NC0087556_Renewal (Application)_20200401 (2)

NPDES APPLICATION FORM D
For privately-owned treatment systems treating 1001/6 domestic wastewaters <1.0 MGD
Mail the complete application to: RECEIVED
N. C. DENR/ Division of Water Quality/ NPDES Unit
1617 Mail Service Center,Raleigh,NC 27699-1617 APR 0 12020
NPDES PerMit 000087556
I you are completing this arm in co WDEWWR/NMES
f y mp g f computer use the TAB key or the up-down arrows to move jrom one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise,please print or type.
1. Contact Information:
Owner Name Ledgestone Property Owners'Association,_Inc.
Facility Name Ledgestone Subdivision WWTP
Mailing Address P. 0. Box 21
City Fairview
State / Zip Code NC 28730
Telephone Number 828-628-2776
Fax Number
e-mail Address [e-mail]
2. Location of facility producing discharge:
Check here if same address as above❑
Street Address or State Road Miller Road (MCSR 2800)
City Fairview
State / Zip Code NC 28730
County Buncombe
3. Operator Information:
Name of the firm, public organization or other entity that operates the facility. (Note that this is not
referring to the Operator in Responsible Charge or ORC)
Name Ledgestone Property Owners'Association, Inc.
Mailing Address P. O. Box 21 -
City Fairview
State / Zip Code NC 28730
Telephone Number 828-628-2776
Fax Number
e-mail Address [e-mail]
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NPDRS APPLICATION - FORM D
For privately-owned treatment systems treating 100%domestic wastewaters<1.0 MGD
4. Description of wastewater:
Facility Generating WA ter(check all that applyr
Industrial ❑ Number of Employees
Commercial ❑ Number of Employees
Residential X Number of Homes
School Number of Students/Staff
Other ❑ Explain:
Describe the source(s) of wastewater(example: subdivision,mobile home park, shopping centers,
restaurants, etc.):
Subdivision, domestic waste
Number of persons served.:
5. Type of collection system
X Separate (sanitary sewer only) ❑ Combined (storm sewer and sanitary sewer)
6. Outfall Information:
Number of separate discharge points 1
Outfall Identification number(s) 001
Is the outfall equipped with a diffuser? ❑ Yes X No
7. Name of receiving streams) (11TEW licants:provide a map showing the exact location of each
outfallp.
Cane Greek in the French Broad River Basin
S. Frequency of Discharge: X Continuous ❑ Intermittent
If intermittent:
Days per week discharge occurs: Duration:
9. Describe the treatment system
List all installed components, including capacities,provide design removal for BOD, TSS, nitrogen and
phosphorus. If the space provided is not sufficient, attach the description of the treatment system in a
separate sheet of paper.
A 0.027 MGD facility with extended aeration basin,chlorine contact
basin/dechloriination.
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NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 1000/0 domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.02?MOD
Annual Average daily flow 0.003 MGD (for the previous 3 years)
Maximum daily flow MGD 0.009 (for the previous 3 years)
11. Is this facility located on Indian country?
❑ Yes X No
12. Effluent Data
NEW APPLICANTS:Provide data for the parameters listed.Fecal Coliform, Temperature and pH shall be grab
samples,for all other parameters 24-hour composite sampling shall be used.If more than'one analysis is reported,
report daily maximum and monthly average.If only one analysis is reported,report as daily maximum.
RENEWAL APPLICANTS: Provide the highest single reading(Daily Maximum)and Monthly Average over
the past 36'months for parameters currently in your permit. Mark other parameters "N/A'.
Parameter Daily Monthly Units of
Maximum Averse Measurement
Biochemical Oxygen Demand (BODs) 15.7 22.4 MG/L
Fecal Coliform 620 3.4 CFU/100ML
Total Suspended Solids 90.0 39.0 MG/L
Temperature (Summer) 24.9 22.0 C
Temperature (Winter) 11.7 9.7 C
pB 13.2 7.6 units
13. List all permits, construction approvals and/or applications:
Type Permit Number Type Permit Number
Hazardous Waste(RCRA) NESHAPS(CAA)
UIC(SDWA) Ocean Dumping(MPRSA)
NPDES NCO087556 Dredge or fill(Section 404 or CWA)
PSD(CAA) Other
Non-attainment program(CAA)
14. APPLICANT CERTIFICATION
I certify that I am familiar with the information contained in the application and that1to the
best of y knowledge and belief such information is true, complete, and ccurate.
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Printed name of Fon Sigring Title
ignature of Applicant Date
North Carolina General Statute 143-216.6(bx2)states:Any Aerson who knowingly makes any false statement representation,or certification in any
application,record,report,plan,or other document files or required to be maintained under Article 21 or regulations of the Environmental Management'
Commission implementing that Article, or who falsifies,tampers with,or knowingly renders inaccurate any recording or monitoring device or method
required to be operated or maintained under Article 21 or regulations of the Environmental Management Commission implementing that Article,shall be
guilty of a misdemeanor punishable by a fine not to exceed$25,000,or by imprisonment not to exceed six months,or by both. (18 U.S.C.Section 1001
provides a punishment by a fine of not more than$25,000 or imprisonment not more than 5 years,or both,for a similar offense.)
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