NC0030848_Renewal (Application)_20160314

Tim Church
209 Martin Way
Jefferson, NC 28640
March 8, 2016 RECEIVED/NCDEQ/DWR
NC QMARY 4 2016
ATTN: NPDES Unit
1617 Mail Service Center Water Quality
Permitting Section
Raleigh, NC 27699-1617
SUBJECT: Renewal Application for NPDES NC0030848
Jefferson Apparel c/o JR Vannoy& Sons Construction
Jefferson, North Carolina Ashe County
Dear Staff:
Please find enclosed the renewal application for NPDES Permit NC0030848 held by JR
Vannoy& Sons Construction Company for the Jefferson Apparel facility. The facility in
question no longer produces a discharge but the permit holder wishes to retain possession
of this permit.
If you have questions or require additional information please call me at [phone]
or contact me by email at ieffwns@century link.net.
Respectfully,
Tim Church
Operator
cc: Mr. Carlton Yearick, Vannoy& Sons

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
Mail the complete application to:
N. C. DENR / Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit 1�TC00 30848
If you are completing this form in computer use the TAB key or the up - down arrows to move from 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 J.R. Vannoy & Sons Construction Co.
Facility Name Jefferson Apparel
Mailing Address 1 608 US Highway 221
City Jefferson, NC 28640 RECEIVED/NCDE�DWR
State / Zip Code North Carolina 28640 MAR 14 2016
Telephone Number (336 ) 846-71 91( 33$ 246-2165 Water QUalit
Fax Number Permitting Section
e-mail Address [e-mail]
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road Jefferson Apparel/ Greensboro Mfg. Road
City Jefferson
State / Zip Code North Carolina 28640
County Ashe
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 J.R. Vannoy & Sons Construction Co.
Mailing Address 1 608 US Highway 221
City Jefferson, NC 28640
State / Zip Code North Carolina 28640
Telephone Number (336 ) 846-7191
Fax Number (246)-2165
e-mail Address [e-mail]
1 of 3 Form-D 11112

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating l00% domestic wastewaters <1.0 MGD
4. Description of wastewater:
Facility Generating Wastewater(check all that applrll:
Industrial ❑ Number of Employees
Commercial J Number of Employees
Rosi{'lential % Nuinher of homes
School Nurnher of Students, Staff
Other ?' Explain: Not op.e.fdir _ Q
I)escribe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants. etc.):
When paYioasly opet'tdtr +6 -Flow was &me-silt inntlillae
fog ot.pprox-1 ma+eily (50 e.mployee5.
Number of persons served: 0 -
5. TTy e of collection system
✓� Separate (sanitary sewer only) 1-1 Combined (storm sewer and sanitat7• sewer)
6. Outfall Information:
Number of separate discharge points
Outfall Identification number(s) Oi
Is the outfall equipped with a diffuser? L] Yes L(No
7. Name of receiving streams) (NEW applicants: Provide a map showing the exact location of each
o,it/allJ:
UT of Dog_Ctee,k'.
8. Frequency of Discharge: [.] Continuous V/ Intermittent
If intermittent:
I)�tvs per week discharge occurs_ V__ Duration:
9. Describe the treatment system
List all installed components. including capacities, provide design removal for ROD, TSS, nitrogen and
phosphorus. If the space provided is not sufficient. attach the description of the treatment system in a
scJrarate sheet of paper.
Aer04i 6:1 - I0,003 e.
C tart err SAO s!oj.
Sand -V1}+err (eWIueicf 2 X $oJ
fable+ c.hlorina-}ia'. /4eli ".
Desired Toc a.ppc . Gt0 % fe,mov)
2 of 3 Form-0 11/12

1
NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information: h
Treatment Plant Design flow C). NO MGD
Annual Average daily flow 0,0 MGD (for the previous 3 years)
Maximum daily flow 0.0 MGD (for the previous 3 years)
11. Is this facility located on In 'an country?
❑ Yes 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 cu_rrentlyiy yourpermit. Mark other .ammeters "N/A".
Parameter i Daily
I
Monthly Units of
Maximum Avera_e Measurement
1 Biochemical Oxygen Demand (BOD;) No &w or I 3 , limh 1
Fecal Coliform
I 1 —
I Total Suspended Solids
1 Temperature (Summer)
Temperature (Winter)
pH
13. List all permits, construction approvals and/or applications: N/A.
Type Permit Number Type Permit Number
Hazardous Waste (RCRA) NESHAPS (CAA)
UIC (SDWA) Ocean Dumping (MPRSA)
NPDES 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 that to the
best of my knowledge and belief such information is true, complete, and accurate.
7m ('fjurch O era-f+r
Printed name of Person Signing Title
. atacki
3/17/4
Signature of Applicant Date
North Carolina General Statute 143-215.6 (b)(2) states: Any person 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.)
3 of 3 Form-D 11112
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PAT MCCRORY
DONALD R. VAN DER VAART
Water Resources S. JAY ZIMMERMAN
ENVIRONMENT AL OUALI7 Y'
March 21, 2016
Tim Church, ORC
J.R. Vannoy& Sons Construction, Co.
1608 US Highway 221
Jefferson, NC 28640
Subject: Acknowledgement of Permit Renewal
Application No. NC0030848
Jefferson Apparel Company WWTP
Ashe County
Dear Permittee:
The Water Quality Permitting Section has received your permit renewal application on March 14,
2016. A member of the NPDES Unit will review your application. They will contact you if additional
information is required to complete your permit renewal. Per G.S. 150B-3 your current permit does not
expire until permit decision on the application is made. Continuation of the current permit is contingent on
timely and sufficient application for renewal of the current permit. Please respond in a timely manner to
requests for additional information necessary to complete the permit application.
If you have any additional questions concerning renewal of the subject permit, please contact Charles
Weaver at 919-807-6394 or [e-mail].
Sincerely,
1 /trZvi Tl.zOtfo.YOt
Wren Thedtord
Wastewater Branch
cc: Central Files
NPDES
Winston-Salem Regional Office
State of North Carolina I Environmental Quality I Water Resources
1617 Mail Service Center I Raleigh,North Carolina 27699-1617
919-807-6300