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Home My WebLink AboutNC0070033_Permit (Modification)_20110411NPDES DOCU TENT :SCANNING COVER SHEET NC0070033 flRetwookeitezetemes MHP A / Mft NPDES Permit: Document Type: Permit Issuance Wasteload Allocation Authorization to Construct (AtC) Permit Modification Complete File - Historical Engineering Alternatives (EAA) Application Instream Assessment (67b) Environmental Assessment (EA) Permit History Document Date: April 11, 2011 Mist document is printed on reuse paper - ignore any - content on the reYerse side NCDENR North Carolina Department of Environment and Natural Resources Division of Water Quality Beverly Eaves Perdue Coleen H. Sullins Dee Freeman Governor Director Secretary April l 1, 2011 CAROLYN A CALDWELL ASSISTANT MANAGER QUAIL RUN MOBILE HOME PARK PO BOX 935 STANLEYTOWN VA 24168 Subject: NPDES Permit Modification- Name and/or Ownership Change Permit Number NC0070033 Quail Run Mobile Home Park Davidson County Dear Ms. Caldwell: Division personnel have reviewed and approved your request to transfer ownership of the subject permit, received on April 1, 2011. This permit modification documents the change of ownership. Please find enclosed the revised permit. All other terms and conditions contained in the original permit remain unchanged and in full effect. This permit modification is issued under the requirements of North Carolina General Statutes 143-215.1 and the Memorandum of Agreement between North Carolina and the U.S. Environmental Protection Agency. If you have any questions concerning this permit modification, please contact the Point Source Branch at (919) 807-6304. Sincerely, Coleen H. Sullins cc: Central Files Winston-Salem Regional Office, Surface Water Protection NPDES Unit File NC0070033 1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Location: 512 N. Salisbury St. Raleigh, North Carolina 27604 Phone: 919-807-6300\ FAX: 919-807-64921 Customer Service: 1-877-623-6748 Internet: www.ncwaterquatity.org An Equal Opportunity \ Affirmative Action Employer North Carolina Naturally Permit NC0070033 STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF WATER QUALITY PERMIT TO DISCHARGE WASTEWATER UNDER THE NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM In compliance with the provisions 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, Eleanor A. Zavala is hereby authorized to discharge wastewater from a facility located at Quail Run Mobile Home Park 136 Quail Place Drive Winston-Salem Davidson County to receiving waters designated as Miller Creek in subbasin 03-07-04 of the Yadkin -Pee Dee River Basin in accordance with effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, III, and IV hereof. The permit shall become effective April 11, 2011. This permit and the authorization to discharge shall expire at midnight on May 31, 2014. Signed this day April 11, 2011. Co1 H. Sullins, Director Division of Water Quality By Authority of the Environmental Management Commission Permit NC0070033 SUPPLEMENT TO PERMIT COVER SHEET All previous NPDES Permits issued to this facility, whether for operation or discharge are hereby revoked, and as of this issuance, any previously issued permit bearing this number is no longer effective. Therefore, the exclusive authority to operate and discharge from this facility arises under the permit conditions, requirements, terms, and provisions included herein. Eleanor A. Zavala is hereby authorized to: 1. Continue to operate an existing 0.017 MGD wastewater treatment plant that includes the following components: • Two 3,200 gallon septic tanks • One 4,000 gallon septic tank • Two 4,500 gallon septic tanks • 8,400 gallon recirculating dosing tank • 4,250 square foot recirculating surface sandfilter • Tablet chlorinator • 350 gallon chlorine contact tank This permitted facility is located at the Quail Run Mobile Home Park WWTP [136 Quail Place Drive, Winston-Salem] in Davidson County. 2. Discharge from said treatment works at the location specified on the attached map into Miller Creek, currently classified C waters in subbasin 03-07-04 of the Yadkin -Pee Dee River Basin. Permit NC0070033 A. (1) EFFLUENT LIMITATIONS AND MONITORING REQUIREMENTS Beginning on the effective date of this permit and lasting until permit expiration, the Permittee is authorized to discharge from Outfall 001. Such discharges shall be limited and monitored by the Permittee as specified below: PARAMETER EFFLUENT LIMITATIONS MONITORING REQUIREMENTS Monthly Average Daily Maximum Measurement Frequency Sample Type Sample Location' Flow 0.017 MGD Weekly Instantaneous r Influent Effluent BOD5 30.0 mglL 45.0 mg/L 2lmonth Grab Effluent Total Suspended Solids 30.0 mg/L 45.0 mglL 2lmonth Grab Effluent NH3-N (April 1— October 31) 6.9 mg/L 34.5 mg/L 2lmonth Grab Effluent NH3-N (November 1— March 31) 25.8 mg/L 35.0 mglL 2lmonth Grab Effluent Dissolved Oxygen (April 1— October 31) Weekly Grab Effluent, U & D Fecal Coliform (Geometric Mean) 200/100 ml 400/100 ml 2/month Grab Effluent Total Residual Chlorine2 28 pg/L 2/Week Grab Effluent Temperature Weekly Grab Effluent, U&D Total Nitrogen (TKN + NO2 + NO3) Quarterly Grab Effluent Total Phosphorus Quarterly Grab Effluent pH > 6.0 and < 9.0 Standard Units 2/month Grab Effluent Notes: 1 U: upstream approximately 100 feet from the outfall. D: downstream at least 300 feet from the outfall. 2 The Permittee shall report all effluent TRC values reported by a NC -certified laboratory [including field - certified]. Effluent values below 50 µg/L will be treated as zero for compliance purposes. THERE SHALL BE NO DISCHARGE OF FLOATING SOLIDS OR VISIBLE FOAM IN OTHER THAN TRACE AMOUNTS. Beverly Eaves Perdue, Governor Dee Freeman, Secretary North Carolina Department of Environment and Natural Resources Coleen H. Sullins, Director Division of Water Quality SURFACE WATER PROTECTION SECTION PERMIT NAME/OWNERSHIP CHANGE FORM I. Please enter the permit number for which the change is requested. NPDES Permit (or) N C 0 0 7 O O 3 3 I I. Permit status prior to status change. a. Permit issued to (company name): b. Person legally responsible for permit: c. Facility natne (discharge): d. Facility address: e. Facility contact person: Certificate of Coverage C G 5 u,I1.( Run) yii bile /4,ne ie ,e ecto' /2 • First MI Last d t.v/v&,e Title /°-D &f (3/ Pennit Holder Mailing Address City' State Zip C336 ) .q/7 -0 / 90 ( ) w/,y Phone Fax /1-; (-Qa,(Q1 n 4,�/eWmme (3rn (Qu A / ! ‘-Are J�et'l/e. Address (/t)11lVs40N- SAIem /V. . a7/e27 City Stale Zip ,4e,0C �" �O.0 (236 S7/7-0/ 90 First / MI / Last I'hone III. Please provide the following for the requested change (revised permit). a. Request for change is a result of: [2<hange in ownership of the facility ❑ Name change of the facility or owner Revised 1/2009 If other please explain: b. Permit issued to (company name): c. Person legally responsible for permit: d. Facility name (discharge): e. Facility address: f. Facility contact person: Lc A II 1" eu,V iz i/e m e / ,e/i fr/3/✓0/e f}. At/)9-/.y- First MI Last ror oAfe /f Title /i9a -OA/PA ,&&u/ 2 Permit H Ider Mailing Address /ip/�Al 0( /c2 G S City /State Zip Phone /� E-mail Address C° es.,A411 1� u^l io-ok,/e Dome 4,ee 13(0 rot, A; / PkAce D2,'tx- Address 7 9 55 OJi v /N . S4-/ern N .K' . o?7/a7 City tate Zip A` A/Fir A .MI Lst 107Z) 3q0-303/ e4/a/we//- eA2o/yn/ `J Phone E-mail Address C0111C4S7' • Ne74 PERMIT NAME/OWNERSHIP CHANGE FORM Page 2 of 2 IV. Permit contact information (if different from the person legally responsible for the permit) Permit contact: C tveol /n/ 4 First MI Last V. VI. 146.64.. • Title la 6 • 4 Mailing Addres5 64A/V/e WA/ 1/ � a2 z/� City I State Zip (o277 )3*o -303/ id We /r_ fAteo fy»J G , Phone E-mail Address aimCAS7 Ate Will the permitted facility continue to conduct the same industrial activities conducted prior to thi wnership or name change? [Yes ❑ No (please explain) Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS ARE INCOMPLETE OR MISSING: ❑—This completed application is required for both name change and/or ownership change requests. Er' Legal documentation of the transfer of ownership (such as relevant pages of a contract deed, or a bill of sale) is required for an ownership change request. Articles of incorporation are not sufficient for an ownership change. The certifications below must be completed and signed by both the permit holder prior to the change, and the new applicant in the case of an ownership change request. For a name change request, the signed Applicant's Certification is sufficient. PERMITTEE CERTIFICATION (Permit holder prior to ownership change): I, Reed. 0 X , attest that this application for a 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 is not included, this lic• '�,c.py}•�;�:f= ,'ere N ed as inco plete. 3-30-// Signature Date APPLICANT CERTIFICATIQN I,1/e4No2 % • ZA (/ir ,fittest that this application for a 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 is not included, this application package will be returned as incomplete. a• 3-3o-// Si ature Date PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO: Division of Water Quality Surface Water Protection Section 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Revised 1/2009 . FILED DAVIDSON COUNTY, NC DAVID T. RICKARD REGISTER OF DEEDS February 09. 2010 02:03:45 PM DEED BOOK 1960 PAGE 774 - 777 INSTRUMENT # 2010000002644 DOCTYPE: DEED RECORDING:$21.00 VERIFICATION:$2.00 EXCISE TAX: $10.00 CR Fee:S5.00 Deputy: NSTANLEY Excise Tax $ /Q . 6 L' Parcel # 0300300000035 Drawn by: Norman L. Nifong NORTH CAROLINA GENERAL WARRANTY DEED THIS DEED made this the 26th day of January, 2010, by and between GRANTOR FREDERIC POOLE COX, JR. and wife, MICHELE ANN TROXEL COX GRANTEE ELEANOR A. ZAVALA, married Grantor's address: P. O.'aox •631 Stanleytown, VA 24168 Grantee's address: 1142 Dalea Bluff Round Rock, Texas 78665 The designation Grantor and Grantee as used herein shall assigns, and shall include singular, plural, masculine, feminine WITNESSETH, that the Grantors, for a valuable of which is hereby acknowledged, have and by these presents Grantee, her heirs, successors and assigns, in fee simple, Davidson County, North Carolina and more particularly include said parties, their heirs, successors, and or neuter as required by context. consideration paid by the Grantee, the receipt do grant, bargain, sell and convey unto the all that certain lot or parcel of land situated in described as follows: and incorporated herein by reference as the primary residence of Grantor. For description see EXHIBIT "A" attached hereto if fully set forth in its entirety. All or a portion of the property herein conveyed does not include TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee, her heirs, successors and assigns. in fee simple. And the Grantors covenant with the Grantee, that Grantors are seized of the premises in fee simple, have the right to convey the same in fee simple, that title is marketable and free and clear of all encumbrances, and that Grantors will warrant and defend the title against the lawful claims of all persons whomsoever. IN TESTIMONY WHEREOF, the Grantors have hereunto set their hands and adopted the printed word [SEAL] as their own seal. FREDERIC POOLE COX, JR. [SEAL] .la6 (L"-: [SEAL] FREDERIC POOLE COX, R. Attomey-in-Fact for Michele Ann Troxel Cox STATE OF NORTH CAROLINA - COUNTY OF Forsyth I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or she voluntarily signed the foregoing document for the purpose stated herein and in the capacity indicated: Frederic Poole Cox, Jr. Date: 1/27/2010 (Official `\ENE A co///// ♦ NOTARy PUBLIC ti. .M. r V • i� ti •• /j 0 ,\\\ Oil it Officia Signature of Notary Jane A. Cox Notary's printed or typed name My commission expires: 6/22/2010 STATE OF NORTH CAROLINA — COUNTY OF Forsyth I, Jane A. Cox , a Notary Public of said county and state, do hereby certify that Frederic Poole Cox, Jr., attorney -in -fact for Michele Ann Troxel Cox, personally appeared before me this day, and being by me duly sworn, says that he executed the foregoing and annexed instrument for and in behalf Michele Ann Troxel Cox, and that his authority to execute and acknowledge said instrument is contained in an instrument duly executed, acknowledged and recorded in the Office of the Register of Deeds of Davidson County, North Carolina in Book / j 96 d , Page 7 6 g , and that this instrument was executed under and by virtue of the authority given by said instrument granting him power of attorney; that the said Frederic Poole Cox, Jr. acknowledged to me that he voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated for and in behalf of Michele Ann Troxel Cox. I do further certify that I am not a party to the atCched instrument. AL&6 Date: 1/27/2010 (Off ``q NOTARY El PUBLIC Off(cial Signature of Notary, Jane A. Cox Notary's printed or typed name My commission expires: 6/22/2010 EXHIBIT "A" BEGINNING at an iron stake in the west right-of-way of Hay Road, said iron stake being at the southwest corner of the James W. Whetstone, Jr. property; and said BEGINNING stake also being South 2 degrees 30 minutes West 395 feet from the intersection of the west line of Hay Road and the south line of Hickory Tree Road; running thence with the south line of Whetstone's property South 87 degrees 45 minutes East 304.79 feet to an iron, the southeastern corner of the Whetstone property; thence with Whetstone's line North 3 degrees 05 minutes 16 seconds East 94.85 feet to an iron, Whetstone's northeastern corner; thence South 87 degrees 45 minutes East 402.95 feet to an iron in the west line of the Mendenhall property; thence with Mendenhall's west line the following two courses and distances: South 2 degrees 04 minutes 01 second West 94.84 feet to an iron and South 2 degrees 21 minutes 30 seconds West 633.70 feet to a right-of-way monument, a corner of the Mendenhall property; thence with Mendenhall's north line North 88 degrees 15 minutes West 711.33 feet, crossing a branch, to a monument on the west right-of-way line of Hay Road, said monument being in the east line of the Anderson property; thence with the Anderson east line, being the west line of Hay Road, North 2 degrees 30 minutes East 669.95 feet to the BEGINNING, containing 11.76 acres, including 46/100 acre in the right-of-way of Hay Road, as shown on a survey, dated April 22, 1987, by Daniel Walter Donathan, RLS #L-1192, and being a resurvey of the property described in Book 503, Page 639; and Book 656, Page 84, in the Office of the Register of Deeds for Davidson County, North Carolina.