NC0077135_Renewal (Application)_20161221

9
Fred D. Curl
707 N. English Street
Greensboro, NC 27405
336-379-9155
[e-mail]
December 14,2016
N.C. DENR
Division of Water Quality/NPDES Unit RECEIVEDINCDEOIDWR
1617 Mail Service Center
Raleigh, NC 27699-1617 DEC 2 1 2016
Water Quality
Re: NPDES Permit: NC0077135 Permitting Section
Hidden Valley Estates WWTP
Dear Sir:
Enclosed please find our renewal application for the above mentioned permit number.
Sincerely,
011
111P;
red D. Curl
Owner

1A13
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 [NC0077135
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 Fred.D. Curl
Facility Name Hidden Valley Estates WWTP
Mailing Address 707 N. English Street
City Greensboro
State / Zip Code NC 27405
Telephone Number ( ) 336-379-9155
Fax Number ( ) 336-379-9155
e-mail Address [e-mail]
2. Location of facility producing discharge: RCEIVENCDf®W
Check here if same address as above ❑ DEC 21 2016
Street Address or State Road 200 Lori Drive
Qua®ity
City Reidsville Permitting Section
State / Zip Code NC 27320
County Rockingham
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 Paul Smith
Mailing Address PO Box 269/235 Richardson Road
City Reidsville
State / Zip Code NC 27323
Telephone Number 336-932-9347
Fax Number ( )
e-mail Address [e-mail]
1 of 3 Form-D 11/12

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
4. Description of wastewater:
Facility Generating Wastewater(check all that apply):
Industrial ❑ Number of Employees
Commercial 277 Number of Employees
Residential Number of Homes 20
School ❑ Number of Students/Staff
Other ❑ Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
100% restrooms
Subdivision
Number of persons served: 68
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 outfallequipped with a diffuser? X Yes No
7. Name of receiving stream(s) (NEW applicants:Provide a map showing the exact location of each
outfall):
Unamed Tributary
8. Frequency of Discharge: Continuous X Intermittent
If intermittent:
Days per week discharge occurs: 3 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.
Influent pumps, aeration basin, circular clarifier, W disinfection, effluent diffuser
2 of 3 Form-D 11/12

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.022 MOD
Annual Average daily flow 0.005 MGD (for the previous 3 years)
Maximum daily flow 0.005 MGD (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 Average Measurement
Biochemical Oxygen Demand (BODS) 10 10 mg/1
Fecal Coliform 50 30 #/100m1
Total Suspended Solids 10 10 mg/1
Temperature (Summer) 25 20 C
Temperature (Winter) 5 5 C
pH 7.2 7.0 SU
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 NC0077135 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.
L - C n uU L_-
Printed namrre of Pe .•. :igning - Title
00
C– /171— 2-0_6
- ...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 11/12

Sludge Management Plan
The sludge generated will be hauled away for disposal by Septic hauling company.