NC0051713_Renewal Application_20181025

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 INC0051713
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 Walter B. Craven Jr.
Facility Name Lakeview Mobile Home Park WWTP
Mailing Address P.O. Box 3421
City Wilmington
State / Zip Code NC 28406-3421
Telephone Number [phone]
Fax Number ( )
e-mail Address
2. Location of facility producing discharge:
Check here if same address as above ❑
Street Address or State Road 5186 High Point Road
City High Point
State / Zip Code NC
County Forsyth
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 Bell Enterprises
Mailing Address P.O. Box 1291
City Clemmons
State / Zip Code NC, 27012
Telephone Number [phone]
Fax Number ( )
e-mail Address [e-mail]
1 of 4 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 ❑ Number of Employees
Residential X Number of Homes 48
School ❑ Number of Students/Staff
Other 0 Explain:
Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers,
restaurants, etc.):
Mobile Home Park
Number of persons served: 175
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 stream(s) (NEW applicants:Provide a map showing the exact location of each
outfall):
Tributary of Cuddybum Creek
8. Frequency of Discharge: X Continuous El Intermittent
If intermittent:
Days per week discharge occurs: 7 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.
Septic tanks at each home.
Extended Aeration package system
Aeration
Diffused air and clarification
Sludge digester
Holding tank
Chlorination
Dechlorination
2 of 4 Form-D 11/12

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Permit NC0051713
Part I
A.(1) EFFLUENT LIMITATIONS AM)MONITORING REQUIREMENTS
During the period beginning on the effective date of t permit and lasting until
expiration,the Permittee is authesisuml to discharge treated.wastewater from outfall OOL
Such discharges shall be limited and innitnred1 by the Permittee as specified below:
PAR*1 - _ --- " _ -r - -- r_ 7 D3111t- -
Fier
0.015 SSD Weekly testanbeexas ItarEfiuent
MGM
tom, 2AT 1711 mg& 23.5 Weekly -(late f
ad
Taut&Epoxied Sad
339.0 45.0 sogi. Weeidi Grab Maxi
1005301
*has it (ter 2-0 11191- SA ogiL toMEd
tellisasIM mug40 auegt. ;f..p Gmb MEd
9-Ma d 391
Total; ._7,1- Marine - 't7tit_ 2iWeek Gab Mod
Feed Celt= ping MUD ad COMMmi t teem
(geometric
Teapetaise
PH
,t >S..Oand<910 steedimiaxes watik tmb Mod
Dissolved Oxygm
Daillawa93?.6 rik; noddy Gob Mixed
TOW I Mate* Grab
I (Weedy Gob twat
f
Footnotes:
L No later� tthan,Aural.2015,the permittee shall begin submitting discharge monitoring reports
electronically the D. n's eD ;Nis apphealion system[see A_Pitt.
2_ U:at least 50 feet upstream from the meal D:downstream 0.1 males below the outran.
3.. The Division shall Wider all effluent TRC values reported<50 pgiL to be in compliance with
the permit.However,the Permittee shall continue to record and submit all values reported by
a North.Carolina certified laboratory ianicluding field certified),even if these values fall below
50 pgiL.
There shall he no discharge of floating sands or foam visible in other than.trace amounts_
3ef5

NPDES APPLICATION - FORM D
For privately-owned treatment systems treating 100% domestic wastewaters <1.0 MGD
10. Flow Information:
Treatment Plant Design flow 0.015 MGD
Annual Average daily flow 0.006 _ MGD (for the previous 3 years)
Maximum daily flow 0.012 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 analysts is reported,
report daily maximum and monthly average.If only one analysts 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) 12 6.6 Mg/1
Fecal Coliform 9 4 #/100m1
Total Suspended Solids 16 7.6 Mg/1
Temperature (Summer) 22 19 Celsius
Temperature (Winter) 11 11 Celsius
pH 7.1 6.8 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 0051713 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.
RPL-10 /3„Q)/ 0 a_c_
Printed na e of Person Signing Title
Z4- .7:1 ______Z—P -- 1 //151 J/3
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.0 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)
4 of 4 Form-D 11/12