: PNOCF 09-06 Page 2 of 2.