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Home My WebLink AboutNC0060224_Fact Sheet_20200511DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D47991D8E4 FACT SHEET FOR EXPEDITED PERMIT RENEWALS This form must be completed by Permit Writers for all expedited permits which do not require full Fact Sheets. Expedited permits are generally simple 100% domestics (e.g., schools, mobile home parks, etc) that can be administratively renewed with minor changes, but can include facilities with more complex issues (Special Conditions, 303(d) listed water, toxicity testing, instream monitoring, compliance concerns). Basic Information for Expedited Permit Renewals Permit Writer/Date Emily DelDuco 02/20/2020 Permit Number NCO060224 Facility Name Jonas Ridge Adult Care Facility WWTP Basin Name/Sub-basin number 03-08-30 Receiving Stream UT Camp Creek Stream Classification in Permit C-Trout Does permit need Daily Max NH3 limits? No — already present Does permit need TRC limits/language? No — already resent Does permit have toxicity testing? No Does permit have Special Conditions? No Does permit have instream monitoring? Dissolved oxygen and temperature Is the stream impaired (on 303(d) list)? For whatparameter? Not on 2018 303d Any obvious compliance concerns? No enforcements this permit cycle Any permit modifications since last permit? None. New expiration date 1/31/2025 Comments on Draft Permit ➢ Added regulatory citations ➢ Added eDMR requirements ➢ HUC and Stream Segment in description ➢ Updated parameter codes ➢ Updated outfall map Compliance Summary (2015-2019): 5 NOVs this permit cycle. 4 monitoring frequency violations and one PC for failure to register for eDMR. No other compliance concerns. Changes from previous permit: Outfall map updated • Parameter codes updated • HUC and Stream Index added to outfall description on supplement to cover page • Regulatory citations for permit requirements have been added throughout the permit. • The language in section A.(2.) has been updated to be consistent with the finalization of federal requirements for electronic reporting. Compliance Inspection on 1/06/20 indicates facility is no longer using a bar screen. Bar screen was removed from components list. In draft cover letter, permittee is asked to specify method of debris removal before issuance of final permit. DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D47991D8E4 eDMR Summary (2015-2020): maximum monthly average flow this permit cycle: 0.0071 MGD average flow this permit cycle: 0.0034 MGD Sampling Location: Effluent Parameter 00010 - Temperature, Water Deg. Centigrade 00300 - Oxygen, Dissolved (DO) 00400 - pH 31616 - Coliform, Fecal MF, MFC Broth, 44.5 C 50050 - Flow, in conduit or thru treatment plant 50060 - Chlorine, Total Residual C0310 - BOD, 5-Day (20 Deg. C) - Concentration CO530 - Solids, Total Suspended - Concentration C0610 - Nitrogen, Ammonia Total (as N) - Concentration lina Location: 15.14 2.00 27.00 1219 7.94 6.00 10.61 257 7.19 6.20 8.50 362 17.86 1.00 400.00 258 0.00 0.00 0.01 290 15.00 15.00 15.00 529 5.76 2.00 34.00 260 8.28 3.13 35.71 259 0.61 0.10 6.34 263 Parameter I Meanj Minj Maxi N� 00010 -Temperature, Water Deg. Centigrade 11.17 2.00 23.00 187 00300 - Oxygen, Dissolved (DO) 8.17 4.21 10.01 181 Location: Downstream 10 - Temperature, Water Deg. Centigrade 00 - Oxygen, Dissolved (DO) There is currently no technical basis for any limit changes. 11.16 2.00 23.00 187 8.21 4.87 10.25 187 DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D4799lD8E4 From: Wims, Linda To: DelDuco, Emilv Subject: RE: Jonas Ridge "barscreen" Date: Thursday, February 27, 2020 5:01:22 PM Attachments: 100 2426.ioo imaQe002.r)nci imaQe003.r)nci Hi Emily, Yes, you can use "manhole with bar screen" for the initial debris removal component. I sent a picture so you could see. @ welcome to my world. Thanks, ... _DEC6 Environmental Senior SpecialistlDivision Water Resources North CarolinaDepartmerYt of Environmental Quality 828-26-4500 (Office) Linda-wiggs&cdenr.gov From: DelDuco, Emily Sent: Tuesday, February 25, 2020 9:35 AM To: Wiggs, Linda <linda.wiggs@ncdenr.gov> Subject: Jonas Ridge "barscreen" Hi Linda, I'm working on a renewal for Jonas Ridge Adult Care/NC0060224 and saw that in your inspection you noted that they are using a manhole and buckets (??) for debris renewal. The old permit says that they have a barscreen, but I'm guessing that is outdated. Seeking advice on how to name their debris renewal equipment in the components list. Just "manhole"? Emily DelDuco Division of Water Resources Department of Environmental Quality 919-707-9125 emily.deIducoPncdenr.gov Nothing Compares, Email correspondence to and from this address is subject to the DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D4799lD8E4 North Carolina Public Records Law and may be disclosed to third parties. DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D47991D8E4 ROY COOPER i 41CHAEL S. RECA Sfrr'rtrary LINDA CULPEPPER pir4weu Jonas Ridge Adult Care George Ware PO Box 519 Newland, NC 28657-0519 NORTH CAROLINA Environmental Qual" January 06, 2020 SUBJECT: Compliance Inspection Report Jonas Ridge Adult Care Facility WWTP NPDES WW Permit No. NCO060224 Burke County Dear Permittee: The North Carolina Division of Water Resources conducted an inspection of the Jonas Ridge Adult Care Facility WWTP on 11/20/2019. This inspection was conducted to verify that the facility is operating in compliance with the conditions and limitations specified in NPDES WW Permit No. NC0060224. The findings and comments noted during this inspection are provided in the enclosed copy of the inspection report entitled "Compliance Inspection Report". Please pay attention to the items noted in the summary area of the Report. Particularly, the Permit renewal is past due; if this is not received in Raleigh by January 31, 2020 you will be operating without a Permit. If you should have any questions, please do not hesitate to contact me at 828-296-4500 or via email at linda.wiggs@ncdenr.gov. Sincerely, DocuSigned �b/y- �in o�ic W*4- 6C38CDE295CF449... Linda Wiggs Water Quality Regional Operations Section Asheville Regional Office Division of Water Resources, NCDEQ ATTACHMENTS Ec: ARO Server, LF G:\WR\WQ\Burke\Wastewater\Minors\Jonas Ridge Adult Care 60224\Inspections\11.20.2019 Insp\20200106_NCO060224_CSI.rtf North.ar•7 ra Depa rtntent of Environrnerktai Quairty I DiusionofWater Riesoerces Asl�i,--v e Fiegora Off re 1 2090 U.S. 70 Highway I Swannamos, North Diwins 287 78 a236-40 DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D47991D8E4 United States Environmental Protection Agency Form Approved. EPA Washington, D.C. 20460 OMB No. 2040-0057 Water Compliance Inspection Report Approval expires 8-31-98 Section A: National Data System Coding (i.e., PCS) Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type 1 IN I 2 15 I 3 I NC0060224 111 12 I 19/11/20 I17 18 Lam] 19 L s j 201 211 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 f6 Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA ---------------------- Reserved ------------------- 671 71 J72 n73I—!74 751 I I I I 70Iu I 80 Section B: Facility Data Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include Entry Time/Date Permit Effective Date POTW name and NPDES oermit Number) 12:30PM 19/11/20 15/04/01 Jonas Ridge Adult Care Facility WWTP NC Hwy 181 INExit Time/Date Permit Expiration Date Jonas Ridge NC 28641 02:OOPM 19/11/20 20/01/31 Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s) Other Facility Data Name, Address of Responsible Official/Title/Phone and Fax Number Contacted George W Ware,PO Box 519 Newland NC 286570519//828-387-1959/ Yes Section C: Areas Evaluated During Inspection (Check only those areas evaluated) Permit Operations & Maintenance 0 Records/Reports Self -Monitoring Program Facility Site Review Effluent/Receiving Waters Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary) (See attachment summary) Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date DS Linda S Wiggs EW DWR/ARO WQ/828-296-4500 Ext.4653/ Signature of Management Q A Reviewer DS Agency/Office/Phone and Fax Numbers Date 1/6/2020 EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete. Page# DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D47991D8E4 NPDES yr/mo/day Inspection Type (Cont.) NCO060224 I11 121 19/11/20 117 18 ISI S Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary) The Inspector, Linda Wiggs, met with the ORC Josh Cagle and BORC Jadd Brewer. The WWTP is aged with apparent rust issues. Photo documentation was sent to the Inspector since the inspection showing patch repairs of the rust. Given the age of the WWTP the Owner needs to keep in mind the life expectancy of these facilities and have a long-term financial plan for replacement. Management of influent debris was not acceptable at the time of the inspection. Influent debris removed from the manhole cannot be filtered through buckets with hole in them on the ground. This method needs to be moved so no wastewater or waste debris comes into contact with the ground; we discussed staging this over the EQ. The ORC sent photo documentation of changes to this practice that are acceptable. The Permit expires January 31, 2020, renewal application is required to be submitted 180 days prior to expiration. If a renewal is not received, then on January 31, 2020 Jonas Ridge is technically discharging without a permit. Solids management is an integral part of operating a WWTP in compliance. The level of solids in the plant were elevated; the blanket was 5' of 8' depth, the settleability test was 800 ml of 1000 ml, the ORC stated WAS takes place — every 3 weeks for —20 minutes, the pumper truck removes solids —4-5 times /year; ORC stated the last pump was this month 11/2019. Effluent samples were obtained: BOD — 2.7 mg/I TSS — 6.2 mg/I Fecal Coliform - <1 col/100ml NH3 — 0.04 mg/I Page# DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D47991D8E4 Permit: NCO060224 Owner - Facility: Jonas Ridge Adult Care Facility WWTP Inspection Date: 11/20/2019 Inspection Type: Compliance Sampling Operations & Maintenance Yes No NA NE Is the plant generally clean with acceptable housekeeping? 0 ❑ ❑ ❑ Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable 0 ❑ ❑ ❑ Solids, pH, DO, Sludge Judge, and other that are applicable? Comment: See summary. Permit Yes No NA NE (If the present permit expires in 6 months or less). Has the permittee submitted a new ❑ 0❑ ❑ application? Is the facility as described in the permit? 0 ❑ ❑ ❑ # Are there any special conditions for the permit? ❑ ❑ 0 ❑ Is access to the plant site restricted to the general public? 0 ❑ ❑ ❑ Is the inspector granted access to all areas for inspection? 0 ❑ ❑ ❑ Comment: Requested renewal be submitted. Equalization Basins Yes No NA NE Is the basin aerated? 0 ❑ ❑ ❑ Is the basin free of bypass lines or structures to the natural environment? 0 ❑ ❑ ❑ Is the basin free of excessive grease? 0 ❑ ❑ ❑ Are all pumps present? 0 ❑ ❑ ❑ Are all pumps operable? 0 ❑ ❑ ❑ Are float controls operable? 0 ❑ ❑ ❑ Are audible and visual alarms operable? 0 ❑ ❑ ❑ # Is basin size/volume adequate? 0 ❑ ❑ ❑ Comment: Aeration Basins Yes No NA NE Mode of operation Type of aeration system Is the basin free of dead spots? ❑ ❑ ❑ Are surface aerators and mixers operational? ❑ ❑ 0 ❑ Are the diffusers operational? 0 ❑ ❑ ❑ Is the foam the proper color for the treatment process? 0 ❑ ❑ ❑ Does the foam cover less than 25% of the basin's surface? 0 ❑ ❑ ❑ Is the DO level acceptable? 0 ❑ ❑ ❑ Page# 3 DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D47991D8E4 Permit: NCO060224 Owner - Facility: Jonas Ridge Adult Care Facility WWTP Inspection Date: 11/20/2019 Inspection Type: Compliance Sampling Aeration Basins Yes No NA NE Is the DO level acceptable?(1.0 to 3.0 mg/1) 0 ❑ ❑ ❑ Comment: ORC DO meter indicated DO at 2.5 with air on. Secondary Clarifier Yes No NA NE Is the clarifier free of black and odorous wastewater? 0 ❑ ❑ ❑ Is the site free of excessive buildup of solids in center well of circular clarifier? ❑ ❑ 0 ❑ Are weirs level? M ❑ ❑ ❑ Is the site free of weir blockage? M ❑ ❑ ❑ Is the site free of evidence of short-circuiting? 0 ❑ ❑ ❑ Is scum removal adequate? 0 ❑ ❑ ❑ Is the site free of excessive floating sludge? 0 ❑ ❑ ❑ Is the drive unit operational? ❑ ❑ 0 ❑ Is the return rate acceptable (low turbulence)? 0 ❑ ❑ ❑ Is the overflow clear of excessive solids/pin floc? 0 ❑ ❑ ❑ Is the sludge blanket level acceptable? (Approximately'/4 of the sidewall depth) ❑ 0 ❑ ❑ Comment: Blanket elevated at 5'. Disinfection -Tablet Yes No NA NE Are tablet chlorinators operational? 0 ❑ ❑ ❑ Are the tablets the proper size and type? 0 ❑ ❑ ❑ Number of tubes in use? 2 Is the level of chlorine residual acceptable? ❑ ❑ ❑ Is the contact chamber free of growth, or sludge buildup? 0 ❑ ❑ ❑ Is there chlorine residual prior to de -chlorination? ❑ ❑ ❑ Comment: De -chlorination Yes No NA NE Type of system ? Tablet Is the feed ratio proportional to chlorine amount (1 to 1)? ❑ ❑ 0 ❑ Is storage appropriate for cylinders? ❑ ❑ 0 ❑ # Is de -chlorination substance stored away from chlorine containers? ❑ ❑ 0 ❑ Comment: Are the tablets the proper size and type? 0 ❑ ❑ ❑ Page# 4 DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D47991D8E4 Permit: NCO060224 Owner - Facility: Jonas Ridge Adult Care Facility WWTP Inspection Date: 11/20/2019 Inspection Type: Compliance Sampling De -chlorination Yes No NA NE Are tablet de -chlorinators operational? 0 ❑ ❑ ❑ Number of tubes in use? 2 Comment: Effluent Sampling Yes No NA NE Is composite sampling flow proportional? ❑ ❑ 0 ❑ Is sample collected below all treatment units? 0 ❑ ❑ ❑ Is proper volume collected? ❑ ❑ 0 ❑ Is the tubing clean? ❑ ❑ 0 ❑ # Is proper temperature set for sample storage (kept at less than or equal to 6.0 degrees ❑ ❑ ❑ Celsius)? Is the facility sampling performed as required by the permit (frequency, sampling type 0 ❑ ❑ ❑ representative)? Comment: Inspector obtained effluent samples, refer to summary for results. Page# 5 DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D4799lD8E4 The McDowell News Advertising Affidavit PO Box 968 Hickory, NC 28603 NCDEQ/DWR ATTN: WREN THEDFORD 1617 MAIL SERVICE CENTER RALEIGH, NC 27699-1617 Account Nurtaber 3611028 Date March 11, 2020 Date Category Description Ad Numher Ad Size 03/11/2020 Legal Notices Poblit du Nod CardinafnviroRmertal Marlagezmt OmmiWorMDES Unit 1617 Mal Servit:e Center 8al6gN NC 2769M617 Notice of dent to tuue a IIPDiS Wastewater Permit NCO01901 Harmanffstptes WWTP The Not Carolina Environmental Management Commission proposes to issue a NPDES wastewater discharge permit to the person(s) listed below. Written comments regarding the proposed permit will be accepted until 10 days after the publish date of this notice. The Director of the NC Divi- sion of Water Resources (DWR) may hold a public hearing should there be asignificant degree of public interest. Please mail comments andtar infor- mation requests 10 DWR at the above address Interested persons may vis, it the DWR at 512 N. Salisbury Street, Raleigh, NC to review information on file. Additional ilornation on NPM permits. and this notice may be found on our website: httpJ/dey �cgovL6o,ut(d vaianslw r-resources notices, or by calling (919) 707-1601. Dennis J. Whitson requested renew- al of permit NC00794811Harmony Estates WWTP in McDowell County. Fa• cility discharges to an unnamed tributary to North Muddy Creek/Catawba River Basin. Currently ammonia nitrogen, fecal colifurn, dissolved oxy- gen, and total residual chlorine are water quality limited. Publish: Marti 11, Mo. Public Notice North Carolina Environmental Management Coml 0000638881 2 x 27 L Publisher of The McDowell News McDowell County Before the undersigned, allotary Public of IredelI County, North Carolina, duly commissioned, qualified, and authorized by law to administer oaths, in said County and State; that he/she is authorized to make this affidavit and sworn statement; that the notice or other legal advertisement, a copy of which is attached hereto, was published in the The McDowell News on the following dates: 03/1112020 and that the said newspaper in which such notice, or legal advertisement was published, was a newspaper meeting all the requirements and qualifications of Section 1-597 of the General Statutes of North Carolina. 7/41— Assistant Bookkeeper Newspaper reference: 0000638881 Sworn to and subscribed before me, this —tt_ day of, 2020 Notary Public My Commission expires: MOA4 THIS IS NOT A BILL. PLEASE PAY FROM INVOICE. THANK YOU lEiLA7rrr�, � ly �i �4 F ; Not r Z Ir�aG/I CoU6�y =_ /0 '';:CgRO�t��`� DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D4799lD8E4 Morganton News Herald Advertising Affidavit PO Box 968 Hickory, NC 28603 NCDEQIDWR ATTN: WREN THEDFORD 1617 MAIL SERVICE CENTER RALEIGH, NC 27699-1617 Account Number 3611028 Date March 11, 2020 bate Category Description Ad Number Ad Size 03/11/2020 Legal Notices Pudic Notice of rent to Issue,a HPDfS WastewahrPermil The North Carolina Environmental Managemed Commission proposes to issue a NPDES wastewater discharge pemut to the persons) listed below, Written comments regarding the proposed permit will be accepted until 30 days after the publish dale of this notice. The Diredor of the NC Divi- sion of water Resources (DWR) may hold a public hearing should Here be a significant degree of public interest. Please mail comments and/or infor- mation requests to DWR at the above address. futerested persons may rs- ft the DWR at 512 N. Salisbury Street, Rafeigh, NC to review information on file. Additional information on NPDE5 permits and this notice may be found on ourwebsile http/�d.n�oy(about(div_isi_nnsJwa[er-resources or by calving (919) 707.360, N00060224: Jonas Ridge Properties d renewal of permit for Jonas Ridge Adult Care WWTPMAe Facility discharges to a UT to Camp Creek/Catawba River Basin, i nitrogen, dissolved oxygen, fecal colfform, and total residual are waterqu6ty Rmited. Publisk Wednesday, March 11,2020. Public Notice North Carolina Environmental Management Comi 0000638758 2 x 26 L Publisher of Morganton News Herald Burke County Before the undersigned, a Notary Public of Iredeli County, North Carolina, duly commissioned, qualified, and authorized by law to administer oaths, in said County and State; that he/she is authorized to make this affidavit and sworn statement; that the notice or other legal advertisement, a copy of which is attached hereto, was published in the Morganton News Herald on the following dates: 03/11 /2020 and that the said newspaper in which such notice, or legal advertisement was published, was a newspaper meeting all the requirements and qualifications of Section 1-597 of the General Statutes of North Carolina. 'Issisyant Bookkeeper Newspaper reference: 0000638758 Sworn to and subscribed before me, this Ak day ofrf�ajr&j, 2020 Noiary Public My Commission expires: Wt1� THIS IS NOT A BILL. PLEASE PAY FROM INVOICE. THANK YOU LiAi i r� F lr lroaefl cour) i O RV- DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D47991D8E4 ROY COOPER Governor MICHAEL S. REGAN secrnfary LINDA CULPEPPER Director Jonas Ridge Properties, LLC. Attn: George W Ware, Owner PO Box 519 Newland, NC 28657-0519 Subject: Permit Renewal Application No. NCO060224 Jonas Ridge Adult Care Facility WWTP Burke County Dear Applicant: NORTH CAROLINA Environmental Quality January 30, 2020 The Water Quality Permitting Section acknowledges the January 22, 2020 receipt of your permit renewal application and supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting branch. Per G.S. 15OB-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. The permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a timely manner to requests for additional information necessary to allow a complete review of the application and renewal of the permit. Information regarding the status of your renewal application can be found online using the Department of Environmental Quality's Environmental Application Tracker at: https://deg.nc.gov/permits-regulations/permit-guidance/environmental-application-tracker If you have any additional questions about the permit, please contact the primary reviewer of the application using the links available within the Application Tracker. kinQ re k, Wren Thedford Administrative Assistant Water Quality Permitting Section cc: Central Files w/application Jadd Brewer-WQ Lab & Operations, Inc. ec: WQPS Laserfiche File w/application N•�rthCahaFi3�5D=psrtrn=iataf.Endircnrn_�ta!•�u�la}�.6�us�;rof1S'at�rR�sc�rd=s Ash=vil;? Regi:ral Offics 1 2090 U.S. 70 H g wn I Swarnahos, North Csrokina 2877S . V $2$-;t5S-4500 DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D47991D8E4 Water Quality Lab & Operations, Inc. P.O. Box 1167/ 1522 Tynecastle Highway Banner Elk, NC 28604 Ph. 828-898-6277 Fax 828-898-6255 July 31, 2019 Ms. Emily Phillips, Environmental Specialist NCDEQ/DWR/Compliance and Expedited Permitting Unit 1617 Mail Service Center Raleigh, NC 27699-1617 Via E-mail to sarah.phillips@ncdenr.gov Re: Jonas Ridge Adult Care WWTP NPDES NC0060224 Dear Ms. Phillips: JAN 2 2 2020 NQDEQ/DWR/NPDES Please find enclosed an application for the permit renewal for Jonas Ridge Adult Care WWTP. All items on the checklist are included with the permit renewal. There have been no significant changes to the facility since the previous permit cycle. If we can be of further assistance, please do not hesitate to contact us. Sincerely, Wd Brewer ignatory Authority DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D47991D8E4 July 31, 2019 Wastewater Branch Water Quality Permitting Section Division of Water Resources 1617 Mail Service Center Raleigh, NC 27699-1617 Subject: Delegation of Signature Authority Jonas Ridge Adult Care NPDES Number NCo06O224 To Whom It May Concern: By notice of this letter, I hereby delegate signatory authority to each of the following individuals for all permit applications, discharge monitoring reports, and other information relating to the operations at the subject facility as required by all applicable federal, state, and local environmental agencies specifically with the requirements for signatory authority as specified in 15A NCAC 2B.0506. Jadd Brewer Operations Manager P.O. Box 1167 1522 Tynecastle Hwy Banner Elk, NC 28604 jaddbrewer@rocketmail.com 828-898-6277 828-260-2027 If you have any questions regarding this letter, please feel free to contact me at 828-733- 0141. Sincerely, V� Lane Ware General Manager Jonas Ridge Adult Care P.U. Box 519, Newland, NC 28657 lware@rencaresolutions.com 828-733-0141 cc: Asheville Regional Office, Water Quality Permitting Section DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D47991D8E4 Water Quality Lab & Operations, Inc. -IECEIV ED P.O. Box 1167/ 1522 Tynecastle Highway Banner Elk, NC 28604 J,AN 2 2 2029 Ph. 828-898-6277 Fax 828-898-6255 NCDECMR/WDES 1, the undersigned, do hereby give my permission and grant my authority as the General Manager of Jonas Ridge Adult Care, to Jadd Brewer, Co-Owner/Operator of Water Quality Lab and Operations, Inc. to complete, sign and submit the Wastewater Permit Renewal Application for Jonas Ridge WWTP for 2019/2020. This is the _ day of 00cQuW , 2019. Printed Name and Title: Lance Ware, General Manager Signature: DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D47991D8E4 NPDES APPLICATION - FORM D For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD Mail the complete application to: NC DEQ / DWR / NPDES 1617 Mail Service Center, Raleigh, NC 27699-1617 NPDES Permit NC0060224 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 Jonas Ridge Properties, LLC Facility Name Jonas Ridge Adult Care Facility WWTP Mailing Address P.O. Box 519 City Newland State / Zip Code NC 28657 Telephone Number (828)733-0141 Fax Number (828)733-9064 e-mail Address lware@rencaresolutions.com 2. Location of facility producing discharge: Check here if same address as above ❑ Street Address or State Road 9051 Highway 181 City Newland State / Zip Code NC 28657 County Burke 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 Water Quality Lab and Operations Mailing Address P.O. Box 1167 City Banner Elk State / Zip Code NC 28604 Telephone Number (828)898-6277 Fax Number (828)898-6255 e-mail Address waterqualitylabs@yahoo.com 1 of 3 Form-D 6/2017 DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D47991D8E4 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 ❑ Number of Homes School ❑ Number of Students/Staff Other ® Explain: Adult care Describe the source(s) of wastewater (example: subdivision, mobile home park, shopping centers, restaurants, etc.): Adult care facility Number of persons served: 44 S. Type of collection system ® 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 ® No 7. Name of receiving stream(s) (NEW applicants: Provide a map showing the exact location of each outfall): Unnamed tributary to Camp Creek, Catawba River Basin 8. Frequency of Discharge: ® 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. Influent bar screen Equalization basin with two (2) pumps Aeration Basin Clarifier Chlorine contact chamber Dechlorination unit Post -aeration tank 2 of 3 Form-D 612017 DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D47991D8E4 NPDES APPLICATION - FORM D For privately -owned treatment systems treating 100% domestic wastewaters <1.0 MGD 10. Flow Information: Treatment Plant Design flow 0.0075 MGD Annual Average daily flow 0.0037 MGD (for the previous 3 years) Maximum daily flow 0.0086 MGD (for the previous 3 years) 11. Is this facility located on Indian 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. REMEWAL APPLICANTS: Provide the highest single reading (Daily Maximum) and Monthly Average over the past 36 months for parameters curre tly in your permit. Mark other parameters "N/A". Parameter Daily Maximum Monthly Average Units of Measurement Biochemical Oxygen Demand (BODs) 34.0 12.02 mg/L Fecal Coliform 200 6.17 cuf/ 100mL Total Suspended Solids 26 14.75 mg/ L Temperature (Summer) 27 24.95 ° C Temperature (Winter) 16 14.4 °C pH 8.1 7.3 s/u 13. List all permits, construction approvals and/or applications: Type Permit Number Type Hazardous Waste (RCRA) UIC (SDWA) NPDES PSD (CAA) Non -attainment program (CAA) NCO060224 14. APPLICANT CERTIFICATION NESHAPS (CAA) Ocean Dumping (MPRSA) Dredge or fill (Section 404 or CWA) Other Permit Number 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. name of Person Signing Applicant Date No h C folina General Statute 143 215.E (b)(2) states: Any person who knowingly makes any false statement representation, or certification in any app)n, record, report, plan, or other document files or required to be maintained under Article 21 or regulations of the Environmental Management Com Ission 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 612017 DocuSign Envelope ID: E986326C-4884-4EC6-9F4D-23D47991D8E4 Water Quality Lab & Operations, Inc. P.O. Box 1167/ 1522 Tynecastle Highway Banner Elk, NC 28604 Ph. 828-898-6277 Fax 828-898-6255 JONAS RIDGE ADULT CARE WWTP SLUDGE MANAGEMENT Sludge is managed via a commercial hauler, Triple T located on 1372 NC Hwy 194 N, Boone, NC 28607.