279 Serenity Hills Trail Lot 4State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
Mr. Gerald Chrisco
2611 Burke Farm Road
Clemmons, North Carolina 27012
Dear Mr. Chrisco:
April 17,1998
TI.N?FA
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APR 2 41998
Permit Issuance
Authorization to Construct
General Permit NCG550000
Cert. of Coverage NCG550961
Chrisco Residence
Davie County
In accordance with your application for an NPDES discharge permit received March 9, 1998 by the
Division, we are herewith forwarding the subject Certificate of Coverage under the state-NPDES general
pern-iit for Gerald Le Ann Chrisco. Authorization is hereby granted for the construction of a 480 GPD
wastewater treatment system consisting of a 1000 gallon septic tank, primary distribution box, 420 square
foot (6'X 70') primary sandfilter, with a loading rate of not more than 1. 15 GPD/square foot for each
filter, secondary distribution box, 2 10 square foot (6'X 35') secondary sandfilter with a loading rate of not
more than 2.30 GPD/square foot, chlorination unit, chlorine contact chamber and rip rap aeration with a
discharge of treated wastewater into the Yadkin River classified WS -IV waters in the Yadkin River Basin.
Upper level infiltration lines in both the primary and secondary filters must be capped or plugged at the
end. We recommend the adjustable cap type for all distribution boxes and all elbow piping must be of the
long sweeping type. This system must be at least 10 feet from the dwelling, 10 feet from property lines
and at least 100 feet from water supply wells on and off the site. The system must also be constructed and
located above a 100 year flood. This Certificate of Coverage is issued pursuant to the requirements of
North Carolina and the U.S Environmental Protection Agency Memorandum of Agreement dated
December 6, 1983 and as subsequently amended.
If any parts, measurement frequencies or sampling requirements contained in this general permit
are unacceptable to you, you have the right to submit an individual permit application and letter requesting
coverage under an individual permit. Unless such demand is made, this decision shall be final and
binding. Please take notice this Certificate of Coverage is not transferable except after notice to the
Division of Water Quality. Part II, EA. addresses the requirements to be followed in case of change of
ownership or control of this discharge.
This Certificate of Coverage shall be subject to revocation unless the wastewater treatment facilities
are constructed in accordance with the conditions and limitations specified in Perrriit No. NCG550000.
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.
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone 919-733-7015 FAX 919-733-0719
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper
Mir. Gerald Chrisco
NCG550961
April 17, 1998
The Winston-Salem Regional Office, telephone number 919/771-4600, 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.
Upon completion of construction and prior to operation of this permitted facility, a certification
must be received certifying that the perinitted facility has been installed in accordance with the NPDES
Permit, the Certificate of Coverage, this Authorization to Construct and the approved plans and
specifications. Mail the Certification to the Stormwater and General Permits Unit, P.O. Box 29535,
Raleigh, NC 27626-0535.
A copy of the approved plans and specifications shall be maintained on file by the Permittee for the
life of the facility.
The sand media of the sandfilters must comply with the Division's sand specifications. The
engineer's certification -will be evidence that this certification has been met.
A leakage test shall be performed on the septic tank and dosing tank to insure that any exfiltration
occurs at a rate which does not exceed twenty (20) gallons per twenty-four (24) hour per 1,000 gallons of
tank capacity. The engineer's certification will serve as proof of compliance with this condition.
Failure to abide by the requirements contained in this Authorization to Construct may subject the
Permittee to an enforcement action by the Division of Water Quality in accordance with North Carolina
General Statute 143-215.6A to 143-215.6C.
The issuance of this permit does not preclude the Permittee from complying with any and all
statutes, rules, regulations, or ordinances which may be required by the Division of Water Quality or
permitsrequired by the Division of Land Resources, the Coastal Area Management Act or any Federal,
Local or other governmental permit that may be required.
If you have any questions or need additional information, please contact Mack Wiggins, telephone
numbergign33-5083, extension 542.
Sincerely,
ORIGINAL SIGNED BY
BRADLEY BENNETT
A. Preston Howard, Jr., P.E.
cc: Central Files
Winston-Salem Regional Office, Water Quality
Point Source Compliance Enforcement Unit
Stormwater and General Permits Unit
Davie County Health Dept.
Mr: Gerald Chri9co
NCG550961
April- 17, 1998
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,
Project Name Location
for the
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
Date
Registration No.
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
CERTIFICATE OF COVERAGE
GENERAL PERMIT NO. NCG550961
TO DISCHARGE DOMESTIC WASTEWATERS FROM SINGLE FAMILY RESIDENCES AND OTHER
DISCHARGES WITH SIN111LAR 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,
Gerald Chrisco
is hereby authorized to operate a wastewater treatment facility that consists of a septic tank, distribution box,
primary sandfilter, distribution box, secondary sandfilter, chlorinator, chlorine contact chamber, discharge pipe and
associated appurtenances with the discharge of treated wastewater from a facility Iodated at the
Chrisco Residence
Lot #4, River Bend Hills
northwest of Hillsdale
Davie County
to. receiving waters designated as the Yadkin River in the Yadkin River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, H, III
and IV hereof
This certificate of coverage shall become effective April 17, 1998
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day April 17, 1998
ORIGINAL SIGNED BY
BRADLEY BENNETT
A. Preston Howard, Jr., P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
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ROAD CLASSIFICATION SCALE 1:24,000 1 MILE
PRIMARY HIGHWAY LIGHT-DUTY ROAD. HARD OR 0 �:ZEEEEEB,
HARD SURFACE IIINNN� IMPROVED SURFACE 0 7000 FEET
SECONDARY HIGHWAY UNIMPROVED ROAD 7=.
HARD SURFACE 0
Latitude:_aE�� Longitude: A002R'P7" CONTOUR INTERVAL 10 FEET
Map # C17SW Sub -basin 03-37-02
Stream Class QUAD LOCATION Gerald Chrisco Residence
Discharge Class 04
Davie County
Receiving Stream Yadkin River NCG550961
Qw: 4QQ_Q_PP_ Permit exp. 07/31/02
.16 . 0
CC: Permits and Engineering
Technical Support Branch
County Health Dept.
Central Files
WSRO
SOC PRIORITY PROJECT: Yes No
If Yes, SOC No.
To: Permits and Engineering Unit
Water Quality Section
Attention: Mack Wiggins
Date: A-Pril 7, 1998
NPDES STAFF REPORT AND RECOMMENDATION
County Davie
Permit No. NCG550961
PART I - GENERAL INFORMATION
1. Facility and Address: Gerald Chrisco S.F.R.
Current Mailing Address: 2G11 Burke Farm Road
Clemmons, N.C. 27012
Phone: (336) 766-7859
2. Date of Investigation: April 3, 1998
3. Report Prepafed by: Abner Braddy
4. Persons Contacted and Telephone Number: Craig Carter,
Contractor (33G) - 940-2341
5. Directions to Site: From Winston-Salem, travel 1-40 west
into Davie County; take the Hwy. 801 north exit from 1-40;
turn right onto Hwy. 801 north, and travel approximately 0.1
mile to S.R. 1452 (Yadkin Valley Road); turn right onto S.R.
1452, and travel approximately 3.0 miles to S.R. 1459; turn
right onto S.R. 14S9 and travel to the entrance of the River
Bend development (brick and steel gate on the left); turn
left into the development, and travel approximately 0.2
miles; the Chrisco residence is to be built on Lot #4, which
sits atop the knoll, on the left side of the private street.
6. Discharge Points(s), List for all discharge points:
Latitude: 360 031 1111 Longitude: 800 281 271,
U.S.G.S. Quad No. C17SW U.S.G.S. Quad Name Clemmons
7. Site size and expansion area consistent with application?
Yes No If No, explain: The site is 7.8 acres in size.
There is ample room for installation of the system.
8. Topography (relationship to flood plain included): The
lower portion of the tract on the west side, is in the flood
plain'of the Yadkin River.
9. Location of nearest dwelling: >1000.1
10. Receiving stream or affected surface waters: Yadkin River
a. Classification WS IV Note: The Regional Water Quality
Supervisor has discussed the proposed discharge with
the regional Public Water Supply supervisor, and they
have no objection this discharge
b. River Basin and Subbasin No.: 03-07-02
C. Describe receiving stream features and pertinent
downstream uses: The Yadkin River is the area's
largest watercourse. Its uses are varied. Its 11WS11
classification at this point is due to a water supply
intake for the City of Winston-Salem located
approximately 7-8 miles downstream on the Yadkin, at
the mouth of Carters Creek.
Part 11 - DESCRIPTION OF DISCHARGE AND TREATMENT WORKS
a. Volume of Wastewater to be permitted: 480 g.p.d.
(Ultimate Design Capacity)
b. What is the current permitted capacity of the Waste
Water Treatment facility? N.A.
C. Actual treatment capacity of the current facility
(currene, design capacity)? None
d. Date(s) and construction activities allowed by previous
Authorizations to Construct issued in the previous two
years. None.
e. Please provide a description of existing or
substantially constructed wastewater treatment
facilities; None.
f. Please provide a description of proposed wastewater
treatment facilities. 1000 gallon septic tank,
distribution box, 6'X 701 subsurface primary
sandfilter, 6'X 35, subsurface secondary sandfilter,
distribution box, 240 gallon chlorine contact chamber,
and approximately 280' of outfall line.
9- Possible toxic impacts to surface waters: None
anticipated.
NPDES Permit Staff Report
Version 10/92
Page 2
h. Pretreatment Program (POTWs only): N.A.
in development approved
should be required not needed
2. Residuals handling and utilization/disposal scheme: To be
pumped by septage hauler.
a. If residuals are being -land applied, please specify DEM
Permit No.
Residuals Contractor
Telephone No.
b. Residuals stabilization: PSRP PFRP
Other
C. Landfill:
d. other disposal/utilization scheme (Specify):
3. Treatment plant classification (attach completed rating
sheet). I
4. SIC Code (s) : 49S2
Primary 04 Secondary
Main Treatment Unit Code: 4 6 0 7
PART III - OTHER PERTINENT INFORMATION
1. Is this facility being constructed with Construction Grant
Funds or are any public monies involved. (municipals only)?
N.A.
2. Special monitoring or limitations (including toxicity)
requests: None.
3. Important SOC, JOC or Compliance Schedule dates: (Please
indicate) N.A.
Date
Submission of Plans and Specifications
Begin Construction
Complete Construction
4. Alternative Analysis Evaluation: Has the facility evaluated
NPDES Permit Staff Report
Version 10/92
Page 3
all of the non -discharge options available. Please provide
regional perspective for each option evaluated.
Spray Irrigation: Soil, topography limitations.
Connection to Regional Sewer System: Not feasible at this
time.
Subsurface: Soil, topography limitations.
other disposal options: None apparent.
5. Other Special Items: None.
PART IV - EVALUATION AND RECOMMENDATIONS
The Region; recommlenthe permit be issued.
s7ign'atu're of report
Water Quality Regional Sup(elrvisor
Date
NPDES Permit Staff Report
Version 10/92
Page 4
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STATESVILLE IINTPRSTATE 77)25MI. 4955 It
blished by the Geological Survey SCALE
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APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMI -AT
Davie County Health Department
Environmental Health Section
P. 0. Box 848
Mocksville, NC 27028 DEC
(704) 634-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCEAED-UNLESS—_
ALL THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed !�kAllh- f*Y\. AAr- e S ContactPerson 17be-vito
HomePhone kto ltelr6 -2-1113
Mailing Address
City/State/Zip A';6'Je. n C_ r. ty 006 6 Business Phone 17' el 8. 4'
2. Name on Permit/ATC if Different than Above
Mailing Address
3. Application For:
4. System to Serve:
City/State/Zip
2— Site Evaluation El Improvement Permit & ATC
9'House C3 Mobile Home El Business 0 Industry
5. If Residence: # People
# Bedrooms
El Other
# Bathrooms
El Both
0 Dishwasher LJ Garbage Disposal Ll Washing Machine El Basement/Plumbing 0 Basement/No Plumbing
6. If Business/Other: Specify type # People # Sinks
R # Showers # Urinals # Water Coolers
If Foodservice: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: El County/City '5—Well
8. Do you anticipate additions or expansions of the facility this system is intended to serve?
Tf xxyhnt tunp'?
C] Community
Q Ye s C3 No
PROPERTY INFORMATION REQUIRED: IMPORTANT A PLAT OF THE PROPERTY MUST BE
ISUBMITTED WITH TJIS APPLICATION.
Property Dimensions: WRITE DIRECTIONS (from
Tax Office PIN: # to .3 t- Mocksville) TO PROPERTY-
Jk), )I Vallee
�5ere_nli�l M'//_-!� J rat (I
Property Address: Road Name
City/Zip va_ 1A 02
If in Subdivision provide information, as follows:
Name:
Section: Lot #:
rmit(s) issued hereafter
This is to certify that the information provided is correct to the best of my knowledge. I understand that any pe
are subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is
ent to
falsified or changed. 1, also, understand that I am responsible for all charges incurred from this application. I, hereby, give cons
the Au th . orized Representative of the Davie County Health Department to enter upon above described property located in Davie County
w� T) l- _r %'0 to conduct all testing procedures
and o ned by
as necessary to determine the site suitability.
DATE t I, I 1/ /6 (_ __ SIGNATURE
Revised DCHD (06-96)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION---/ LOT—Y
Soil/Site Evaluation A&
APPLICANT'S NAME /�Mw DATEEVALUATED /ju A?z
PROPOSED FACILITY PROPERTY SIZE 7
SUBDIVISION ROAD NAME
Water Supply: On -Site Well Community Public
Evaluation By: Auger Boring Pit tl__� - Cut
FACTORS
1
2
3 4 5 6 7
Landscape position
Z_
Ae
R
Slope %
_62
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON 11 DEPTH
Texture group
Consistence
Structure
"V
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: EVALUATION BY: &
LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT:
REMARKS:
V_
LEGEND
Landscape Position
R - Ridge S - Shoulder L - Linear slope FS - Foot slope N - Nose slope
CC - Concave slope CV - Convex slope T - Terrace FP - Flood plain H - Head slope
Texture
S - Sand LS - Loamy sand SL - Sandy loam L - Loam Sl - Silt
SICL - Silty clay loam SIL - Silty loam CL - Clay loam SCL - Sandy clay loam
SC - Sandy clay SIC - Silty clay C - Clay
CONSISTENCE
Moist
VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm
Wet
NS - Non sticky SS - Slightly sticky S - Sticky VS - Very Sticky
NP - Non plastic SP - Slightly plastic P - Plastic VP - Very plastic
I
Structure
SC - Single grain M - Massive CR - Crumb GR - Granular ABK - Angular blocky
SBK - Subangular blocky PL - Platy PR - Prismatic
7---,p V.,
Mineralogy
1: 1, 2: 1, Mixed
Notes
Horizon depth - In inches
Depth of fill - In inches
Restrictive horizon - Thickness and inches from land surface
Saprolite - S(suitable), U(unsuitable)
Soil wetness - Inches from land surface to free water or inches from land surface to soil colors with chroma 2 or less
Classification - S(suitable), PS(provisionally suitable), U(unsuitable)
LTAR - Long-term acceptance rate - gal/day/ft2
DCHD(Ol-90)
No
No
M
MEMEMME
MMEMEMN
mommoom
OMMMUM
MEME 0
MMEMEME
MMEMEMM
MEMMEME
MEMEMEM
EMEMMUM
MEEMMEM
EMEMEMN
MEMEMME
No
ONE
NEE
ENE
MEN
noun
EMME
EMMONS
OWMEMS MEMMME MENNEN MENNEN RIESIMME
0
APPLICATION FOR SITE EVALUATIONAMPROVEMENT P
Davie County Health Department
Environmental Health Section 2
P.O. Box 848
Mocksville, NC 27028
(704) 634-8760
****IMEPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed too' f t, 467,-' Z�(e r /Z!�!�o —
Contact Person -X"' /,.—
Mailing Address Home Phone
City/State/Zip Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: Site Evaluation r/1 improvement Permit & ATC Both
4. System to Serve: ouse Mobile Home Business Industry Other
5. �Iff Re �idde # People # Bedrooms # Bathrooms_ lj� Dishwashe:r �[�bage Disposal
s
ashing Machine_��asement/Plumbing Xasement/No Plumbing
6. If Business/Other: Specify type # People #Sinks # Commodes
# Showers # Urinals # Water Coolers
If Foodservice: # Seats Estimated W er Usage (gallons per day)
— _ XiW e, ,
7. Type of water supply: [ ] County/City Well [ ]Community
8. Do you anticipate additions or e?Lp sions of the facility this system is intended to serve? I
If yes, what type?
I Yes No
."3
EITHER A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED: IMPORTANT **VXFLIAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions WRITE DIRECTIO S (from M ville) TO PROPERTY.
#'o
Tax Office PIN:
Property Address: Road lame
City/Zip
If in Subdivision provide informati Ilows:
Name:
Section: Lot #: V
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter are
subject to suspension or revocation, if the site plans or intended use change, or if the information submit this application is falsified or
changed. I, also, understand that I am responsible for all charges incu this plic tio onsent to the Authorized
Representative of the Davie County Health Department t u 0 esc pr ty ated in Davie County and owned
by —t ct a tin roc s as n to determine the site suitability.
DATE SIGNATURE
Revised DCHD (06-96)
THIS AREA AIAY 13E USED FOR MAWINC7 YOUR SITE PLAN:
Davie County Health Department
andHome Health Agency
Environmenta[Heafth Section
P.0. Box 848 / 210 HospiTAL STREEr
COURIER #09-4-06
MOCKSVILLE. N.C. 27028
PHONE: (704) 634-8760
February 24, 1998
Craig Carter Builders
119 Highway 801 South
Advance, KC 27006
Re: Site Evaluation(s)
Riverbend Hills I/Lot 4
Tax PIN: #5863-56-5838
Dear Mr. Carter:
As requested through your application, Robert B. Hall, Jr., R.S.,
Environmental Health Specialist(s) with this office, visited the aforementioned
site on February 19, 1998. The purpose of said evaluation(s) was to determine
the soil/site suitability for the installation of an on-site sewage system.
Based on the size house proposed for lot 4 along with the added amenities
of a pool and gymnasium this lot is classified unsuitable for the installation
of a ground absorption sewage disposal system. The house would require at
least 800 linear feet of drainfield with 100% repair area. Due to the complex
topography and steep slope these requirements cannot be met. This lot is
classified unsuitable because of the reasons listed below:
Topography - Rule .1940 (c) Slopes greater than 65%
Shallow Soil - Rule .1943 (a) Soil depth less than 36"
Available Space for Installation and Repair
- Rule .1945 (a) Initial installation
(b) Repair area
Due to the limitation(s) on your site, this office is not aware of any
modifications or alternative measures that can be implemented at the present
time to upgrade the classification from *unsuitable' to 'provisionally
suitable." Your application for an Improvement Permit must, therefore, be
denied.
You have the right to an informal review of this decision by the
Environmental Health Director of this office and also by the regional staff of
the Department of Environment, Health, and Natural Resources. You should
contact this office to arrange for this further review.
0
Snige 2
Craig Carter Builders
February 24, 1998
You may also wish to obtain the services of a private consultant to
collect site-specific data and submit such data and a system design to this
office for technical review. A site may be reclassified to provisionally
suitable provided written documentation, including engineering, hydrogeologic,
geologic or soil studies indicates to this office that a proposed on-site
sewage system or a proposed alternative system can reasonably be expected to
function satisfactorily. The substantiating data from these studies must
indicate that:
A. The effluent (wastewater) will receive adequate treatment;
B. The effluent (wastewater) will not contaminate any ground water
or surface water; and
C. The effluent (wastewater) will not be exposed on the ground surface or
be discharged to surface waters where it could come into contact with
people, animals or vectors.
Finally, you have the right to a formal appeal of this decision if you
file a petition for a contested case hearing with the Office of Administrative
Hearings, P. 0. Drawer 27447, Raleigh, N.C. 27611-7447. A copy of a petition
form can be provided to you upon request. The petition must be received by the
Office of Administrative Hearings within thirty (30) days of the date of this
notice. The hearing may be held in Davie County.
If you file a petition for a hearing, you must send a copy of the petition
to Hr. Richard Whisnant, DEHNR, Office of General Council, P. 0. Box 27687,
Raleigh, N.C. 27611-7687.
Please call or write this office if
additional assistance. Telephone number:
Address:
RBH/wd
you have any questions or need any
704/634-8760
Davie County Health Department
Environmental Health Section
P. 0. Box 848
Mocksville, N.C. 27028
Sincerely,
Robert B. Hall, Jr., R.S.
Environmental Health Section
Enclosure(s): Soil -site report(s)
Billing statement(s)