HomeMy WebLinkAboutWQ0028693_Staff Report_20190531State of North Carolina
Department of Environmental Quality
Division of Water Resources
Water Quality Permitting
Regional Staff Report
FORM: APSRSR 04-10 Page 1 of 3
May 29, 2019
To: DWR Water Quality Permitting Section Central Office Application No.: WQ0028693
Attn: Ashley Kabat Regional Login No.:
From: Bev Price
Asheville Regional Office
I. GENERAL SITE VISIT INFORMATION
1. Was a site visit conducted? Yes or No
a. Date of site visit: August 10, 2017 & May 22, 2019
b. Site visit conducted by: August 10, 2017 – Bev Price & Mikal Willmer; May 22, 2019 – Bev Price
c. Inspection report attached? Yes or No
d. Person contacted: and their contact information: Eric Shoemaker (August 2017 Inspection) – no longer with
the facility. Bob Barr, RPB Systems (contract operations firm) – 828-251-1900 - (May 2019 Inspection).
e. Driving directions: From intersection of Hwy.64 & Hwy. 107 go north on Hwy.107 for approximately 1.5mi.
Turn left on Laurel Knob Rd. (SR1142). Turn left at entrance to Mountaintop, cross bridge to guard shack. Go
straight; turn right just past driving range, go approx. ¼ mi. and WWTP is on the left.
f.
II. PROPOSED FACILITIES FOR NEW AND MODIFICATION APPLICATIONS
1. Facility Classification: (Please attach completed rating sheet to be attached to issued permit)
2. Are the new treatment facilities adequate for the type of waste and disposal system? Yes or No
If no, explain:
3. Are site conditions (soils, depth to water table, etc) consistent with the submitted reports? Yes No N/A
If no, please explain:
4. Do the plans and site map represent the actual site (property lines, wells, etc.)? Yes No N/A
If no, please explain:
5. Is the proposed residuals management plan adequate? Yes No N/A
If no, please explain:
6. Are the proposed application rates (e.g., hydraulic, nutrient) acceptable? Yes No N/A
If no, please explain:
7. Are there any setback conflicts for proposed treatment, storage and disposal sites? Yes or No
If yes, attach a map showing conflict areas.
8. Is the proposed or existing groundwater monitoring program adequate? Yes No N/A
If no, explain and recommend any changes to the groundwater monitoring program:
9. For residuals, will seasonal or other restrictions be required? Yes No N/A
If yes, attach list of sites with restrictions (Certification B)
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
FORM: APSRSR 04-10 Page 2 of 3
III. EXISTING FACILITIES FOR MODIFICATION AND RENEWAL APPLICATIONS
1. Are there appropriately certified Operators in Charge (ORCs) for the facility? Yes No N/A
ORC: Mike Beck Certificate #:991669 SI & 7930 WW4
Backup ORC: Bob Barr Certificate #:24262 SI & 8928 WW3
2. Are the design, maintenance and operation of the treatment facilities adequate for the type of waste and disposal
system? Yes or No
If no, please explain:
3. Are the site conditions (e.g., soils, topography, depth to water table, etc) maintained appropriately and adequately
assimilating the waste? Yes or No
If no, please explain:
4. Has the site changed in any way that may affect the permit (e.g., drainage added, new wells inside the compliance
boundary, new development, etc.)? Yes or No
If yes, please explain: See additional regional staff comments and attached inspection reports.
5. Is the residuals management plan adequate? Yes or No
If no, please explain:
6. Are the existing application rates (e.g., hydraulic, nutrient) still acceptable? Yes or No
If no, please explain:
7. Is the existing groundwater monitoring program adequate? Yes No N/A
If no, explain and recommend any changes to the groundwater monitoring program:
8. Are there any setback conflicts for existing treatment, storage and disposal sites? Yes or No
If yes, attach a map showing conflict areas. See additional regional staff comments & attached inspection reports.
9. Is the description of the facilities as written in the existing permit correct? Yes or No
If no, please explain:
10. Were monitoring wells properly constructed and located? Yes No N/A
If no, please explain:
11. Are the monitoring well coordinates correct in BIMS? Yes No N/A
If no, please complete the following (expand table if necessary):
Monitoring Well Latitude Longitude
○ ′ ″ - ○ ′ ″
○ ′ ″ - ○ ′ ″
○ ′ ″ - ○ ′ ″
○ ′ ″ - ○ ′ ″
○ ′ ″ - ○ ′ ″
12. Has a review of all self-monitoring data been conducted (e.g., NDMR, NDAR, GW)? Yes or No
Please summarize any findings resulting from this review: Groundwater monitoring violations are addressed
separately by Asheville Regional Office staff hydrogeologist.
13. Are there any permit changes needed in order to address ongoing BIMS violations? Yes or No
If yes, please explain:
14. Check all that apply:
No compliance issues Current enforcement action(s) Currently under JOC
Notice(s) of violation Currently under SOC Currently under moratorium
Please explain and attach any documents that may help clarify answer/comments (i.e., NOV, NOD, etc.) See
additional regional staff comments & attached inspection reports.
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
FORM: APSRSR 04-10 Page 3 of 3
15. Have all compliance dates/conditions in the existing permit been satisfied? Yes No N/A
If no, please explain:
Are there any issues related to compliance/enforcement that should be resolved before issuing this permit?
Yes No N/A
If yes, please explain: See additional regional staff comments & attached inspection reports.
IV. REGIONAL OFFICE RECOMMENDATIONS
1. Do you foresee any problems with issuance/renewal of this permit? Yes or No
If yes, please explain:
2. List any items that you would like APS Central Office to obtain through an additional information request:
Item Reason
Minor modification to
establish a new compliance
boundary and to show
reduced acreage associated
with moving/shutting off
sprayheads within 100 ft.
radius of WSW#6.
This was required as a response to the Notice of Violation (NOV-
2017-SP-0013). The updated map including the change in compliance
boundary, and the long term agreement between the Permittee and
Mountaintop Golf & Lake Club to ensure disposal and accessibility to
irrigation areas located within the golf club was submitted. See
additional regional staff comments & attached inspection reports.
3. List specific permit conditions recommended to be removed from the permit when issued:
Condition Reason
4. List specific special conditions or compliance schedules recommended to be included in the permit when issued:
Condition Reason
5. Recommendation: Hold, pending receipt and review of additional information by regional office
Hold, pending review of draft permit by regional office
Issue upon receipt of needed additional information
Issue
Deny (Please state reasons: )
6. Signature of report preparer:
Signature of APS regional supervisor:
Date:
V. ADDITIONAL REGIONAL STAFF REVIEW ITEMS
The map submitted with the renewal reflects the proposed new compliance boundary (at waste boundary), location of
the new monitoring well (MW-1B) and water supply wells (WSW) #1, #2, #3 and #6. The new compliance boundary
should be reviewed as the current depiction leaves the permitted monitoring wells at the property line. WSW’s are
depicted outside the compliance boundary on the updated map. The WSW #6 is less than 100 feet from the waste
boundary. The proposed new compliance boundary was in response to the last compliance inspection – the associated
Inspection Report & Notice of Violation are attached. A minor permit modification was to be submitted showing
reduced acreage associated with moving/shutting off spray heads and to establish a new CB closer to the waste
boundary.
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
5/31/2019
May 31, 2019
Rob Duckett
Mountaintop Community Association Inc
34 High Mountain Dr #4
Cashiers, NC 28717
SUBJECT: Compliance Inspection Report
Mountaintop Golf & Lake Club WWTF
Non-discharge Permit No. WQ0028693
Jackson County
Dear Permittee:
The North Carolina Division of Water Resources conducted an inspection of the Mountaintop Golf & Lake
Club WWTF on 5/22/2019. This inspection was conducted to verify that the facility is operating in
compliance with the conditions and limitations specified in Non-discharge Permit No. WQ0028693. The
findings and comments noted during this inspection are provided in the enclosed copy of the inspection
report entitled "Compliance Inspection Report".
There were no significant issues or findings noted during the inspection and therefore, a response to this
inspection report is not required. However, you will be required to address any additional information requests
associated with the current permit renewal. You will be notified by the Non-Discharge permitting section if
additional information is needed.
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
If you should have any questions, please do not hesitate to contact me at 828-296-4500 or via email at
bev.price@ncdenr.gov.
Sincerely,
Beverly Price, Environmental Specialist II
Water Quality Regional Operations Section
Asheville Regional Office
Division of Water Resources, NCDEQ
ATTACHMENTS: Inspection Report
Ec: Bob Barr, RPB Systems
WQS ARO Server
LF
G:\WR\WQ\Jackson\Wastewater\Non-discharge\MountainTop Reuse\Inspections\May 22, 2019\20190530_WQ0028693_CEI
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
Compliance Inspection Report
Permit:WQ0028693 Effective:09/26/14 Expiration:08/31/19 Owner :Mountaintop Community Association Inc
SOC:
Contact Person:
Region:
County:
Directions to Facility:
Jackson
Asheville
Rob Duckett
Effective:Expiration:Facility:Mountaintop Golf & Lake Club WWTF
Laurel Knob Rd
Cashiers NC 28717
Title:Phone:828-743-4755General Manager
From intersection of Hwy. 64 & Hwy. 107 in Cashiers go North on Hwy. 107 for approx. 1.5 mi. Left onto Laurel Knob Rd.(SR 1142,
gravel). Left at entrance to MontainTop, cross bridge to guard shack. Go straight, turn right at driving range, wwtp on left
Robert P Barr 24262 828-251-1900
Secondary ORC(s):
828-545-7724Phone:991669Certification:Michael Dwayne BeckPrimary ORC:
SI,WW2,System Classifications:
24 hour contact name Bob Barr 828-251-1900
On-site representative Michael Dwayne Beck 828-545-7724
On-Site Representative(s):
Related Permits:
Secondary Inspector(s):
Primary Inspector:
Inspection Date:Exit Time:Entry Time:
Phone:
05/22/2019 09:15AM 11:45AM
Beverly Price 828-296-4500
Facility Status:
Permit Inspection Type:
Reason for Inspection:Inspection Type:
Not CompliantCompliant
Routine
Reclaimed Water
Compliance Evaluation
Question Areas:
Treatment Flow Measurement-Effluent Treatment Flow Measurement-Influent Miscellaneous Questions
Treatment Flow Measurement-Water
Use Records
Treatment Barscreen Treatment Filters
Record Keeping Treatment Activated Sludge Treatment Sludge Storage/Treatment
Treatment Influent Pump Station Treatment Clarifiers Treatment Disinfection
Treatment Flow Measurement Storage End Use-Reuse
Standby Power Wells
(See attachment summary)
Page 1 of 9
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
Inspection Date:
Permit:
Inspection Type :
Owner - Facility:
Reason for Visit:
WQ0028693
05/22/2019 Compliance Evaluation
Mountaintop Community Association Inc
Routine
Inspection Summary:
The inspection was conducted by Beverly Price of the Asheville Regional Office. Mr. Mike Beck and Mr. Keith Buchanan
with RPB Systems were present and assisted with the inspection.
The permit expires 8/31/19 and is in renewal.
Irrigation was not occurring at the time of inspection.
An updated site map showing the location of Monitoring Well (MW-1B) which replaced the old MW-3, location of Water
Supply Wells (#1, #2, #3 & #6 - new well) and a proposed new Compliance Boundary (CB) was submitted by the permittee
because of the last compliance inspection conducted August 8, 2017. A minor permit modification was to have been
submitted for the change in the CB. The new map and CB are being reviewed by central & regional office staff as part of the
permit renewal. Additional information (regarding the change) may be requested during the renewal.
The facility appears to be well maintained and operated. The following minor issues were noted during the inspection:
1.Some solids were observed in the left side of the weir trough. The trough should be cleaned.
2.Safety grates are showing some rust. This was noted during the last inspection. The grates appear to be solid but should
be monitored as this could become a safety issue.
3.The visual alarm in the tertiary filter tank was not working. This was noted during the last inspection; however, the ORC
indicated the light had been replaced. The alarm should be checked more frequently.
Page 2 of 9
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
Inspection Date:
Permit:
Inspection Type :
Owner - Facility:
Reason for Visit:
WQ0028693
05/22/2019 Compliance Evaluation
Mountaintop Community Association Inc
Routine
Type Yes No NA NE
Single Family Drip
Infiltration System
Lagoon Spray, LR
Single Family Spray, LR
Activated Sludge Spray, LR
Activated Sludge Spray, HR
Activated Sludge Drip, LR
Recycle/Reuse
Reuse (Quality)
Treatment Influent Pump Station Yes No NA NE
Is the pump station free of bypass lines or structures?
Is the general housekeeping acceptable?
Are all pumps present?
Are all pumps operable?
Are floats/controls operable?
Are audio and visual alarms available?
Are audio and visual alarms operational?
# Are SCADA/Telemetry alarms required?
Are SCADA/Telemetry available?
Are SCADA/Telemetry operational?
Lift Station (LS) #9. The ORC reports that this LS typically has the most problems. It receives
flow from the clubhouse and restaurant. This LS is pumped as necessary and was pumped
during the summer 2018 per the ORC. The wet well did not have an excessive amount of
grease. Pump run times are documented. The LS has a backup generator (Kohler).
Comment:
Treatment Flow Measurement-Influent Yes No NA NE
Is flowmeter calibrated annually?
Is flowmeter operating properly?
Does flowmeter monitor continuously?
Does flowmeter record flow?
Does flowmeter appear to monitor accurately?
Comment:
Treatment Flow Measurement-Water Use Records Yes No NA NE
Is water use metered?
Are the daily average values properly calculated?
Page 3 of 9
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
Inspection Date:
Permit:
Inspection Type :
Owner - Facility:
Reason for Visit:
WQ0028693
05/22/2019 Compliance Evaluation
Mountaintop Community Association Inc
Routine
Comment:
Treatment Flow Measurement-Effluent Yes No NA NE
Is flowmeter calibrated annually?
Is flowmeter operating properly?
Does flowmeter monitor continuously?
Does flowmeter record flow?
Does flowmeter appear to monitor accurately?
Calibration 3.27.19 by Mike Beck.Comment:
Standby Power Yes No NA NE
Is automatically activated standby power available?
Is generator tested weekly by interrupting primary power source?
Is generator operable?
Does generator have adequate fuel?
Generators are serviced by Carolina Energy Systems.Comment:
Treatment Barscreen Yes No NA NE
Is it free of excessive debris?
Is disposal of screenings in compliance?
Are the bars spaced properly?
Is the unit in good condition?
The bar screen contained a lot of wipes.Comment:
Treatment Activated Sludge Yes No NA NE
Is the aeration mechanism operable?
Is the aeration basin thoroughly mixed?
Is the aeration equipment easily accessed?
Is Dissolved Oxygen adequate?
Are Settleometer results acceptable?
Is activated sludge an acceptable color?
D.O. was measured using the ORC's meter: 2.42 mg/l at 20.6 deg C
Settleometer result: 190ml. The MLSS appeared to be "thin"; the ORC reports that he likes to
have approximately 200-300ml/l solids.
Comment:
Treatment Clarifiers Yes No NA NE
Are the weirs level?
Are the weirs free of solids and algae?
Is the scum removal system operational?
Is the scum removal system accessible?
Page 4 of 9
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
Inspection Date:
Permit:
Inspection Type :
Owner - Facility:
Reason for Visit:
WQ0028693
05/22/2019 Compliance Evaluation
Mountaintop Community Association Inc
Routine
Is the sludge blanket at an acceptable level?
Is the effluent from the clarifier free of excessive solids?
Solids buildup was observed in the left corner of the weir trough and some floating sludge in the
clarifier. The weir trough should be cleaned.
Comment:
Treatment Filters Yes No NA NE
Is the filter media present?
Is the filter media the correct size and type?
Is the air scour operational?
Is the scouring acceptable?
Is the clear well free of excessive solids?
Is the mud well free of excessive solids and filter media?
Does backwashing frequency appear adequate?
Media is anthracite/sand/gravel; backwash is based on flow (float controlled).
The visual alarm was not working. This was noted in the last inspection; ORC reports the bulb
was changed.
Comment:
Treatment Sludge Storage/Treatment Yes No NA NE
Is the aeration operational?
Is the aeration pattern even?
If required, are Sanitary "Ts" present in tankage?
Sludge is hauled by B&B Septic. The ORC reports that sludge was hauled approximately 2
years ago.
Sludge hauling should be documented.
Comment:
Treatment Disinfection Yes No NA NE
Is the system working?
Do the fecal coliform results indicate proper disinfection?
Is there adequate detention time (>=30 minutes)?
Is the system properly maintained?
If gas, does the cylinder storage appear safe?
Is the fan in the chlorine feed room and storage area operable?
Is the chlorinator accessible?
If tablets, are tablets present?
Are the tablets the proper size and type?
Is contact chamber free of sludge, solids, and growth?
If UV, are extra UV bulbs available?
If UV, is the UV intensity adequate?
# Is it a dual feed system?
Does the Stationary Source have more than 2500 lbs of Chlorine (CAS No. 7782-50-5)?
Page 5 of 9
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
Inspection Date:
Permit:
Inspection Type :
Owner - Facility:
Reason for Visit:
WQ0028693
05/22/2019 Compliance Evaluation
Mountaintop Community Association Inc
Routine
If yes, then is there a Risk Management Plan on site?
If yes, then what is the EPA twelve digit ID Number? (1000-____-____)
If yes, then when was the RMP last updated?
6 tubes are available; all are in use.Comment:
Record Keeping Yes No NA NE
Is a copy of current permit available?
Are monitoring reports present: NDMR?
NDAR?
Are flow rates less than of permitted flow?
Are flow rates less than of permitted flow?
Are application rates adhered to?
Is GW monitoring being conducted, if required (GW-59s submitted)?
Are all samples analyzed for all required parameters?
Are there any 2L GW quality violations?
Is GW-59A certification form completed for facility?
Is effluent sampled for same parameters as GW?
Do effluent concentrations exceed GW standards?
Are annual soil reports available?
# Are PAN records required?
# Did last soil report indicate a need for lime?
If so, has it been applied?
Are operational logs present?
Are lab sheets available for review?
Do lab sheets support data reported on NDMR?
Do lab sheets support data reported on GW-59s?
Are Operational and Maintenance records present?
Were Operational and Maintenance records complete?
Has permittee been free of public complaints in last 12 months?
Is a copy of the SOC readily available?
No treatment units bypassed since last inspection?
Groundwater monitoring includes: Fecal Coliform bacteria, TOC, Ammonia Nitrogen, TP, VOC,
TDS, Nitrate & Chloride.
Reviewed March 2019 NDMR for parameters that would exceed 2L Groundwater Standards:
Ammonia Nitrogen reported at 1.6 mg/L. 2L Std=1.5 mg/L
Comment:
End Use-Reuse Yes No NA NE
Is the acreage in the permit being utilized?
Does the acreage specified in the permit correspond to the measured acreage at the site?
Page 6 of 9
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
Inspection Date:
Permit:
Inspection Type :
Owner - Facility:
Reason for Visit:
WQ0028693
05/22/2019 Compliance Evaluation
Mountaintop Community Association Inc
Routine
Are all essential units provided in duplicate?
Is an automatically activated standby power source available?
Is the equalization capacity adequate?
Is aerated flow equalization present?
Has the turbidity meter been calibrated in the last 12 months?
Does the turbidity meter have recording capabilities?
Is all flow diverted at the appropriate times?
Is all upset wastewater diverted from reuse storage unit?
Is all upset wastewater treated, retreated, or disposed of acceptably?
Is upset wastewater treated prior to discharge to irrigation storage?
Is public access restricted from irrigation area during active site use?
If golf course, is a sign posted in plain sight on the club house?
Is the cover crop acceptable?
Are buffers adequate?
Is the site free of ponding/runoff?
Is the acreage in the permit being utilized?
Is the application equipment acceptable?
Is the application area free of limiting slopes?
How close is the closest water supply well?
Are any supply wells within the CB?
Are any supply wells within 250' of the CB?
Is municipal water available in the area?
Are GW monitoring wells required?
Are GW monitoring wells located properly w/ respect to RB and CB?
Are GW monitoring wells properly constructed, including screened interval?
Irrigation zones currently in use: 29/30/31/32. Irrigation was not occurring at the time of
inspection.
Turbidity meter calibration:3/29/19
Effluent not meeting the turbidity limit of 10 NTU's is automatically diverted to the 5-day upset
tank. Effluent not meeting the fecal coliform limit would go to the irrigation tank unless the
turbidity limit is also exceeded.
Public access to the site is not restricted as this is a golf course; however, irrigation is usually
done at night or early morning when golfing is not occurring.
Water Supply Wells (WSW) #1, #2 & #3 appear to be outside of the Compliance Boundary (CB)
based on the new map submitted with the permit renewal package. WSW #6 does not have the
required 100- ft. setback from the waste boundary. The well is approximately 60 ft. from the
waste boundary. A new CB has been established according to the new map. Any new CB will
require a minor permit modificaiton.
Comment:
5-DAY UPSET TANK - Adjacent to the WWTP
Storage Yes No NA NE
Page 7 of 9
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
Inspection Date:
Permit:
Inspection Type :
Owner - Facility:
Reason for Visit:
WQ0028693
05/22/2019 Compliance Evaluation
Mountaintop Community Association Inc
Routine
Storage Type?Aboveground
storage tank
Storage amount?300000
Gallons
# At what point is side-stream wastewater returned to treatment?The ORC would
determine when
the WWTP can
handle additional
flow.
Is there a Spill Control Plan?
Aerated or Mixed?NONE
If aeration is present, is it adequate?
If present, are diffusers cleaned regularly?
Is influent structure acceptable?
Are banks/berms free of seepage and erosion?
Are banks/berms free of excessive vegetation?
Is pond lined?
Liner Type
Is liner acceptable?
Are baffles/curtains acceptable?
Does the pond have a freeboard marker?
Required freeboard?2
Feet
Actual freeboard?20
Feet
Is there suitable grassed vegetation?
Is the vegetation maintained?
Is the area free of excessive weeds and/or woody species?
Is the area free from signs of overflow?
Is color acceptable?
Are floating mats acceptable?
No excessive buildup of solids?
Are aerators/mixers acceptable?
Is effluent structure acceptable?
If present, is pond cover acceptable?
Floating mats would only be acceptable if it did not cause problems when side-stream water is
returned to the WWTP for retreatment.
Comment:
WET WEATHER STORAGE - Adjacent to the WWTP
Storage Yes No NA NE
Page 8 of 9
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
Inspection Date:
Permit:
Inspection Type :
Owner - Facility:
Reason for Visit:
WQ0028693
05/22/2019 Compliance Evaluation
Mountaintop Community Association Inc
Routine
Storage Type?Aboveground
storage tank
Storage amount?1267000
Gallons
# At what point is side-stream wastewater returned to treatment?
Is there a Spill Control Plan?
Aerated or Mixed?NONE
If aeration is present, is it adequate?
If present, are diffusers cleaned regularly?
Is influent structure acceptable?
Are banks/berms free of seepage and erosion?
Are banks/berms free of excessive vegetation?
Is pond lined?
Liner Type
Is liner acceptable?
Are baffles/curtains acceptable?
Does the pond have a freeboard marker?
Required freeboard?2
Feet
Actual freeboard?16
Feet
Is there suitable grassed vegetation?
Is the vegetation maintained?
Is the area free of excessive weeds and/or woody species?
Is the area free from signs of overflow?
Is color acceptable?
Are floating mats acceptable?
No excessive buildup of solids?
Are aerators/mixers acceptable?
Is effluent structure acceptable?
If present, is pond cover acceptable?
Floating mats/vegetation would only be acceptable if it does not cause clogging of the irrigation
heads.
Comment:
Page 9 of 9
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
Certificate Of Completion
Envelope Id: 60E4346B7CED460BAF805BCE59EF3952 Status: Completed
Subject: Please DocuSign: 20190531_WQ0028693_CEI.docx, 20190531_WQ0028693_CEI_INSP Draft.pdf
Source Envelope:
Document Pages: 11 Signatures: 1 Envelope Originator:
Certificate Pages: 1 Initials: 1 Beverly Price
AutoNav: Disabled
EnvelopeId Stamping: Disabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
217 W. Jones Street
Raleigh, NC 27699
Bev.Price@ncdenr.gov
IP Address: 149.168.204.10
Record Tracking
Status: Original
5/31/2019 8:45:19 AM
Holder: Beverly Price
Bev.Price@ncdenr.gov
Location: DocuSign
Signer Events Signature Timestamp
Beverly Price
bev.price@ncdenr.gov
North Carolina Department of Environmental Quality
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 149.168.204.10
Sent: 5/31/2019 8:45:40 AM
Viewed: 5/31/2019 8:45:45 AM
Signed: 5/31/2019 8:46:21 AM
Freeform Signing
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 5/31/2019 8:45:40 AM
Certified Delivered Security Checked 5/31/2019 8:45:45 AM
Signing Complete Security Checked 5/31/2019 8:46:21 AM
Completed Security Checked 5/31/2019 8:46:21 AM
Payment Events Status Timestamps
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
DocuSign Envelope ID: 849E387B-3487-4662-94D3-343645F33491
Certificate Of Completion
Envelope Id: 849E387B3487466294D3343645F33491 Status: Completed
Subject: Please DocuSign: 20190529_WQ0028693_STFRPT.docx, WQROSNDARR 4.29.2019.pdf, 05312019_WQ0028693_C...
Source Envelope:
Document Pages: 28 Signatures: 2 Envelope Originator:
Certificate Pages: 2 Initials: 0 Beverly Price
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
217 W. Jones Street
Raleigh, NC 27699
Bev.Price@ncdenr.gov
IP Address: 149.168.204.10
Record Tracking
Status: Original
5/31/2019 8:51:53 AM
Holder: Beverly Price
Bev.Price@ncdenr.gov
Location: DocuSign
Signer Events Signature Timestamp
Beverly Price
bev.price@ncdenr.gov
North Carolina Department of Environmental Quality
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 149.168.204.10
Sent: 5/31/2019 8:56:00 AM
Viewed: 5/31/2019 8:56:10 AM
Signed: 5/31/2019 8:56:58 AM
Freeform Signing
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
G. Landon Davidson
landon.davidson@ncdenr.gov
Asheville Regional Office, Regional Supervisor
DEQ, Division of Water Resources, Water Quality
Regional Operatoins
Security Level: Email, Account Authentication
(None)
Signature Adoption: Uploaded Signature Image
Using IP Address: 149.168.204.10
Sent: 5/31/2019 8:56:59 AM
Viewed: 5/31/2019 8:57:20 AM
Signed: 5/31/2019 8:57:38 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 5/31/2019 8:56:59 AM
Certified Delivered Security Checked 5/31/2019 8:57:20 AM
Signing Complete Security Checked 5/31/2019 8:57:38 AM
Envelope Summary Events Status Timestamps
Completed Security Checked 5/31/2019 8:57:38 AM
Payment Events Status Timestamps